A systematic review of sexuality measurement in transgender and gender diverse populations.

Abstract

Research related to the lives of transgender and gender diverse (TGD) people has grown substantially in recent years. One area of such growth has been research on TGD people's sexuality. Sexuality can include sexual behaviors, sexual attraction, and sexual identity, among other domains. Historically, sexuality of TGD people was often policed by providers with expectations of heterosexuality or the conflation of sexuality and gender experiences. This resulted in a lag in understanding the lived experiences of TGD people in relation to sexuality. In this review, we examine research that has been conducted over the past 5 years with any measurement of sexuality with TGD participants. The initial search revealed 11,891 articles. After removing duplicates, there were 6,538 articles in the abstract review stage, with 1,669 retained for full text review and 179 retained for extraction. Most studies included majority white samples, and about half were conducted solely in the United States. Most studies measured a single dimension of sexuality, specifically sexual identity, whereas only 2.2% asked about all three dimensions of identity, behavior, and attraction. Of those that inquired about sexual identity, most samples were majority sexual minorities. Many studies had issues related to inclusivity, such as the language used in response options or questions. These findings are placed within the context of the revised 2021 guidelines for practice with sexual minorities and emphasize the importance of diversifying our field's understandings and assessments of sexuality for TGD people. Public Significance StatementThis review of the last 5 years of research with transgender and gender diverse people reveals that sexuality has been measured inconsistently for TGD people and little research has evaluated multiple dimensions of sexuality. Clinicians and researchers must reevaluate how they measure or assess sexuality to better consider the experiences of transgender and gender diverse people.

Measurement of sexuality for trans and gender diverse populations: Application of the 2021 APA Guidelines for Psychological Practice with Sexual Minority Persons.

“…The academic literature has indeed expanded our knowledge about TGD individuals and the nuances of their experiences. Puckett and colleagues (2021) acknowledge the diversity and complexity of sexuality of TGD individuals in a manner that clearly aligns with the new Guideline #4 (APA, 2021). Both emphasize that all sexual minority identities are normal variations of human sexuality (APA, 2009a, 2009b).…”

“…Puckett and colleagues’ (2021) article, “A Systemic Review of Sexuality Measurement in Transgender and Gender Diverse Populations,” offers a timely update, highlighting ongoing concerns in the extant literature such as major racial discrepancies and a United States-centric approach. The authors’ systemic review uses a nuanced framework of sexuality, highlighting three dimensions (i.e., sexual identity, attraction, behavior) that are often overlooked or oversimplified in both research and clinical settings.…”

“…A foundational principle of the updated Guidelines (APA, 2021) is that sexuality and sexual orientation are related, but distinct, from gender identity and/or expression, with Guideline #2 emphasizing that transgender and gender diverse (TGD) individuals may or may not also be sexual minority persons. Puckett and colleagues’ (2021) review focuses specifically on the measurement of sexuality among TGD individuals, highlighting the problematic tendency to assume the sexuality of TGD individuals and/or to conflate sexual orientation and gender identity. Additionally, Guideline #16 emphasizes the importance of affirming research practices when addressing topics of sexuality, an approach echoed by Puckett et al (2021) with regard to the TGD community.…”

“…Puckett and colleagues’ (2021) review focuses specifically on the measurement of sexuality among TGD individuals, highlighting the problematic tendency to assume the sexuality of TGD individuals and/or to conflate sexual orientation and gender identity. Additionally, Guideline #16 emphasizes the importance of affirming research practices when addressing topics of sexuality, an approach echoed by Puckett et al (2021) with regard to the TGD community. Notably, the National Institutes of Health (NIH, 2016, 2019) has recognized sexual and gender minority individuals as a health disparity population.…”

“…Academic research has sorely lagged with regard to sexual health, gender health, and the intersections between sexuality, gender, and other facets of identity. Puckett and colleagues (2021) discuss a number of barriers to research that prevent better understanding of the sexuality of TGD people. Importantly, however, TGD individuals have been attempting to fill this gap in knowledge for many years.…”