Variation in the Measurement of Sexual Orientation | Newswise – Newswise

Sustainable Development Goals and Sexual Orientation Measurement

Introduction

Sexual orientation, which encompasses sexual identity, attraction, and behavior, poses challenges in comprehensive measurement. Variations in the number of lesbian, gay, bisexual, and transgender (LGBT) individuals recorded across surveys using different measurement approaches reflect this difficulty. While most approaches focus on ‘sexual identity’ to understand mental health disparities, differences in perceived notions of ‘identity’ and ‘attraction/behavior’ are prevalent. Some individuals report same-sex attraction but identify as ‘heterosexual’ in surveys, indicating the existence of an ‘invisible’ sexual minority group. This group, which does not align with traditional labels but experiences similar mental stress as other sexual minorities, remains unrecognized by policies aimed at mental health support.

Study on Sexual Orientation Measurement

In order to improve the inclusivity and relevance of current sexual orientation measurements, Assistant Professor Dr. Nicole F. Kahn from the University of Washington and her research team conducted a study published in the American Journal of Public Health on November 6, 2024. The purpose of the study was to describe and compare responses from respondents asked to complete two different survey questions designed to measure sexual orientation and understand how variation in responses to these questions are associated with mental health outcomes. The team hypothesized that measures using a broader continuum of sexuality would identify more sexual minority (SM) respondents than those using narrower labels. Additionally, they hypothesized that individuals identifying as heterosexual on one survey and SM on another would show mental health patterns similar to SM respondents in both surveys.

Data Collection and Analysis

The study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), which follows a cohort of adolescent school students from 1994–1995 (wave I) until 2016–2019 (wave V), with wave VI ongoing. Between 2020 and 2021, participants from the Add Health study were invited to complete the Sexual Orientation/Gender Identity, Socioeconomic Status, and Health Across the Life Course (SOGI-SES) survey. Respondents who identified as mostly heterosexual, bisexual, mostly homosexual, or homosexual; reported same-sex partners at waves III, IV, or V; or were discordant on sex assigned at birth and gender expression were all solicited for participation in SOGI-SES. These respondents are referred to as sexual and gender minorities (SGMs).

Results and Findings

The study asked respondents two questions on sexual orientation: one from the Add Health survey providing a continuum ranging from ‘100% heterosexual’ to ‘not sexually attracted to either males or females,’ and the second from the National Health Interview Survey (NHIS) offering fewer options. Respondents identifying as “heterosexual (straight)” on both surveys were classified as such, while those choosing non-heterosexual options in both surveys were categorized as sexual minorities. A third group, termed ‘undetected sexual minorities,’ included those who marked ‘100% heterosexual (straight)’ in one survey but a sexual minority option in the other. Mental health outcomes were assessed by asking respondents whether they had ever been diagnosed with conditions like depression, anxiety, or panic disorders. Gender was assigned based on alignment between sex at birth and current gender identity.

Of the 2,576 respondents, a larger proportion of cisgender males (93.9%) and cisgender females (91.2%) identified as ‘straight’ in response to the NHIS question compared to cisgender males (92.2%) and cisgender females (79.1%) who identified as ‘100% heterosexual’ in response to the Add Health question. The study found that Add Health questions were able to detect more sexual minorities (SMs) than the NHIS questions (14.4% vs 6.8%). Interestingly, cisgender females were significantly more likely to be undetected by NHIS than cisgender males (12.8% vs 2.6%). In terms of mental health outcomes, SMs and undetected SMs were more likely to report a depression diagnosis than heterosexual respondents. Similarly, anxiety or panic disorder diagnoses were significantly different only between SMs and heterosexual or straight respondents among both cisgender males (46.3% vs 30.1%) and cisgender females (54.7% vs 37.1%).

Implications and Recommendations

The current measures of sexual orientation may lead to an underestimation of the sexual minority population, thereby underestimating the health disparities they experience. The study suggests that further research on other measures that consider response options reflecting a broader continuum of sexuality is needed to inform health policy and service planning to meet the needs of the sexual minority population.

About Dr. Nicole F. Kahn from the University of Washington

Dr. Nicole F. Kahn is an Assistant Professor at the Division of Adolescent Medicine, Department of Pediatrics, University of Washington School of Medicine in Seattle, US. She completed her Ph.D. in maternal and child health from the Gillings School of Global Public Health at the University of North Carolina in 2018, where she continues to serve as an adjunct assistant professor. Dr. Kahn has extensive experience in the field of adolescent healthcare and has published numerous articles. She believes that research policies using human-centered design approaches can help understand diverse youth and families, thereby improving health systems for adolescents.

About the American Public Health Association (APHA)

The American Public Health Association champions optimal, equitable health and well-being for all. With a broad-based member community and a 150-year perspective, the organization influences federal policy to improve the public’s health. To learn more, visit www.apha.org.

SDGs, Targets, and Indicators Analysis

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 5: Gender Equality
• SDG 10: Reduced Inequalities

The article discusses the measurement of sexual orientation and its impact on mental health outcomes. This is connected to SDG 3, which aims to ensure good health and well-being for all. It is also connected to SDG 5, which focuses on achieving gender equality and empowering all women and girls. Additionally, the article highlights the existence of an “invisible” sexual minority group, which indicates the need to address reduced inequalities (SDG 10) and ensure that policies and support systems are inclusive and recognize the experiences of all individuals.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
• Target 5.1: End all forms of discrimination against all women and girls everywhere.
• Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.

The article emphasizes the need to improve the inclusivity and relevance of current sexual orientation measurements to address mental health disparities. This aligns with Target 3.4 of SDG 3, which aims to promote mental health and well-being. The article also highlights the underestimation of the sexual minority population and the need for policies that consider a broader continuum of sexuality, which relates to Target 5.1 of SDG 5, focusing on ending discrimination against women and girls. Additionally, the article emphasizes the importance of recognizing and including the experiences of the “invisible” sexual minority group, which aligns with Target 10.2 of SDG 10, aiming to promote social, economic, and political inclusion for all individuals.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease.
• Indicator 5.1.1: Whether or not legal frameworks are in place to promote, enforce, and monitor equality and non-discrimination on the basis of sex.
• Indicator 10.2.1: Proportion of people living below 50 percent of median income, disaggregated by age, sex, and persons with disabilities.

While the article does not explicitly mention specific indicators, the identified targets can be measured using relevant indicators from the SDG framework. Indicator 3.4.1 can be used to measure progress towards Target 3.4, as it focuses on mortality rates attributed to non-communicable diseases, including mental health conditions. Indicator 5.1.1 can be used to measure progress towards Target 5.1, as it assesses the presence of legal frameworks promoting equality and non-discrimination based on sex. Indicator 10.2.1 can be used to measure progress towards Target 10.2, as it examines the proportion of people living below a certain income threshold, disaggregated by age, sex, and disability status.

SDGs, Targets, and Indicators Table

Source: newswise.com