Associations of Discrimination, Body Image, and Physical Activity among Transgender Women in Atlanta, GA Público

Abstract

Background: Previous literature suggests that transgender individuals have worse physical and mental health outcomes, and while physical activity can provide direct health benefits, transgender persons are less likely to participate in physical activity than cisgender persons. Furthermore, studies have demonstrated that transgender individuals frequently experience gender-based discrimination at the interpersonal and institutional levels, and body image issues are especially prevalent among transgender persons. Barriers to physical activity may include gender-based discrimination or body image issues, but to date, no research has assessed these relationships among transgender women, who are a particularly vulnerable sub-group of the transgender population.

Objective: This study examines: (1) whether perceived interpersonal discrimination and physical activity are associated, (2) whether perceived institutional discrimination and physical activity are associated, (3) whether body image and physical activity are associated, (4) whether body image mediates the relationship between perceived interpersonal discrimination and physical activity, and (5) whether body image mediates the relationship between perceived institutional discrimination and physical activity.

Methods: Secondary data analysis was conducted using data collected as part of an observational study of N=92 transgender women in Atlanta, Georgia. All observations were included in the analysis, and data were analyzed using SPSS and SAS. Descriptive statistics were calculated, and bivariate analyses included running Pearson R tests, independent T-tests, and one-way ANOVA tests. Multivariable analyses were conducted using multiple linear regression. Mediation analyses produced 10,000 bootstrap samples and 95% confidence intervals. Multivariable and mediation analyses controlled for significant demographic covariates.

Results: Bivariate analyses showed that four demographic variables had p-values less than 0.20: race, ethnicity, education, and employment. When controlling for these demographic covariates, the association between perceived interpersonal discrimination and physical activity was not significant (p=0.908). The associations between perceived institutional discrimination and physical activity (p=0.163), as well as body image and physical activity (p=0.428), were also not significant. Body image did not mediate the relationship between perceived interpersonal discrimination and physical activity (95% CI= -0.1510, 0.0643), nor the relationship between perceived institutional discrimination and physical activity (95% CI= -0.0451, 0.0639).

Discussion: Although the findings were not statistically significant, this study still adds to the existing body of literature. To the author’s knowledge, this is the first study to assess the role of interpersonal discrimination, institutional discrimination, and body image on physical activity among transgender women. This study also examines a unique, understudied population of transgender women who are less likely to engage in physical activity and are at higher risk for obesity. Additional research is recommended to address the study’s limitations, such as improving upon measures by considering the complexities of discrimination, body image, and physical activity.

Table of Contents

INTRODUCTION............................................................................................................ 1

Background...................................................................................................................... 1

Theoretical Framework.................................................................................................... 8

Purpose of Study............................................................................................................. 9

LITERATURE REVIEW.............................................................................................. 12

Discrimination & Physical Activity................................................................................ 12

Body Image & Physical Activity.................................................................................... 13

Research Gap................................................................................................................. 14

METHODS....................................................................................................................... 16

Study Procedures........................................................................................................... 16

Measures........................................................................................................................ 17

Data Analysis................................................................................................................. 20

RESULTS........................................................................................................................ 22

Descriptive Analyses..................................................................................................... 22

Bivariate Analyses......................................................................................................... 24

Multivariable Analyses.................................................................................................. 25

Mediation Analyses....................................................................................................... 26

DISCUSSION.................................................................................................................. 28

Main Findings by Hypothesis........................................................................................ 28

Analysis of Main Findings............................................................................................ 29

Limitations..................................................................................................................... 34

Implications & Recommendations.................................................................................. 35

Conclusion..................................................................................................................... 37

REFERENCES................................................................................................................ 38

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	Atlanta transwomen body image discrimination physical activity transgender women
Committee Chair / Thesis Advisor	Lang, Delia, Emory University
Committee Members	Salazar, Laura, Georgia State University
Partnering Agencies	University, college or education institution (other than Emory)

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