Measuring Sexual Identity Using Survey Questionnaires: How Valid Are Our Measures?

We used National Health and Nutrition Examination Survey data to examine insurance status, source of routine care, cigarette and alcohol use, and self-rated health among lesbian, bisexual, and heterosexual women who have sex with women (WSW), compared to heterosexual women who do not have sex with women. We found higher risks of being uninsured among lesbian and bisexual women, worse self-rated health among bisexual women, higher alcohol use among bisexual and heterosexual WSW, and higher smoking across all subgroups.

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“…It is unclear, however, whether this resulted in any significant misidentification of women’s sexual identity. 28,29 …”

Section: Discussionmentioning

confidence: 99%

Health and Health Risks Among Sexual Minority Women: An Examination of 3 Subgroups

et al. 2014

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“…Some argue that survey respondents fail to respond to sexual orientation questions not because the questions are too “sensitive,” but because they have rarely thought about or do not understand sexual orientation identity (Miller & Ryan, 2011; Ridolfo et al, 2012). Our findings suggest that there has been significant societal change and only a very small number of respondents do not understand sexual orientation measures.…”

Section: Discussionmentioning

confidence: 99%

“…While the inclusion of sexual orientation measures in public health surveys has provided evidence that young and middle-aged adults respond to sexual orientation questions (Ridolfo, Miller, & Maitland, 2012; VanKim, Padilla, Lee, & Goldstein, 2010), to what extent older adults respond to these questions is not yet known.…”

Section: Introductionmentioning

confidence: 99%

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Fredriksen-Goldsen

Kim

2014

Res Aging

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Health disparities exist among sexual minority older adults. Yet, health and aging surveys rarely include sexual orientation measures and when they do, they often exclude older adults from being asked about sexual orientation. This is the first population-based study to assess item nonresponse to sexual orientation measures by age and change over time. We compare response rates and examine time trends in response patterns using adjusted logistic regressions. Among adults aged 65 and older, the nonresponse rate on sexual orientation is lower than income. While older adults show higher nonresponse rates on sexual orientation than younger adults, the nonresponse rates have significantly decreased over time. By 2010, only 1.23% of older adults responded don’t know/not sure, with 1.55% refusing to answer sexual orientation questions. Decisions to not ask sexual orientation among older adults must be reconsidered, given documented health disparities and rapidly changing social trends in the understanding of diverse sexualities.

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“…Miller and Ryan (2011). Consequently, individuals' sexual identities do not necessarily conform to discrete, objective, and uniformly-defined categories. Additionally, as previous QDRL study of sexual identity questions revealed, the construct, itself, can differ substantially across various sexuality subgroups (Ridolfo, Miller, & Maitland, 2012). While the concept of 'sexual identity' holds a particularly distinct and salient meaning for those identifying as lesbian, gay, bisexual, or transgender, many non-minority respondents do not hold salient sexual identities.…”

Section: Background Construct Definition Question Design and Questimentioning

confidence: 94%

On the Design, Development, and Testing of Sexual Identity Questions: A Discussion and Analysis of Kristen Miller and J. Michael Ryan's Work for the National Health Interview Survey

Weinrich

2014

Journal of Bisexuality

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A remarkable article by Kristen Miller and J. Michael Ryan, working at the Centers for Disease Control and Prevention, deserves wider attention. They developed two sexual identity-related questions for the (U.S.) National Health Interview Survey: one pertaining to gender identity and one to sexual orientation. They conducted 386 indepth cognitive interviews and concluded that there are substantial problems with existing sexual identity questions. Words such as 'heterosexual' and 'bisexual' are often grossly misunderstood (especially by those with less education), triggering substantial measurement errors. Revised questions substantially reduced missingvalue responses and increased validity, even though responses used phrases such as 'straight, that is, not gay' and avoided the words 'heterosexual' and 'homosexual.' Spanish translation was neither straightforward nor intuitive. These questions should generate improved estimates of the lesbian, gay, and bisexual population and raise important issues that must be considered by anyone designing sexual orientation questions in the future.

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Measuring Sexual Identity Using Survey Questionnaires: How Valid Are Our Measures?

Cited by 59 publications

References 22 publications

Health and Health Risks Among Sexual Minority Women: An Examination of 3 Subgroups

Health and Health Risks Among Sexual Minority Women: An Examination of 3 Subgroups

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On the Design, Development, and Testing of Sexual Identity Questions: A Discussion and Analysis of Kristen Miller and J. Michael Ryan's Work for the National Health Interview Survey

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