Surveys and Measures

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• Close versions of this have been used in the Behavioral Risk Factor Surveillance System (BRFSS) (since 2014), the National Crime Victimization Survey (NCVS) (since 2016), the National Health Interview Survey (NHIS) (since 2013), and the National Health and Nutrition Examination Survey (since 2013)
• Close versions used in electronic medical records (EMR) in health systems following a 2015 final rule by the Office of the National Coordinator for Health Information Technology (ONC).
• Recommended by the Federal Interagency Working Group on Improving Measurement of Sexual Orientation and Gender Identity in Federal Surveys (2016)

• Measures sexual orientation identity only (i.e., does not conflate identity with attraction and/or behavior)
• Clearly distinguished people with varying sexual orientation identities and broadly between sexual minority and sexual majority populations, while allowing for enumeration of those who do not use any of the listed labels
• Allows for culturally specific identification for Indigenous populations; response category needs to be explicitly included only in automated data collection where racial identity is collected, and respondent endorses AIAN [American Indian and Alaska Native] identity.

• Debriefing interviews, targeted interviews, cognitive interviewing, and focus groups (Austin et al., 2007; Michaels et al, 2017; Holzberg et al. 2019; Martinez et al. 2017; Miller, 2001; Miller et al, 2011; Ridolfo et al., 2012; Truman et al. 2019; Wilson et al., 2016)
• Acceptability studies in clinical settings (Cahill et al., 2014; Ruben et al., 2017; Rullo et al., 2018)
• Behavior coding and split-sample question format experiments in telephone interviews (Dahlhamer et al., 2019; West and McCabe., 2021; Michaels et al., 2017)

• Sexual minority and heterosexual/straight identified
• Spanish and English speakers
• U.S. general population, including racially diverse samples, urban and rural residents, and ages 12–85

• Testing options with expanded response list to existing list (Meyer et al., 2019)
• Testing response rate and willingness to be asked sexual orientation questions in the census (Bates et al., 2020; Ruben et al., 2017; Saewyc et al., 2004; Truman et al., 2019)
• Nonresponse rates on the BRFSS (2020), NCVS (2017), NHIS (2019), General Social Survey (2018) ≤3%

• Removed “something else” and replaced with open-text and wording of “I use a different term”
• Include Two-Spirit category in automated data collection where racial identity is collected and AIAN is indicated

• Narrow set of responses that do not reflect current culture and terms used by many sexual minorities (e.g., queer, Two-Spirit)
• Write-in sexual orientation identity field will have to be cleaned and coded for reporting; newer terms not listed (e.g., pansexual) also may grow in popularity and need to be assessed for inclusion as explicit options
• Does not provide a clear option to indicate lack of sureness about a label that describes them (i.e., questioning)
• Though testing showed a need for the “that is, not gay” phrase among some heterosexual respondents, it is not clear this is still needed; also, as written, it is a conceptually inaccurate description of what it means to be “straight” and has implications for the definition of bisexual
• Response options are not presented in order of prevalence or other common ordering (e.g., alphabetical)

• Behavioral Risk Factor Surveillance System (BRFSS-CDC)
• National Crime Victimization Survey (NCVS-DOJ)
• National Health Interview Survey (NHIS-CDC)
• National Health and Nutrition Examination Survey (NHANES)
  Men Only

• Behavioral Risk Factor Surveillance System (BRFSS-CDC)
• National Crime Victimization Survey (NCVS-DOJ)
• National Health Interview Survey (NHIS-CDC)
• National Health and Nutrition Examination Survey (NHANES)
  Women Only

Now I will read a list of terms people sometimes use to describe how they think of themselves:

• Lesbian or gay, that is, homosexual
• Straight, that is, heterosexual
• Bisexual
• Don’t know
• Another sexual orientation

As I read the list again, please say ‘Yes’ when you hear the option that best describes how you think of yourself.

• National Longitudinal Study of Adolescent to Adult Health (Add Health)
• National Longitudinal Study of Adolescent and Adult Health (Add Health—SOGI-SES Supplement)

United Kingdom:

• 2021 Census of England and Wales
• 2022 Census of Scotland (Office of National Statistics, 2016)

• Close versions used in the National Crime Victimization Survey (since 2016) and the U.S. Census Bureau Pulse Survey (2021). Will be added to the National Health Interview Survey in 2022.
• Close versions used in electronic medical records (EMR) in health systems such as the Veterans Administration and recommended for EMRs by the U.S. Office of the National Coordinator for Health Information Technology.
• Recommended by the Federal Interagency Working Group on Improving Measurement of Sexual Orientation and Gender Identity in Federal Surveys (2016)

• Clearly distinguishes between sex assigned at birth and current gender, which allows for enumerating the broadest definition of the transgender population
• Cross-tabulation of the two items provides data for cisgender men; cisgender women; transgender men; transgender women; people who identify primarily as transgender and people identifying with other terms via write-ins, which may include terms such as nonbinary, genderqueer, and gender nonconforming.
• *Allows for culturally specific identification for Indigenous populations; response category is explicitly included only in automated data collection where racial identity is collected, and respondent endorses American Indian or Alaska Native (AIAN) identity.

• Debriefing interviews, targeted interviews, cognitive interviewing, and focus groups (Truman et al. 2019; Holzberg et al. 2019; Martinez et al. 2017; Wilson et al., 2016; GenIUSS Group 2014)
• Acceptability studies in clinical settings (Lau et al., 2021; Rullo et al. 2018)
• Behavior coding and split- sample question format experiments in telephone interviews (Grant et al. 2015; Jans et al., 2015)
• Split-sample experiments to test question ordering (Amaya 2020; Sanderson and Immerwahr, 2019; Saperstein and Westbrook, 2021)

• Transgender and cisgender people
• Spanish and English speakers
• U.S. general population, including racially diverse samples, urban and rural residents, and ages 12–85

• Nonresponse rates on the order of 1% per question (Truman et al. 2019, Saperstein and Westbrook 2021)
• Demonstrated test-retest reliability (Saperstein 2022)

• Female-first response list corresponds with both alphabetical and population size ordering
• Removes “none of these” response and replaced with “I use a different term” followed by a free-text field
• Includes Two-Spirit category in automated data collection where racial identity is collected and AIAN is indicated

• Format for current gender question is forced choice but response options are not necessarily mutually exclusive
• Write-in gender identity field will have to be cleaned and coded for reporting; newer terms not listed (e.g., nonbinary) also may grow in popularity and need to be assessed for inclusion as explicit options
• Asking for sex assigned at birth is considered sensitive for some transgender people and may not be appropriate in settings where privacy and confidentiality cannot be assured (e.g., employment contexts)
• Sex assigned at birth question offers only binary responses though some states have begun to allow nonbinary options on birth certificates

Male
Female

[If needed: We have to know your sex in order to direct you to the right questions.]

Australia

Sex: Census (2021)

Gender identity: Recommendations (January 2021)

Australia Recommendations

(Only recommended for self- report)

InterACT Recommended Measures

(Modification for youth respondents)