• Yihong Bai, Peiya Cao, Chungah Kim, Kristine Ienciu, Inthuja Selvaratnam, Alex Abramovich, Brittany Jakubiec, David J Brennan, and Antony Chum.
• School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, Toronto, Ontario, Canada.
• Prev Med. 2025 Jan 11: 108224108224.

IntroductionActivity limitations among transgender and non-binary individuals remain largely unexplored using population-based samples. This study examines the risk of activity limitations across different gender identities in Canada.MethodUsing data from the 2021 Canadian long-form Census, logistic regressions estimated the adjusted odds of reporting activity limitations (seeing, hearing, mobility/dexterity, mental, cognitive, and other) across gender identities.ResultsNon-binary individuals assigned female at birth (AFAB) had the highest predicted probability of reporting any activity limitations (76.13 %), followed by non-binary individuals assigned male at birth (AMAB) at 61.56 %, transgender men (44.71 %), and transgender women (34.41 %). Cisgender men (19.31 %) and cisgender women (21.98 %) had the lowest probabilities. Mental limitations showed the largest disparity, with 39.4 % of non-binary AFAB individuals affected, compared to 4.9 % of cisgender men. These findings highlight significant disparities in activity limitations across gender identities.ConclusionNon-binary and transgender individuals are most at risk for activity limitations. These findings underscore the need for targeted policies to address challenges faced by gender-diverse populations. Future research should investigate the mechanisms behind these disparities. Healthcare policies must prioritize culturally competent, transgender-inclusive care to reduce disparities in activity limitations.Copyright © 2025. Published by Elsevier Inc.

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