Abstract
To address pervasive measurement biases in sexual and reproductive health (SRH) research, our interdisciplinary team created an affirming, customizable electronic survey to measure experiences with contraceptive use, pregnancy, and abortion for transgender and gender nonbinary people assigned female or intersex at birth and cisgender sexual minority women. Between May 2018 and April 2019, we developed a questionnaire with 328 items across 10 domains including gender identity; language used for sexual and reproductive anatomy and events; gender affirmation process history; sexual orientation and sexual activity; contraceptive use and preferences; pregnancy history and desires; abortion history and preferences; priorities for sexual and reproductive health care; family building experiences; and sociodemographic characteristics. Recognizing that the words people use for their sexual and reproductive anatomy can vary, we programmed the survey to allow participants to input the words they use to describe their bodies, and then used those customized words to replace traditional medical terms throughout the survey. This process-oriented paper aims to describe the rationale for and collaborative development of an affirming, customizable survey of the SRH needs and experiences of sexual and gender minorities, and to present summary demographic characteristics of 3,110 people who completed the survey. We also present data on usage of customizable words, and offer the full text of the survey, as well as code for programming the survey and cleaning the data, for others to use directly or as guidelines for how to measure SRH outcomes with greater sensitivity to gender diversity and a range of sexual orientations.
Highlights
The ways in which we conduct research have implications for data quality and inferential value.[1]
We present data on usage of customizable words, and offer the full text of the survey, as well as code for programming the survey and cleaning the data, for others to use directly or as guidelines for how to measure sexual and reproductive health (SRH) outcomes with greater sensitivity to gender diversity and a range of sexual orientations
At least 1.4 million transgender and gender nonbinary (TGNB) people are included in this group, and almost certainly more.[13]
Summary
The ways in which we conduct research have implications for data quality and inferential value.[1]. Gender identity–defined as one’s internal sense of being a man, woman, both, neither of these, or something else–is a powerful determinant of one’s lived experience. Gender identity can be consistent with or different from the sex that someone was assigned at birth. An estimated 4.5% of the United States population, or 11.3 million people,[11] identifies as a sexual and/or gender minority (SGM).[12] At least 1.4 million transgender and gender nonbinary (TGNB) people are included in this group, and almost certainly more.[13] Gender identity and sexual orientation, are distinct. Sexual orientation and its constituent domains of identity, attraction, and behavior are each independently and combined strong determinants of a person’s lived experience
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