Knaus Sarah, Teutsch Friedrich, Steininger Jo, Alguacil Diana Esteve, Riedl Stefan
Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Austrian National Public Health Institute (Gesundheit Österreich GmbH), Vienna, Austria.
Eur J Pediatr. 2025 Feb 13;184(3):197. doi: 10.1007/s00431-025-06014-x.
Transgender and gender-diverse (TGD) adolescent populations are at a higher risk for obesity. The aim of this study was to explore possible reasons, such as differences in eating and exercise behaviors. This was a prospective cross-sectional study of TGD adolescent patients at the pediatric endocrinology outpatient clinic of the Vienna General Hospital from January to July 2022. Patients were included in the World Health Organization's Health Behaviour in School-Aged Children (HBSC) survey, which assesses for multiple measures including exercise, eating, and mental wellbeing. We recruited 32 patients via the outpatient clinic, and a further 55 adolescents self-identified as TGD through the survey. Responses from the cohort of 87 TGD adolescents were compared to the Austrian sample containing 10,110 participants. TGD adolescents reported significantly lower levels of physical activity than the national sample, both in instances of vigorous activity (p = 0.002) and any physical activity lasting > 60 min (p < 0.001) per week. Gender variance was here demonstrated to be a strong predictor for physical inactivity levels, even when correcting for low mental health scores. Regarding body image, TGD participants were also more likely to describe themselves as feeling "too fat" (p = 0.001). No statistically significant difference in eating behavior was found.
The results of this study point towards the complexity of healthcare needs in the TGD adolescent population. The interconnectedness of mental health and exercise behavior is well described. However, qualitative work is needed to understand the specific relationship between gender expression, body image, eating and exercise behaviors, as well as social inclusion.
• Transgender and gender-diverse (TGD) adolescents are at an increased risk for obesity. The causes for this are most likely complex, and remain poorly understood. • Survey studies in the United States and New Zealand have reported reduced levels of physical activity in the TGD population. However, data is scarce, particularly regarding adolescents.
• This prospective, national survey study is the first to demonstrate reduced levels of self-reported physical activity in a cohort of central European TGD adolescents.
跨性别和性别多样化（TGD）的青少年人群肥胖风险更高。本研究的目的是探究可能的原因，比如饮食和运动行为的差异。这是一项对2022年1月至7月在维也纳总医院儿科内分泌门诊就诊的TGD青少年患者进行的前瞻性横断面研究。患者被纳入世界卫生组织的学龄儿童健康行为（HBSC）调查，该调查评估多项指标，包括运动、饮食和心理健康。我们通过门诊招募了32名患者，另有55名青少年通过调查自我认定为TGD。将87名TGD青少年的队列反应与包含10110名参与者的奥地利样本进行比较。TGD青少年报告的身体活动水平显著低于全国样本，无论是剧烈活动（p = 0.002）还是每周任何持续超过60分钟的身体活动（p < 0.001）。即使校正低心理健康得分后，性别差异在这里也被证明是身体活动不足水平的一个强预测因素。关于身体形象，TGD参与者也更有可能将自己描述为感觉“太胖”（p = 0.001）。未发现饮食行为有统计学显著差异。
本研究结果表明TGD青少年人群医疗保健需求的复杂性。心理健康和运动行为的相互联系已得到充分描述。然而，需要进行定性研究来理解性别表达、身体形象、饮食和运动行为以及社会包容之间的具体关系。
• 跨性别和性别多样化（TGD）的青少年肥胖风险增加。其原因很可能很复杂，仍知之甚少。
• 美国和新西兰的调查研究报告称TGD人群的身体活动水平降低。然而，数据稀缺，尤其是关于青少年的数据。
• 这项前瞻性的全国性调查研究首次证明中欧TGD青少年队列中自我报告的身体活动水平降低。
