Sports Team Participation, Bias-Based Bullying, and Mental Health Among Transgender and Gender Diverse Adolescents.

Purpose: We investigated associations between sport participation and depressive and anxiety symptoms among transgender and gender diverse (TGD) adolescents, considering social positions and experiences of bias-based bullying specific to sexual orientation, gender identity, and/or gender expression (SOGIE-BB). Method: TGD adolescents (n = 10,454) completed a school survey. Adolescents in eighth, ninth, or 11th grade self-reported sports team participation, elevated depressive and anxiety symptoms, experiencing past-month SOGIE-BB, specific gender identity, race/ethnicity, and access to resources. We identified groups with highest prevalences of elevated depressive and anxiety symptoms by sports team participation (any/none), experiences of SOGIE-BB (any/none), and social positions using Exhaustive Chi-square Automatic Interaction Detections. Via post-hoc tests, we determined whether prevalences differed between adolescents with the same social positions 1) without SOGIE-BB, 2) with sports participation, and 3) without SOGIE-BB and with sports participation. Results: Experiencing SOGIE-BB comprised each of the highest prevalence elevated depressive and anxiety groups. Four of 7 groups with elevated depressive symptoms and 3 of 4 groups with elevated anxiety symptoms reported no sports participation. Among adolescents sharing social positions, experiencing no SOGIE-BB was significantly associated with lower prevalences of elevated depressive and anxiety symptoms. Sports participation was also significantly associated with lower prevalences of elevated depressive and anxiety symptoms, including when experiencing SOGIE-BB. This was true for all but two high prevalence groups. Conclusion: Sports team participation is associated with better mental health among TGD adolescents. Experiencing SOGIE-BB is associated with higher mental health risks. Promoting sports participation and preventing SOGIE-BB could each enhance TGD adolescents' well-being.