Measures Of Sexual Orientation 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).

Toward inclusive and equitable LGBTIQ+ measurement: Assessing gender and sexual orientation measures and scale validity in national surveys across 21 countries

AbstractDespite growing global interest in lesbian, gay, bisexual, trans, intersex, and queer/questioning (LGBTIQ+) research, variations in measurement practices across countries have remained underexplored. In this work, we focused on two fundamental aspects of measurement vital to understanding the experiences of LGBTIQ+ people. Specifically, we documented current measures of sex, gender, and sexual orientation used in national mental well‐being‐related surveys and reviewed whether the mental well‐being scales in those surveys have been validated for LGBTIQ+ people. We employed a stratified sampling strategy and evaluated national surveys from a list of randomly selected countries representing 10% of global nations (N = 21). Fewer than half of the countries measured sexual orientation and fewer than one‐third measured gender beyond the binary in their national surveys. Among the countries that measured gender or sexual orientation, the response options and question phrasing were often not inclusive. In addition, most of the mental well‐being scales lacked validity evidence for LGBTIQ+ populations. Finally, we outline recommendations for the future of reimagining LGBTIQ+ research in terms of measurement, highlighting the importance of research engagement with the global LGBTIQ+ community.

Factor structure of the Klein Sexual Orientation Grid among Latina/o/x Adolescents

Measuring sexual orientation involves assessing multiple domains to account for the various conceptualizations adolescents may have. The purpose of this study was to examine: (1) the factor structure and reliability of the Klein Sexual Orientation Grid (KSOG) and (2) measurement invariance across age and nativity groups. Participants included 454 Latina/o/x adolescents [25.3% Latina/o/x sexual minority youth (LSMY) and 74.7% Latina/o/x non-SMY]. We examined the hypothesized factor structure of the KSOG using confirmatory factor analysis and the configural, metric, and scalar invariance of the identified factor structure was examined between age (12–14 and 15–17) and nativity (U.S. born and foreign-born) groups. A single factor captured: identity, attraction, emotional connection, and fantasies (CFI/RMSEA = 1.00/.000). We found evidence for metric noninvariance suggesting that sexual orientation as a latent construct does not perform equivalently among Hispanic adolescents who are younger versus older (Δχ2(3) = 106.01, p < 0.001, ΔCFI = 0.041, ΔTLI = 0.064, and ΔRMSEA = 0.154) or adolescents who are U.S. born versus foreign-born (Δχ2(3) = 10.34, p < 0.05, ΔCFI = 0.003, ΔTLI = 0.002, and ΔRMSEA = 0.011). The KSOG may not be used equivalently among older and younger Latina/o/x adolescents and Latina/o/x adolescents who are U.S. born and foreign-born.

Using Routine Data to Improve Lesbian, Gay, Bisexual, and Transgender Health.

The collection of sexual orientation in routine data, generated either from contacts with health services or in infrastructure data resources designed and collected for policy and research, has improved substantially in the United Kingdom in the last decade. Inclusive measures of gender and transgender status are now also beginning to be collected. This viewpoint considers current data collections, and their strengths and limitations, including accessing data, sample size, measures of sexual orientation and gender, measures of health outcomes, and longitudinal follow-up. The available data are considered within both sociopolitical and biomedical models of health for individuals who are lesbian, gay, bisexual, transgender, queer, or of other identities including nonbinary (LGBTQ+). Although most individual data sets have some methodological limitations, when put together, there is now a real depth of routine data for LGBTQ+ health research. This paper aims to provide a framework for how these data can be used to improve health and health care outcomes. Four practical analysis approaches are introduced-descriptive epidemiology, risk prediction, intervention development, and impact evaluation-and are discussed as frameworks for translating data into research with the potential to improve health.

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.

Childhood Adversity and Offense-Supportive Cognitions Among Czech Adults with a Sexual Interest in Violence or Children.

Individuals with paraphilic interests in sexual violence or children may be more likely to sexually offend if they possess offense-supportive cognitions. These cognitions may develop in response to childhood adversity. However, this idea is largely based on research in men convicted of sexual offenses and may not generalize to non-incarcerated adults with paraphilic interests. In a sample of 178 adults screened for paraphilic interests in violence or children (from the general Czech population), we hypothesized that childhood sexual abuse and emotional neglect would be associated with offense-supportive cognitions about rape and child molestation. Participants came from a nationally representative sample of Czech adults and were selected if they self-reported high levels of sexual interest in violence and/or children. Participants completed an online survey with self-report measures of sexual orientation, offense-supportive cognitions (Bumby RAPE and MOLEST scales), and childhood sexual abuse and emotional neglect (Childhood Trauma Questionnaire). Controlling for gender, age, and sexual orientation, we found that both rape-supportive cognitions and child molestation-supportive cognitions were significantly associated with higher levels of childhood sexual abuse, but not emotional neglect. These findings indicate that childhood sexual abuse may lead to offense-supportive cognitions among men and women with paraphilia.

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...

Reducing LGBTQ+ Physical Activity Disparities Through Improved Measurement and Inclusion of Sexual Orientation in US National Data Sets.

Adequate participation in physical activity (PA) is effective in reducing negative health outcomes, including cardiovascular disease, stroke, type 2 diabetes, as well as stress, anxiety, and depression. However, 1 in 4 adults meet the PA guidelines, with lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons reporting increased rates of inactivity and higher rates of negative health outcomes. Limited research can be conducted on best methods to promote PA among LGBTQ+ adults as there is a lack of standardized measurements for both sexual orientation status and PA used in US national data set methodologies. A call to action is warranted to highlight the lack of uniform methodologies for collecting both sexual orientation and PA data in national data sets, with an overall goal of promoting inclusion and transparency of sexual orientation as a primary, secondary, and tertiary influence on PA. The current societal disconnect of national data sets collecting sexual orientation does not allow for proper extrapolation within the LGBTQ+ classifications. LGBTQ+ identities each report differing PA and health outcomes, promoting the need for proper sexual orientation measures. Without this inclusion, we will continue to see larger health disparities among LGBTQ+ persons due to outdated measurements in current US national data sets. This commentary provides sexual orientation status on health outcomes linked to physical inactivity, the need to include uniform sexual orientation measures in national data sets, and implications of the inclusion of this measure to conduct PA research as it relates to health outcomes.

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.

The Association Between Masculinity Ideology and Sexism: The Role of Sexual Orientation Among Heterosexual and Bisexual Women

The current study explored the relation between sexual orientation, masculinity ideology, and sexism among 380 adult heterosexual and bisexual women. Participants completed measures of sexual orientation, masculinity ideology, hostile sexism, and benevolent sexism. Mean-level analyses concluded that heterosexual women scored significantly higher on hostile and benevolent sexism than their bisexual counterparts. Findings from the regression analyses revealed that masculinity ideology predicted both hostile and benevolent sexism. Sexual orientation only moderated the association between masculinity ideology and hostile sexism, such that the effect was stronger for heterosexual women. Sexual orientation did not moderate the association between women’s masculinity ideology and benevolent sexism, suggesting that women’s relationship with benevolent sexism may be more complex. The current findings suggest that heterosexual women’s conceptions of gender-role attitudes toward men and women may be more salient and potentially harmful compared to bisexual women, and heterosexual intimacy may be an important factor to consider.

Psychometric Evaluation and Validation of the HIV Stigma Scale in Spanish among Men who have Sex with Men and Transgender Women.

Stigma and discrimination toward the LGBTQ community is pervasive and negatively impacts health. Validated measures of stigma in Spanish, however, are limited and none have specifically validated HIV-related stigma in Spanish-speaking men who have sex with men (MSM) and transgender women (TGW) in resource-limited settings. The aim of this study is to evaluate the psychometric properties of a standardized HIV Stigma Scale, translated to Spanish, including its factor structure. Measures consisted of self-reported socio-demographic measures of age, sex, sexual orientation, education, employment status, income, living situation, HIV stigma, depressive symptoms, and social support. Using SPSS AMOS 24, a confirmatory factor analysis (CFA) of the 10-item Wright HIV Stigma Scale translated to Spanish was conducted in 359 MSM and TGW with HIV recruited from HIV clinics in Lima, Peru. The path model with three sub-scales: enacted, anticipated and internalized stigma, with eight items had an adequate fit to the data. The Spanish version (HIV Stigma Scale-ES) and its dimensions are similar to the ones validated in English for people with HIV (not MSM). Each construct was deemed to be reliable and showed good construct validity. Given the need to better understand and measure stigma in Spanish-speaking MSM, the HIV Stigma Scale-ES can be a useful tool to examine stigma.

Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study

BackgroundEmployment outcomes among sexual minority (i.e., lesbian, gay, bisexual) workers are poorly understood, and previous research on this topic has focused almost exclusively on inequities in earnings, neglecting other important dimensions of job quality. We address this gap by describing and comparing the job quality of straight and sexual minority workers in Canada. MethodsData are from the 2016 General Social Survey: Canadians at Work and Home, the only national survey providing both a measure of sexual orientation and a multidimensional view of job quality in Canada. We identified 25 unique job quality indicators (e.g., temporary employment; job insecurity; health benefits; low income; job satisfaction; job control; discrimination). Latent class cluster analysis was used to establish a typology of job quality describing standard, flexible, and precarious employment types. We used multivariable regression methods to examine the association between sexual orientation and job quality. ResultsSexual minorities reported lower job quality than their straight counterparts along many dimensions, with bisexual people reporting the lowest job quality. While inequities were generally observed among both sexual minority men and women, they sometimes differed in magnitude by gender. The prevalence of precarious employment was nearly three times higher among lesbian, gay, and bisexual workers (PR: 2.94, CI: 1.89–4.58 among all sexual minorities; PR: 3.04, CI: 1.71–5.43 among gay/lesbian workers; and PR: 2.81, CI: 1.45–5.47 among bisexual workers) compared to their straight counterparts. ConclusionInequities in job quality among sexual minorities persist despite comprehensive human rights protections in Canada. These inequities are pervasive, extending well beyond conventional indicators such as dollars earned and hours worked. Multi-pronged interventions are needed that move beyond simply ensuring that sexual minority workers are employed. Sexual minority workers deserve access to secure, well-paid work with benefits where they can foster connection and be free from discrimination.

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.

Sexual orientation in transgender adults in the United States

BackgroundSexual orientation refers to a person’s enduring emotional, romantic, or sexual attractions to other people. Sexual orientation measures do not typically consider desires for, or sexual behavior with, transgender people. We describe measures inclusive of transgender people and characterize sexual orientation identity, behavior, and attraction in a representative sample of the U.S. transgender population.MethodsBetween April 2016-December 2018, a U.S. national probability sample of transgender (n = 274) and cisgender (n = 1,162) adults were invited to complete a self-administered web or mailed paper survey. We assessed sexual identity with updated response options inclusive of recent identity terms (e.g., queer), and revised sexual behavior and attraction measures that included transgender people. Multiple response options were allowed for sexual behavior and attraction. Weighted descriptive statistics and sexual orientation differences by gender identity groups were estimated using age-adjusted comparisons.ResultsCompared to the cisgender population, the transgender population was more likely to identify as a sexual minority and have heterogeneity in sexual orientation, behavior, and attraction. In the transgender population, the most frequently endorsed sexual orientation identities were “bisexual” (18.9%), “queer” (18.1%), and “straight” (17.6%). Sexually active transgender respondents reported diverse partners in the prior 5 years: 52.6% cisgender women (CW), 42.7% cisgender men (CM), 16.9% transgender women (TW), and 19.5% transgender men (TM); 27.7% did not have sex in the past 5 years. Overall, 73.6% were “somewhat”/ “very” attracted to CW, 58.3% CM, 56.8% TW, 52.4% TM, 59.9% genderqueer/nonbinary-females-at-birth, 51.9% genderqueer/nonbinary-males-at-birth. Sexual orientation identity, behavior, and attraction significantly differed by gender identity for TW, TM, and nonbinary participants (all p < 0.05).ConclusionsInclusive measures of sexual orientation captured diverse sexual identities, partner genders, and desires. Future research is needed to cognitively test and validate these measures, especially with cisgender respondents, and to assess the relation of sexual orientation and health for transgender people.

From continua to kaleidoscopes: How plurisexuality challenges traditional conceptualizations of sexual orientation

Traditional measures of sexual orientation (e.g., the Kinsey Scale, the Klein Sexual Orientation Grid, single-item sexual identity questions) focus on a person’s behaviour, identity, and attraction yet are described by plurisexual, asexual, and gender-diverse individuals as inadequate in capturing the complexity of how they experience and understand their sexuality. This study explores how plurisexual and asexual individuals make sense of their sexual orientation. Across several studies, participants (n = 2,306) completed demographic questionnaires related to their gender and sexual identity while also responding to the Kinsey Scale. Additionally, participants wrote open-ended responses explaining why they had selected a particular sexual identity or Kinsey score earlier in the survey. The authors used an abductive reflective thematic analysis to review these open-ended responses, focusing on whether responses aligned with a dominant model of sexual orientation (i.e., behaviour-identity-attraction). While many participants described their choice of sexual identity label and Kinsey score using at least one aspect of the behaviour-identity-attraction trichotomy, not all responses fit within this model. For example, participants emphasized their attraction to individual characteristics other than gender/sex, distinguished between romantic and sexual attraction, and discussed plurisexuality and experiences of sexual fluidity. Traditional measures of sexual orientation may not be adequate when working with sexually diverse samples. Researchers should consider how best to conceptualize sexual orientation and other related constructs, including emotional/romantic attraction, sexual fluidity, and the role of gender expression in processes of attraction and identity construction.

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.

Let’s Talk About Sex(uality): A Content Analysis of the Inclusion and Measurement of Sexual Identity and Sexual Orientation in Published Criminological Research

&lt;i&gt;Time and again, criminology has been criticized for its lack of inclusion in research regarding diverse populations. Scholars continuously call for criminological research to diversify its focus and measurements, particularly regarding individual characteristics such as race, sex, gender, and, more recently, sexuality. This study utilizes summative content analysis to examine the inclusion, measurement, and context of sexuality and sexual orientation in all articles published between 2011-2020 from four criminological and criminal justice (CCJ) journals. Specifically, we explored to what extent sexuality is incorporated in the selected publications among the sections of each article and if it varies among journals, if sexuality is being measured in the empirical articles examined and, if so, as what type of variable, if the calls for inclusion in 2014 changed the amount of sexuality included in articles, and if the gender makeup of the author team impacts inclusion of sexuality. Results indicate that sexuality and sexual orientation are rarely mentioned in the literature and are measured even less. While sexuality is included more as time passes, much of this is limited. Additionally, articles published by female authors and within the more gender-specialized journal incorporate sexuality more frequently while still limited. &lt;/i&gt;

How to Ensure Inclusivity in Large-Scale General Population Cohort Studies? Lessons Learned with Regard to Including and Assessing Sex, Gender, and Sexual Orientation

Despite recent advances in the measurement of sex, gender, and sexual orientation in large-scale cohort studies, the three concepts are still gaining relatively little attention, may be mistakenly equated, or non-informatively operationalized. The resulting imprecise or lacking information hereon in studies is problematic, as sex, gender, and sexual orientation are important health-related factors. Omission of these concepts from general population cohort studies might dismiss participants’ identity and experiences and pushes research on sexual or gender minority populations toward purposive sampling, potentially introducing selection bias. It also reinforces the unintentional notion of irrelevance of these concepts to health research, ultimately disadvantaging sexual and gender minority populations. Similarly, a lack of uniform measures on sex, gender, and sexual orientation hampers multi-cohort studies in which data from multiple studies are combined, facilitating increased statistical power. This paper discusses the encountered pitfalls and lessons learned on including and assessing sex, gender, and sexual orientation in large-scale general population cohort studies, exemplified by the Dutch Lifelines Cohort Study. Additionally, we propose hands-on strategies on how to operationalize these concepts in an inclusive manner that is useful for large-scale general population cohort studies.

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