An Experimental Evaluation of How Survey Measurement of Sexual Identity Affects Population Estimates of Identity-Based Differences in the Prevalence of Adverse Health Outcomes

Data & Methods

Project Summary

A large body of research has shown that individuals who identify as sexual minorities (e.g., lesbian, gay, bisexual) are at higher risk of substance use disorders, mental health disorders, suicidality, discrimination, and risky sexual behaviors. This research has led to the implementation of public health policies designed to understand and reduce these differences at the local, state and national levels. While the large national survey data sets used for the majority of this research collect measures of both sexual identity and health behaviors, the questions asked are relatively simple and closed-ended. This practice introduces a risk of survey respondents being misclassified in terms of their sexual identity, especially if respondents do not perceive that the small number of sexual identity options provided apply to them. This could lead to understating differences among these groups or providing misleading estimates of the directions of the differences.

We are conducting secondary analyses of data collected from five years of the NSFG (2015-2019), where two large national half-samples were randomly assigned to receive different versions of a question about sexual identity, and also performing parallel analyses of identical data from the National Survey of Drug Use and Health (2015-2019) for replication purposes. Using the results, this project will evaluate the possibility of attenuation in estimates of the differences between sexual identity subgroups in the distributions of additional health outcomes of interest to NICHD, and extend the study of the attenuation problem to socio-demographic subgroups and the potential moderation of these differences by state-level policies related to the protection of sexual minorities. This work will inform existing policies and motivate future experimental research further evaluating improved tools for the measurement of sexual identity in national surveys.


Brady Thomas West, Sean Esteban McCabe

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