Active Pride

In the first of a series of blogs looking at diversity and inclusion in physical activity, I thought I’d start with the rainbow theme and reflect on lesbian, gay, bisexual and trans issues in the physical activity space.

London and New York Prides have come to an end for this year, but across England, and across the World there are many more lesbian, gay, bisexual and trans Pride celebrations to go. Hundreds of thousands of LGBTQI people and their allies will march short and long parades to raise awareness and celebrate diversity and inclusion – all while being physically active but does this annual march translate into every day activity?

In terms of research, the evidence base on physical activity inequalities in the LGB and T communities is varied, although it is growing, and sadly what evidence we have is contradictory with some studies finding increased physical activity rates in gay men and lesbian and bisexual women compared to heterosexuals and others finding reduced rates, especially in LGBTQ youth, and some also find increased sedentary behaviour.

What research there is, which is very very limited, on trans people has highlighted the barriers and issues around regulation in sport for trans people.

Sport England and Public Health England have included sexual orientation in the national survey on sport and physical activity for several years and it is included in their open data hub to allow some on the spot exploration…..Looking at the 2016-17 Survey data the picture looks quite positive but as with most things could always be better.

So given the data suggests that LGB people might be doing better than heterosexual counterparts, why should we worry about inclusion for this group?

We as for heterosexuals and cis-gender people there are lots of health benefits of being physically active, and for LGBT people there might be some added value linked to health inequalities that disproportionately affect these populations:

Mental health – 52% of young LGBT people reported self-harm either recently or in the past compared to 25% of heterosexual non-trans young people and 44% of young LGBT people have considered suicide compared to 26% of heterosexual non-trans young people – physical activity has been shown to have a significant impact on depression, stress and anxiety.

HIV – Despite significant progress in treatment and the advent of PEP and PREP, HIV disproportionately affects gay and bisexual men. Although the evidence base on the scale of impact of physical activity on HIV progression is varied and from small scale studies, there is evidence of reduction of medication side effects such as lipodystrophy.

Cancer – the evidence about cancer incidence in LGBT people varies in which types of cancer are more common and to what extent, and some of this is linked to the consistently higher rates of smoking among LGBT people, but the evidence of the impact of physical activity on breast and bowel cancer is pretty good, so yet another reason to get active!

Osteoporosis – this is particularly important for Trans people and for people living with HIV, where medication can increase the chances of bones becoming weaker and more prone to breaks and fractures. Physical activity, particularly muscle and bone strengthening activities like running and carrying heavy shopping bags can reduce the risk of osteoporosis and the risk of falls.

Sadly many LGBT people have bad memories of sport and team games, this is often linked to gender stereotypes and bad experiences at school, and research funded by Sport England in 2016 demonstrated that often it didn’t stop in school.

Although social attitudes are changing and now we have a fantastic range of LGBT sports clubs and LGBT inclusive clubs as well as a growing spectrum of LGBT football fan groups! And there are more and more openly LGBT professional and olympic athletes, there is still some way to go in developing a truly inclusive approach.

Improving uptake of physical activity for LGBT people comes down to three basic principles:

Recognise LGBT people are a customer/client base and tell the community you want them to come and take part, reach out to LGBT community events like Pride and be visible in your acceptance and welcoming approach.
Train staff and volunteers to be LGBT inclusive, this is particularly important for supporting trans inclusion, staff need to be inclusive but they also need to be able to challenge homophobia, biphobia and transphobia when they see it.
Monitor uptake and engagement so you know if you’re getting it right, if you’re not seeing LGBT people being comfortable to disclose in your memberships or monitoring databases then you probably still have a way to go.

Sport and the Gym are great ways to get active but very few adults will achieve the recommended 150 minutes of moderate intensity physical activity and two days a week of muscles strengthening activity just through sport. One of the fundamental challenges for physical activity is helping people see it as important and incorporating it into every day life.

For LGBT people hate crime, particularly for trans people, can be a real barrier to both utility and recreational cycling and walking.

In 2016/17 in England and Wales there were over 9,000 reported sexual orientation based hate crimes reported and over 1,000 trans related hate crimes.

However the Stonewall survey in 2017 found that one in five LGBT people have experienced a hate crime or incident because of their sexual orientation and/or gender identity in the last 12 months , this rose to two in five trans people. Four in five anti-LGBT hate crimes and incidents go unreported, with younger LGBT people particularly reluctant to go to the police. So the national statistics are probably a massive underestimate of what’s really going on….

So if we really want to help LGBT people to be active every day then we have to tackle hate crime as well as improving inclusive spaces to be active in.

Ultimately helping every lesbian, gay, bisexual or trans person to achieve at least 150 minutes of physical activity a week and the two days of muscle strengthening activity will take a whole system approach.