Understanding the experiences of lesbian, gay, bisexual, and transgender (LGBT) youth is critical to promoting their healthy development and creating safe and supportive environments. Research shows that these youth may be at higher risk for bullying victimization, drug and alcohol use, and sexual risk behaviors.1
In recent years, several surveys, both national large-scale collections as well as smaller research studies, have included items asking about adolescents’ sexual orientations and gender identities. However, there are widespread concerns that the items included on these surveys do not accurately identify LGBT youth as such.2 Data from previous surveys suggest that many respondents may skip answering items pertaining to their sexual orientation and/or gender identity, or may answer in unintended ways—for example, by mistakenly identifying as bisexual interpreting it to mean attraction to the opposite sex—due to their misunderstanding the items’ content.2,3
Adolescence is a time when youth become more aware of their sexual orientation and gender identity, which may be still developing. Those still working to understand their sexual orientation may not yet have a solidified sexual identity (as gay, for example), but may report same-sex attraction and/or behaviors. Someone who identifies as a gender different from their biological sex may not self-identify as transgender, if, for instance, they associate transgender status with hormonal or surgical transition, and they have not pursued that transition. Thus, collecting accurate data on these complex personal characteristics is particularly challenging. However, such data are critical for the development of targeted policies, programs, and practices.
To develop more valid and reliable measures of adolescent sexual orientation and gender identity, Child Trends, with support from the Arcus Foundation, convened a panel of researchers and practitioners with extensive experience assessing and/or working with LGBT youth. We then conducted cognitive interviews with a diverse set of youth to ensure students would understand and feel comfortable responding to tested survey items. Finally, we performed a field test of items resulting from the cognitive interviews by including them in the U.S. Department of Education’s School Climate survey in Washington, DC, administered during the 2016-17 school year with over 3,000 middle and high school students.
- Middle- and high-school-aged youth included in our cognitive interviews generally understood and were able to respond to our tested sexual orientation and gender identity items. However, these youth stressed the importance of ensuring that survey respondents feel their answers are confidential and that they can respond in a private setting.
- Piloted items performed well in the field test. When placed at the beginning of the survey, and among students who reached the items when placed at the end of the survey, they had lower nonresponse rates than sexual identity items on the national Youth Risk Behavior Survey did.
- Providing response options of “I am not sure yet” and “something else” for sexual identity items (which is consistent with strategies employed with adults on the National Health Interview Survey) led to greater interpretability of resulting data (i.e., ability to distinguish between those who are questioning their identities and those who identify with other labels).
- Validly assessing sexual orientation among adolescents often requires measurement of multiple dimensions (i.e., identity, attraction, and/or behavior), particularly for middle-school-aged youth, whose understanding of their sexual identity may still be in development.
- Traditionally used binary gender items (i.e., “are you male or female”) do not validly capture either current gender identity or gender at birth for transgender students and, according to expert panel members, may disengage transgender or other gender-expansive youth from participating in survey research.
- The two-step approach to identifying transgender youth—consisting of asking about gender at birth and current gender identity—is appropriate for middle- and high-school-aged respondents.
Which of the following best describes your sexual orientation? Mark one response.
- Straight, that is, not gay
- Gay or lesbian
- I am not sure yet
- Something else
Have you ever had a crush on a boy or a girl? Mark one response. (Middle school)
- A boy
- A girl
Who are you sexually attracted to? Mark one response. (High school)
Gender at birth
What gender were you at birth, even if you are not that gender today? That is, what is the gender on your birth certificate? Mark one response.
Current gender identity
What is your current gender identity, even if it is different than the gender you were born as? Mark one response.
- I do not identify as either male or female
- I’m not sure yet
This project is one of the first large-scale efforts to develop and test sexual orientation and gender identity items for use with middle- and high-school-aged adolescents. These items move the field closer to more consistent, valid measures and provide a foundation for better understanding the experiences of LGBT youth.
1. Kann, L., McManus, T., Harris, W., Shanklin, S., Flint, K., Hawkins, J., et al.(2015). Youth Risk Behavior Surveillance-United states, 2015. Surveillance Summaries, 65(6).
2. Miller, K. (2012). Developing a “Perfect” Sexual Identity Measure. National Center for Health Statistics.
3. Saewyc, E. M., Bauer, G. R., Skay, C. L., Bearinger, L. H., Resnick, M. D., Reis, E., et al. (2004). Measuring sexual orientation in adolescent health surveys: evaluation of eight school-based surveys. Journal of Adolescent Health, 35(4), 345e., 341-315.