ORF46-04 - Physical Activity Levels in Transgender and Gender Diverse Patients before and after Gender Affirming Hormone Therapy

Objectives
To compare amounts of walking and non-walking exercise among transgender and gender (TGD) diverse individuals before and after gender affirming hormone therapy (GAHT) and to identify factors that may influence exercise rates.

Background
TGD individuals have lower baseline rates of exercise relative to cisgender individuals. The effects of GAHT on physical activity have been incompletely characterized.

Methods
A single-center, cross-sectional cohort study that enrolled TGD individuals from a gender clinic in Boston (Table 1). Patients completed paper surveys before and/or after ≥1 year of GAHT. Data collected included time spent walking per day and exercise activities, frequencies and duration over the prior month. Other data collected included weight, BMI, weight satisfaction, barriers to exercise and the presence of common mental health diagnoses. Primary outcome was a change in physical activity levels following GAHT. Secondary outcomes were ascertaining variables that may predict exercise.

Results
Among the 145 TGD patients enrolled, 52% were assigned male at birth (AMAB); pre-GAHT data were available for 61 individuals and post-GAHT data were available for 100 individuals. The duration of walking (minutes/week; median, interquartile range; mean ± standard deviation) pre- vs post-GAHT was similar in both AFAB (45, 30-60; 101 ± 126) vs (60, 39-120; 99 ± 92) and AMAB (60, 30-120; 98 ± 115) vs (60, 30-120; 99 ± 128), respectively. Following GAHT, those AFAB were more likely to be exercising than those AMAB (63% vs 48%). For those AMAB, rates of exercise were higher pre GAHT than post GAHT (64% vs 48%). Among all TGD patients, those satisfied with their weight were more likely to be exercising than those dissatisfied (58% vs 38%). The likelihood of exercise was not related to age at initial visit, BMI or the presence of common mental health diagnoses.

Conclusion
Duration of walking was similar for both AFAB and AMAB individuals before and after GAHT. Following GAHT, those AFAB were more likely to be exercising than those AMAB. Weight satisfaction was a positive predictor of exercise.