Measures Of Gender Identity Research Articles

Mapping the scientific literature on obstetric and perinatal health among sexual and gender minoritized (SGM) childbearing people and their infants: a scoping review

BackgroundEvidence suggests sexual and gender minoritized (SGM) childbearing individuals and their infants experience more adverse obstetric and perinatal outcomes compared to their cisgender, heterosexual counterparts. This study aimed to comprehensively map obstetric and perinatal physical health literature among SGM populations and their infants and identify knowledge gaps.MethodsPubMed, Embase, CINAHL, and Web of Science Core Collection were systematically searched to identify published studies reporting obstetric and perinatal outcomes in SGM individuals or their infants. Study characteristics, sample characteristics, and outcome findings were systematically extracted and analyzed.ResultsOur search yielded 8,740 records; 55 studies (1981–2023) were included. Sexual orientation was measured by self-identification (72%), behavior (55%), and attraction (9%). Only one study captured all three dimensions. Inconsistent measures of sexual orientation and gender identity (SOGI) were common, and 68% conflated sex and gender. Most (85%) focused on sexual minorities, while 31% addressed gender minorities. Demographic measures employed varied widely and were inconsistent; 35% lacked race/ethnicity data, and 44% lacked socioeconomic data. Most studies (78%) examined outcomes among SGM individuals, primarily focusing on morbidity and pregnancy outcomes. Pregnancy termination was most frequently studied, while pregnancy and childbirth complications (e.g., gestational hypertension, postpartum hemorrhage) were rarely examined. Evidence of disparities were mixed. Infant outcomes were investigated in 60% of the studies, focusing on preterm birth and low birthweight. Disparities were noted among different sexual orientation and racial/ethnic groups. Qualitative insights highlighted how stigma and discriminatory care settings can lead to adverse pregnancy and birth outcomes.ConclusionsFrequent conflation of sex and gender and a lack of standardized SOGI measures hinder the comparison and synthesis of existing evidence. Nuanced sociodemographic data should be collected to understand the implications of intersecting identities. Findings on perinatal health disparities were mixed, highlighting the need for standardized SOGI measures and comprehensive sociodemographic data. The impact of stigma and discriminatory care on adverse outcomes underscores the need for inclusive healthcare environments. Future research should address these gaps; research on SGM perinatal outcomes remains urgently lacking.Trial registrationThe review protocol was developed a priori in February 2023, registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/5DQV4) and published in BMJ Open (https://bmjopen.bmj.com/content/13/11/e075443).

Perceptions of Academic Performance, Impairment, and Mental Health in University Students With and Without ADHD

Objective: This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences. Method: The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average. Results: ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals. Conclusion: This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.

Preliminary development of a brief parent-report gender identity alignment/distress screener for children.

This research develops a brief, and preliminary, parent-report screener to assess gender identity alignment/distress in children. The increasing prevalence of children not identifying with their sex at birth, the length and outdated language of existing gender identity measures, and the need to assess gender identity among children (as opposed to adolescent/adult measures) motivate a screener. A survey containing 14 items from existing instruments was administered to a diverse set of 1110 parents of children ages 3-12. Exploratory and confirmatory factor analyses, followed by multiple indicators and multiple causes (MIMIC) modelling, were used to develop a 5-item, unidimensional screener that may assess gender identity alignment/distress. The screener may be suitable to identify children who experience misalignment between their gender and sex assigned at birth and parents or children for whom this misalignment causes distress. These families may benefit from additional resources and conversations between paediatric staff and children about their gender identity, including education for parents, and/or referrals for specialty care. Future research should further streamline and validate this preliminary screener, examine its convergence with gender identity and distress measures and explore including children's perspectives.

Issues in Distinguishing Sex and Gender in Surgical Registries: A NSQIP and VASQIP Analysis.

Surgical registries do not have separate sex (the biological construct) and gender identity variables. We examined procedures specific to sexually dimorphic anatomy, such as ovaries, testes, and other reproductive organs, to identify "discrepancies" between recorded sex and the anatomy of a procedure. These "discrepancies" would represent a structural limitation of surgical registries, one that may unintentionally perpetuate health inequities. Retrospective cohort study using 2015-2019 NSQIP and 2016-2019 VASQIP. Surgeries were limited to procedures pertaining to anatomy that is either specifically male (CPT codes 54000-55899) or female (56405-59899). The sex recorded in the surgical registries, often automatically retrieved from electronic health record data, was compared to the specified anatomy of each procedure to quantify discrepancies. 575,956 procedures were identified specific to sexually dimorphic anatomy (549,411 NSQIP; 26,545 VASQIP). Of those, 2,137 recorded a sex discordant with the anatomy specified by the surgical procedure (rates 0.4% in NSQIP; 0.2% in VASQIP). Procedures specific to female anatomy with recorded male sex were more frequent (82.6% in NSQIP; 98.4% in VASQIP) than procedures specific to male anatomy with recorded female sex. Discrepancies between recorded sex and the anatomy of a surgical procedure were limited. However, because sex in surgical registries is often directly acquired from electronic health record data, these cases likely represent transgender, gender diverse, or living with a difference of sex development (intersex) patients. As these populations increase and continue to seek healthcare, precise measurement of sex, gender identity, and legal sex is necessary for adequate risk adjustment, risk prediction, and surgical outcome benchmarking for optimal care.

Sexual and Gender Identity Properties and Associations With Physical and Mental Health Among SGM Midlife and Older Adults: Findings From Aging With Pride: National Health, Aging, and Sexuality/Gender Study.

Objectives: Unidimensional measures of sexual and gender identity are most often used in research. Yet, sexuality and gender are defined by complex characteristics. Guided by the Health Equity Promotion Model, we assess multidimensional properties of sexual and gender identity. Methods: This study utilizes 2016 survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) to investigate properties of identity (affirmation, visibility, centrality, integration, congruence, continua, transformation) and their association with multimorbidity, disability, general health, depression, quality of life among SGM adults (N = 2233), 50 and older. Results: Higher affirmation, centrality, congruence, and transformation were associated with better health, while identity integration and continua were associated with some adverse health outcomes. Bisexual men, sexually diverse and transgender individuals had the lowest identity centrality and visibility. Discussion: The findings necessitate a multidimensional approach to identity and the use of measures that are comprehensive and responsive to sexual and gender diversity.

What do measures of gender identity tell us about gender identity over time?

Gender identity is a multifaceted concept and is represented by a wide range of measures and constructs including both self-report and researcher observations of preferences and behaviours. However, despite their similar theoretical underpinning, gender identity measures are rarely found to correlate with one another, and contrasting patterns and trajectories are often found for each construct (Egan & Perry, Developmental Psychology, 37, 2001, 451). Therefore, this systematic review aimed to present a review of the longitudinal research evidence surrounding gender identity development in the absence of formal intervention. Using a systematic search strategy, 21 studies were identified. Narrative synthesis was used to synthesize the data collected in these studies and trajectories were explored for (1) self-identification measures of gender identity, (2) clothing preferences, (3) peer preferences, and (4) object/activity preferences. Overall, the results of this systematic review are consistent with wider research suggesting that distinct developmental patterns can be observed when using different constructs and measures of gender identity.

Predictive Validity of the K-CAT-SS in High-Risk Adolescents and Young Adults

Suicide is a leading cause of death in adolescents and young adults and has increased substantially in the past 15 years. Accurate suicide risk stratification based on rapid screening can help reverse these trends. This study aimed to assess the ability of the Kiddie Computerized Adaptive Test Suicide Scale (K-CAT-SS), a brief computerized adaptive test of suicidality, to predict suicide attempts (SAs) in high-risk youth. A total of 652 participants (age range, 12-24 years), 78% of whom presented with suicidal ideation or behavior, were recruited within 1 month of mental health care contact. The K-CAT-SS, scaled from 0 to 100, was administered at baseline, and participants were assessed at about 1, 3, and 6 months after intake. Weekly incidence of SAs was assessed using the Adolescent Longitudinal Interval Follow-up Evaluation and Columbia-Suicide Severity Rating Scale. A secondary outcome was suicidal behavior, including aborted, interrupted, and actual SAs. The K-CAT-SS showed a 4.91-fold increase in SAs for every 25-point increase in the baseline score (95% CI 2.83-8.52) and a 3.51-fold increase in suicidal behaviors (95% CI 2.32-5.30). These relations persisted following adjustment for prior attempts; demographic variables including age, sex, gender identity, sexual orientation, and race/ethnicity; and other measures of psychopathology. No moderating effects were identified. At 3 months, area under the receiver operating characteristic curve was 0.83 (95% CI 0.72-0.93) for 1 or more SAs. The K-CAT-SS is an excellent tool for suicide risk stratification, particularly in higher-risk populations where other measures have shown lower predictive validity.

The Longitudinal Measurement of Sexual Orientation and Gender Identity: A Study of Identity Change in a Nationally Representative Sample of U.S. Adults and Adolescents.

Purpose: Research and lived experience demonstrate that sexual orientation and gender identity (SOGI) can change over the life course; however, little empirical work exists to understand the prevalence of such changes. To address this gap, we used data from a large nationally representative panel of adults and adolescents to assess changes in self-reported SOGI over time and identify trends by sex assigned at birth, age, race and ethnicity, and survey mode. Methods: We reviewed SOGI data collected between 2014 and 2022 for a sample of 19,469 adults and 970 adolescents. Up to eight SOGI measurements per panelist were available over the nine-year period, collected through a combination of panel recruitment and demographic refresh surveys and topic-specific surveys. Results: Among adults older than 18 years, 4.1% reported a change in sexual orientation and 3.6% reported a change in gender identity. Among teens, who are developmentally more apt to change identity, 13.5% reported a change in sexual orientation and 9.3% reported a change in gender identity. Conclusions: Findings demonstrate that SOGI can change over time, particularly for adolescents, so it is important to re-ask SOGI questions to ensure current information. We recommend re-asking SOGI questions at least every three years of adults and every two years of adolescents. Potential undercounting of sexual and gender minority (SGM) respondents decreases visibility and our ability to understand health and economic disparities affecting these populations. Improvements in SOGI measurement can help advance data quality and, ultimately, evidence-based interventions in support of SGM communities that these data help to inform.

Responses to Sexual and Gender Identity Measures in Population-Level Data by Birth Cohort: A Research Note

The measurement of sexual and gender identity in the United States has been evolving to generate more precise demographic estimates of the population and a better understanding of health and well-being. Younger cohorts of sexual- and gender-diverse adults are endorsing identities outside of the lesbian, gay, bisexual, and transgender (LGBT) labels. Current population-level surveys often include a category such as “something else” without providing further details, and doing so inadequately captures these diverse identities. In this research note, our analysis of the most recent federal data source to incorporate sexual and gender identity measures—the Household Pulse Survey—reveals that younger birth cohorts are more likely to select “something else” for their sexual identity and “none of these” for their gender identity. The observed sexual and gender identity response patterns across birth cohorts underscore the importance of developing and applying new strategies to directly measure sexual- and gender-diverse adults who identify with identities outside of those explicitly captured on surveys. The integration of sexual and gender identity measures in population-level surveys carries broader implications for civil rights and for addressing health inequities and therefore must be responsive to cohort differences in identification.

Sexual orientation and gender identity measures and viral suppression for people living with HIV: a protocol for a population-based cohort study

IntroductionThe measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that...

Measurement opportunities for studying sexual and gender diverse partnerships in population-based surveys.

This article outlines for family scholars and researchers designing surveys or searching for data on sexual and gender-diverse (SGD) families the latest methodological advancements in United States population-based surveys for studying SGD partnerships by reviewing five recently collected, publicly available, population-representative data sets. LGBTQIA+ adults and SGD partnerships are an expanding demographic group in the United States. Yet, measurement limitations have restricted studies of these partnerships that use population-based studies. To address this issue, researchers designing population-representative data collections have adopted new strategies to measure SGD partnerships accurately. However, most population representative surveys continue to lack data on growing segments of the LGBTQIA+ population by relying solely on the sex of partners or limited sexual and gender identity measures. We recommend expanding population-based surveys to incorporate inclusive measures of sexual and gender identity, directly asking about the gender composition of a couple and measurement of cohabiting and other nonmarital relationships. These approaches are especially important for understanding relationships among younger populations who do not follow heteronormative relationship trajectories and hold diverse gender and sexual identities. Although the research opportunities on SGD individuals and partnerships are expanding; researchers must remain mindful of the limitations of current data sets and advocate for updates to the United States population data infrastructure.

Environmental Exposure Inequities Among Sexual and Gender Minority Populations in the United States: A Scoping Review

Despite growing attention and guiding frameworks, we still know very little about how environmental exposures may be contributing to the health inequities experienced by sexual and gender minority (SGM) people, especially exposures beyond psycho-behavioral mechanisms that have traditionally been viewed as the pathways between minority stress and negative health outcomes. To address this gap in knowledge, we conducted a scoping review to determine the extent to which disparities in environmental exposures between SGM and non-SGM (ie, heterosexual and cisgender) populations have been measured in the United States. We searched PubMed for studies that were (1) peer-reviewed; (2) written in English; (3) quantitatively measured environmental exposures; (4) included 1 or more groups identifying as a sexual minority, gender minority, or both; (5) compared to the general population; (6) in the United States; and (7) published on or after January 1, 2011. Our scoping review identified very few studies that examined and documented environmental exposure disparities between SGM and non-SGM populations in the United States. These studies focused mostly on cigarette smoke exposures. None examined environmental exposure disparities between gender minority and cisgender populations. To address this critical gap in environmental health research for SGM populations in the short term, researchers can merge existing environmental data (eg, data from the Environmental Protection Agency) with SGM population data. Longer-term solutions require systematically including validated sexual orientation and gender identity measures across federal, state, and local datasets, as well as increased funding for original research that explores diverse environmental exposures. Taken together, these efforts can significantly advance our ability to identify and address environmental health inequities experienced by SGM people.

Sexual Orientation and Gender Identity Reporting in Highly Cited Current Alcohol Research.

Purpose: This study aimed to measure the frequency of high-quality and transparent sexual orientation and gender identity (SOGI) data collection and reporting in highly cited current alcohol use research, using the extant literature to identify community-informed priorities for the measurement of these variables. Methods: A single search to identify alcohol use literature was conducted on PubMed with results restricted to primary research articles published between 2015 and 2022. The 200 most highly cited studies from each year were identified and their titles and abstracts reviewed against inclusion criteria after deduplication. After full-text review, study characteristics and data indicating quality of SOGI reporting were extracted. The fidelity of the results was verified with a random sample before analyses. Results: The final sample comprised 580 records. Few studies reported gender identity (n = 194; 33.4%) and, of these, 7.2% reported the associated gender identity measure. A two-stage approach to measure gender was adopted in 3 studies, one study used an open-ended question with a free-text response option, and 13 studies recorded nonbinary gender identities (reported by 0.9% of the whole sample). Nineteen (3.3%) studies reported sexual orientation and more than half of these provided the sexual orientation measure. Eight of the 20 studies that reported sexual orientation and/or gender identity measures were classified as sexual and gender minority specialist research. Conclusions: Culturally competent SOGI reporting is lacking in highly cited current alcohol research. SOGI measures should be disclosed in future research and should provide free-text response options.

Construction and Application of Education Discourse Analysis for Functional Linguistic Influencing Gender Identity: From the Perspective Educational Cultural Values & Social Context

Educational culture is a community or society's values, conventions, and practices that guide educational systems and institutions. It includes schools, universities, informal learning contexts, pedagogical methodologies, curriculum design, and education attitudes. Gender identity based on male and female teachers and its impact at the empowerment of female teachers in education sector have garnered huge interest from researchers and students across numerous fields of examine. This particular study sought to delve into the connection between gender identity and female teacher empowerment in education sector, with a particular recognition on exploring the moderating function of Linguistic Discourse in education and the mediating role of educational cultural values and educational social context . A sample of 500 women spanning numerous areas and socioeconomic backgrounds inside the China become recruited, encompassing an age range of 18 to sixty five years. To acquire information, an online survey was employed, which integrated standardized measures of gender identity, cultural values, educational social context , and empowerment in education sector. Additionally, a comprehensive evaluation of participants' communication patterns and language usage in education sector was conducted to assess Educational linguistic discourse in education sector. Structured equation modeling was used to conduct statistical analysis. Results indicated that gender identity predicts female teacher empowerment in education sector significantly, and that educational cultural values and educational social context partially mediate this relationship. Women who held more progressive educational cultural values and perceived a more supportive social environment reported greater levels of empowerment. In addition, educational linguistic discourse in education moderated the relationship between gender identity and female teacher empowerment in a substantial way. The relationship between gender identity and empowerment was stronger among women who used more inclusive language and avoided gender stereotypes. These findings shed light on the complexity of female teacher empowerment in education and how gender identity, educational cultural values, educational social context, and language use shape women's experiences. The study emphasizes developing progressive educational cultural values and a supportive social environment in education sector to empower women and reduce gender inequities. The study emphasizes inclusive language and eliminating gender stereotypes to promote gender equality and women's empowerment.

Construction and Application of Education Discourse Analysis for Functional Linguistic Influencing Gender Identity: From the Perspective Educational Cultural Values & Social Context

Educational culture is a community or society's values, conventions, and practices that guide educational systems and institutions. It includes schools, universities, informal learning contexts, pedagogical methodologies, curriculum design, and education attitudes. Gender identity based on male and female teachers and its impact at the empowerment of female teachers in education sector have garnered huge interest from researchers and students across numerous fields of examine. This particular study sought to delve into the connection between gender identity and female teacher empowerment in education sector, with a particular recognition on exploring the moderating function of Linguistic Discourse in education and the mediating role of educational cultural values and educational social context . A sample of 500 women spanning numerous areas and socioeconomic backgrounds inside the China become recruited, encompassing an age range of 18 to sixty five years. To acquire information, an online survey was employed, which integrated standardized measures of gender identity, cultural values, educational social context , and empowerment in education sector. Additionally, a comprehensive evaluation of participants' communication patterns and language usage in education sector was conducted to assess Educational linguistic discourse in education sector. Structured equation modeling was used to conduct statistical analysis. Results indicated that gender identity predicts female teacher empowerment in education sector significantly, and that educational cultural values and educational social context partially mediate this relationship. Women who held more progressive educational cultural values and perceived a more supportive social environment reported greater levels of empowerment. In addition, educational linguistic discourse in education moderated the relationship between gender identity and female teacher empowerment in a substantial way. The relationship between gender identity and empowerment was stronger among women who used more inclusive language and avoided gender stereotypes. These findings shed light on the complexity of female teacher empowerment in education and how gender identity, educational cultural values, educational social context, and language use shape women's experiences. The study emphasizes developing progressive educational cultural values and a supportive social environment in education sector to empower women and reduce gender inequities. The study emphasizes inclusive language and eliminating gender stereotypes to promote gender equality and women's empowerment.

Problematizing the Measurement of Gender Identity in K-12 Education Survey Research: A Systematic Review

The increase in youth’s self-identification as trans in the United States and Canada has created new urgency in schools to meet the needs of these students, yet education survey researchers have yet to find ways to assess their educational outcomes based on sex and gender. In this critical systematic review, I provide an overview of surveys from 2009–2019 that have been utilized to assess the sex and gender identity of trans youth. Findings suggest a range of measurement approaches and types of research interests, as well as important aspects that were absent from the surveys. Recommendations for those who currently or plan to engage with survey research that includes gender identity are included.

The role of sexism in holding politicians accountable for sexual misconduct

Experimental research on the impact of the #MeToo movement on the evaluation of politicians has focused on how the impact is conditioned by partisan motivation. Beyond partisanship, gender identity and sexist attitudes may also act as a barrier to the success of #MeToo in challenging sexual misconduct in politics. In a conjoint experiment, we examine the extent to which sexism and gender identities (feminine/masculine identity and self-identified gender) condition how individuals respond to politicians accused of sexual misconduct. Respondents were shown two profiles of fictional British male candidates accused of sexual misconduct where the characteristics of the candidate and the scandal were (the number of allegations made, whether they apologized for the misconduct, their partisanship, and their stance on Brexit). We find that in general, more severe misconduct has a more negative impact on evaluations but that respondents who expressed attitudes consistent with hostile sexism were less likely to punish politicians for multiple offenses and less likely to reward a recognition of wrongdoing. Categorical gender identity, whether the respondent was a man or a woman, did not condition the electoral consequences of the scandal and a feminine and masculine identities moderated the impact of the political stance of the candidate. We conclude by discussing the importance of measuring gender attitudes, especially sexism and non-categorical measures of gender identity, in future studies on the political consequences of #MeToo.

LGBT+ Self-Identification Among Youth in Ireland Aged 17-18 Years: A Research Brief

In 2016, for the first time, a nationally representative survey of 6216 respondents, Growing Up in Ireland (GUI), included measurement of sexual orientation and gender identity (SOGI) among young people. Irish LGBTI+ youth and inclusion strategies identified collection of SOGI data as a policy objective, prioritizing analyses of GUI. In line with policy objectives, this research brief reports previously unpublished LGBT+ self-identification for youth in Ireland from Cohort ’98 born five years after decriminalization of homosexuality, with their coming-of-age coinciding with the marriage equality referendum, and legislation providing for greater gender recognition (2015). Ten percent of youth in Ireland, at 17-18 years, identify as lesbian, gay, bisexual, transgender, questioning, asexual or describe their gender as other. Female youth are significantly more likely to identify as a sexual minority, and to be bisexual than their male peers. A quarter of LGBT+ youth are questioning their sexual orientation. This finding supports the inclusion of a ‘questioning’ response in surveys collecting SOGI data, and also suggests sexual orientation self-identification is a dynamic process. A small percentage identify as asexual (0.2%). Just over 1% of young people identify as transgender or describe their gender as other. As the first generation in Ireland to grow up in an environment with increased LGBT+ visibility and social acceptance, these findings of a relatively high proportion of sexual and gender minorities among young people likely reflect improved social and legal climates. The importance of publication of SOGI estimates is underscored. GUI are committed to ensuring visibility of LGBT+ youth populations in data collection. Suggestions for improved SOGI placement and phrasing will be considered in the questionnaire with Cohort ’08 at age 17, currently being drafted. The findings from these analyses will inform future policy and research. GUI offers rich possibilities for future comparative cross-cohort analyses.

Measurement of Sex and Gender Identity in the Behavioral Risk Factor Surveillance System Survey, 2014 to 2020.

Effective measurement of sex and gender identity is challenging. Questions measuring gender identity were added as an optional module of the Behavioral Risk Factor Surveillance System (BRFSS) in 2014 and were modified repeatedly in following years. This study examines BRFSS participant responses to gender identity and sex questions, 2014-2020. About 70% of participants who identified as transgender male-to-female reported male sex while 30% reported female sex. Participants who identified as transgender female-to-male reported female sex about 65% of the time and reported male sex 35% of the time. Despite changes in sex question wording, these percentages were consistent over time. Reported sex is used in computing health-related variables and in routing participants to questions about birth control, pregnancy, HPV vaccines, and cancer screenings. Without better measurement, it is challenging to assess health and health risks and inform guidelines, programs, and policies protecting the health of transgender people.

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals