Using Ancillary Sociodemographic Data to Identify Sexual Minority Adults Among Those Responding “Something Else” or “Don’t Know” to Sexual Orientation Questions

Abstract

Background: General population surveys are increasingly offering broader response options for questions on sexual orientation—for example, not only gay or lesbian, but also “something else” (SE) and “don’t know” (DK). However, these additional response options are potentially confusing for those who may not know what the terms mean. Researchers studying sexual orientation-based disparities face difficult methodological trade-offs regarding how best to classify respondents identifying with the SE and DK categories. Objectives: Develop respondent-level probabilities of sexual minority orientation without excluding or misclassifying the potentially ambiguous SE and DK responses. Compare 3 increasingly inclusive analytic approaches for estimating health disparities using a single item: (a) omitting SE and DK respondents; (b) classifying SE as sexual minority and omitting DK; and (c) a new approach classifying only SE and DK respondents with >50% predicted probabilities of being sexual minorities as sexual minority. Materials and Methods: We used the sociodemographic information and follow-up questions for SE and DK respondents in the 2013–2014 National Health Interview Survey to generate predicted probabilities of identifying as a sexual minority adult. Results: About 94% of the 144 SE respondents and 20% of the 310 DK respondents were predicted to identify as a sexual minority adult, with higher probabilities for younger, wealthier, non-Hispanic white, and urban-dwelling respondents. Using a more specific definition of sexual minority orientation improved the precision of health and health care disparity estimates. Conclusions: Predicted probabilities of sexual minority orientation may be used in this and other surveys to improve representation and categorization of those who identify as a sexual minority adult.

Chronic pain among U.S. sexual minority adults who identify as gay, lesbian, bisexual, or “something else”

“…The NHIS is a large nationally representative cross-sectional health survey, conducted by U.S. Census Bureau on behalf of the National Center for Health Statistics (NCHS). 57 The NHIS is considered a “gold-standard” 18 survey for its quality and sample size; it is the primary source of information on the U.S. noninstitutionalized civilian population. The survey uses a complex multistage area probability household sample design and oversamples respondents from understudied population groups including Black and Hispanic adults.…”

Relying on an “Other” Category Leads to Significant Misclassification of Sexual Minority Participants

“…4,5 Using an ''Other'' category to capture additional identities could address this, but ''Other'' labels can be stigmatizing. 3,6,7 Moreover, offering an ''Other'' option is only helpful if people choose this label when their preferred identity is not present. However, there is evidence that some sexual minority individuals, particularly ''mostly heterosexual'' people, may instead choose the closest label available, potentially contributing to misleading findings.…”

Re-considering Re-partnering: New Insights about Gender and Sexuality in the Study of Second Union Formation

“…We use the last reported sexual identity 4 and restrict the analysis to three mutually exclusive groups: bisexual, gay/lesbian, and heterosexual/straight. We exclude the categories Other or Prefer not to Say because evidence suggests that these categories include large shares of heterosexuals (Elliott et al 2019). We distinguish between women and men based on the question: "And you are male/female?"…”