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Measuring Sex, Gender Identity, and Sexual Orientation (2022)

Chapter: Appendix A: Measures Evaluated by the Committee

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Suggested Citation:"Appendix A: Measures Evaluated by the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. doi: 10.17226/26424.
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Page 173
Suggested Citation:"Appendix A: Measures Evaluated by the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. doi: 10.17226/26424.
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Page 174
Suggested Citation:"Appendix A: Measures Evaluated by the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. doi: 10.17226/26424.
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Page 175
Suggested Citation:"Appendix A: Measures Evaluated by the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. doi: 10.17226/26424.
×
Page 176
Suggested Citation:"Appendix A: Measures Evaluated by the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. doi: 10.17226/26424.
×
Page 177
Suggested Citation:"Appendix A: Measures Evaluated by the Committee." National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. doi: 10.17226/26424.
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Page 178

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Appendix A Measures Evaluated by the Committee The table in this appendix lists the measures used in federally sponsored surveys and other data collection approaches to measure sexual orientation and gender identity that the committee considered. 173

TABLE A-1  Sexual Orientation and Gender Identity Measures by Survey 174     Measure(s)       Gender Identityb Sexual One-Step Two-Step Name of Data Collection Instrument Sponsora Orientation Approach Approach Population Data Type Mode(s) All of Us NIH X   X All ages Medical CATI, P&P American National Election Studies NSF X X Adults (eli- Survey Web, CAPI, (ANES) gible voters) CASI, CATI, Video Behavioral Risk Factor Surveillance CDC X Xc   Adults Survey CATI System (BFRSS) Center for Substance Abuse Treat- SAMHSA   X   Youth and Admin n/a ment—Government Performance Adults Results and Modernization Act (CSAT-GPRA) Centers for Disease Control and CDC X X n/a Medical n/a Prevention Recommendations for Health Care Providers (CDC Recs) Gallup Gallup Xd Adults Survey CATI General Social Survey (GSS) NSF X X  Adults Survey CAPI (SAQ)

Growing Up Today Study (GUTS) NIH X Young Adults Survey P&P (20s) Web Health Center Patient Survey (HCPS) HRSA X     All ages Admin CAPI ASPEe Health and Retirement Study (HRS) NIH, SSA, X Older adults Survey CAPI CATI DOL, ASPE, State of Florida High School Longitudinal Study of NCES X   X Young adults Survey Web 2009 (HSLS:09)—2016 Collection 3 (early 20s) CAPI Years After High School Graduation CATI National Adult Tobacco Survey NCHS X X Adults Survey CATI (NATS) National Crime Victimization Survey BJS X   X Ages 16+ Survey CAPI, (NCVS) CATI National Epidemiologic Survey of NIAAA X Adults Survey CAPI Alcohol and Related Conditions (NESARC) National Health Interview Survey CDC X   Adults Survey CAPI (NHIS) CATI 175 continued

TABLE A-1  Continued 176     Measure(s)       Gender Identityb Sexual One-Step Two-Step Name of Data Collection Instrument Sponsora Orientation Approach Approach Population Data Type Mode(s) National Health and Nutrition Ex- CDC X Adults Survey CAPI amination Survey (NHANES) National HIV Behavioral Surveillance CDC X   X Adults (high Survey CAPI (NHBS) HIV risk) National Inmate Survey (NIS) BJS X X Ages 16+f Survey ACASI National Intimate Partner and Sexual CDC, X   Adults Survey CATI Violence Survey (NISVS) DOD, NIJ National Longitudinal Study of Multipleg X   X Adults Survey Web, P&P, Adolescent and Adult Health, Wave V CAPI, (Add Health) CASI, CATI National Opinion Research Cen- CMS X X Ages 60+ Survey n/a ter (NORC) recommendations for Medicare Current Beneficiary Survey (MCBS) National Outcome Measures, Center SAMHSA X Xh Adults Admin n/a for Mental Health Services (NOM) CMHS National Survey of Drug Use and SAMHSA X   Adults Survey ACASI Health (NSDUH) National Survey of Family Growth CDC X Ages 15–49 Survey CAPI, (NSFG) ACASI

National Survey of Older Americans AOA X Age 60+ Survey CATI Act Participants (NSOAAP) Admin Population Assessment of Tobacco NIDA, X X   Ages 14+ Survey ACASI, and Health Study (PATH) NIH, CTP, CAPI FDA Survey of Today’s Adolescent Rela- CDC X X Ages 13–24i Survey Web, Focus tionship and Transitions (START) Groups GenIUSS Report Recommendations Williams X X  X Adults Survey n/a Institute Youth Risk Behavior Surveillance CDC X     Grades 9–12 Survey P&P System (YRBSS) NOTES: ACASI, audio computer-assisted self-interview; AOA, Administration on Aging; ASPE, U.S. Department of Health and Human Services Office of the Assistant Secretary of Planning and Evaluation; BJS, Bureau of Justice Statistics; CAPI, computer-assisted personal interview; CASI, computer-assisted self-interview; CATI, computer-assisted telephone interview; CDC, Centers for Disease Control and Prevention; CMHS, Center for Mental Health Services; CMS, Center for Medicare and Medicaid Services; CTP, Center for Tobacco Products; DOD, U.S. Department of Defense; DOL, U.S. Department of Labor; FDA, Food and Drug Administration; HRSA, Health Resources and Services Administration; NCES, National Center for Education Statistics; n/a, not applicable; NCHS, National Center for Health Statistics; NIAAA, National Institute on Alcohol Abuse and Alcoholism; NIDA, National Institute on Drug Abuse; NIH, National Institutes of Health; NIJ, National Institute of Justice; NSF, National Science Foundation; P&P, paper and pencil; SAMHSA, Substance Abuse and Mental Health Services Administration; SAQ, self-administered questionnaire; SSA, Social Security Administration. aSponsors cited are drawn from websites and publicly available survey documentation. bSingle-step gender identity measures use a single question to assess gender identity and transgender experience or identity. Two-step measures use a sequence of two questions that can be compared to identify respondents with transgender experience. cBeginning in 2019, BRFSS added a measure of sex assigned at birth to the approved optional sexual orientation and gender identity module. This module has included a stand-alone measure of transgender status since 2014. continued 177

TABLE A-1  Continued 178 dThe Gallup measure is a measure of LGBT status that instructs respondents to select all that apply from the following response options: straight or heterosexual; lesbian; gay, bisexual; and transgender. eThe U.S. Department of Health and Human Services Office of the Assistant Secretary of Planning and Evaluation (ASPE) provides support for generating public-use data files that can be used for research. fAdults in jails or prisons and juveniles in detention centers. gThe National Survey of Adolescent and Young Adults Health (Add Health) is funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. hGuidelines recommend asking respondent to report their gender with an open-ended response field. Instructions tell interviewers they may clarify by asking whether the respondent sees themselves as a man or male, woman or female, transgender, or other. iSexual minority males ages 13–18 years and transgender youth ages 13–24 years when interviewed who were recruited through social media sources.

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Sex, gender identity, and sexual orientation are key indicators of the demographic diversity in the United States. Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. This is turn affects sexual orientation, because it is defined on the basis of the relationship between a person's own sex or gender and that of their actual or preferred partners. Sex, gender, and sexual orientation are core aspects of identity that shape opportunities, experiences with discrimination, and outcomes through the life course; therefore, it is crucial that measures of these concepts accurately capture their complexity.

Recognition of the diversity within the lesbian, gay, bisexual, transgender, queer, intersex, and other sexual and gender minorities - the LGBTQI+ population - has also led to a reexamination of how the concepts of sex, gender identity, and sexual orientation are measured. Better measurement will improve the ability to identify sexual and gender minority populations and understand the challenges they face. LGBTQI+ people continue to experience disparate and inequitable treatment, including harassment, discrimination, and violence, which in turn affects outcomes in many areas of everyday life, including health and access to health care services, economic and educational attainment, and family and social support. Though knowledge of these disparities has increased significantly over the past decade, glaring gaps remain, often driven by a lack of reliable data.

Measuring Sex, Gender Identity, and Sexual Orientation recommends that the National Institutes of Health (NIH) adopt new practices for collecting data on sex, gender, and sexual orientation - including collecting gender data by default, and not conflating gender with sex as a biological variable. The report recommends standardized language to be used in survey questions that ask about a respondent's sex, gender identity, and sexual orientation. Better measurements will improve data quality, as well as the NIH's ability to identify LGBTQI+ populations and understand the challenges they face.

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