Development of an affirming and customizable electronic survey of sexual and reproductive health experiences for transgender and gender nonbinary people

Abstract

To address pervasive measurement biases in sexual and reproductive health (SRH) research, our interdisciplinary team created an affirming, customizable electronic survey to measure experiences with contraceptive use, pregnancy, and abortion for transgender and gender nonbinary people assigned female or intersex at birth and cisgender sexual minority women. Between May 2018 and April 2019, we developed a questionnaire with 328 items across 10 domains including gender identity; language used for sexual and reproductive anatomy and events; gender affirmation process history; sexual orientation and sexual activity; contraceptive use and preferences; pregnancy history and desires; abortion history and preferences; priorities for sexual and reproductive health care; family building experiences; and sociodemographic characteristics. Recognizing that the words people use for their sexual and reproductive anatomy can vary, we programmed the survey to allow participants to input the words they use to describe their bodies, and then used those customized words to replace traditional medical terms throughout the survey. This process-oriented paper aims to describe the rationale for and collaborative development of an affirming, customizable survey of the SRH needs and experiences of sexual and gender minorities, and to

An undergraduate medical curriculum framework for providing care to transgender and gender diverse patients: A modified Delphi study

“…Although TGD was not a term used by the LGBTQ+ community, it is more commonly used in academic and medical literature. The term Gender Diverse may also be in flux given the use of Gender Expansive in some newer publications [ 31 ].…”

From ‘Shark-Week’ to ‘Mangina’: An Analysis of Words Used by People of Marginalized Sexual Orientations and/or Gender Identities to Replace Common Sexual and Reproductive Health Terms

“…The full text of this survey and associated methodology has been published elsewhere. 12 Cisnormative and heteronormative language have been a source of great discrimination, erasure, and oppression for SGM people, contributing to health disparities in SRH. We offer these findings in the hope that others will adopt and adapt these methods to create more inclusive and individualized clinical and research experiences, which place greater autonomy in the hands of patients and research participants.…”

“…Recruitment materials invited interested individuals to participate in an online quantitative survey covering a broad range of SRH topics. 12 …”

“… 11 One approach to avoiding these issues is for researchers and clinicians to elicit person-centered language from individuals, potentially allowing for greater inclusivity and precision in research and clinical care. 12 To explore this understudied topic, we set out to measure SRH-related word-use among SGM individuals. Specifically, we aimed to ascertain how many study participants use standard SRH-related medical terms versus their own words, and what those words are through a novel, online questionnaire.…”

Beyond the Binary: Sexual and Reproductive Health Considerations for Transgender and Gender Expansive Adolescents

“…(1) sexual and gender questions did not allow for identity fluidity and complexity, reducing inclusion and representation; and (2) question stems and answer choices were often not clear as to whether gender identity or sexual orientation were being assessed (100). Measurement error from imprecise survey questions impose biases.…”