Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors

Derrick D. Matthews · John R. Blosnich · Grant W. Farmer · Brian Adams

95 citations0/0 files storedLGBT Health

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LGBTQ Health, Identity, and Policy Adolescent Sexual and Reproductive Health Gender, Sexuality, and Education

Abstract

PURPOSE: Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. METHODS: Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. RESULTS: Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as "not sure" also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors. CONCLUSION: Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations.

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References

2012The Health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding 2008A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people 2011Suicidality and Depression Disparities Between Sexual Minority and Heterosexual Youth: A Meta-Analytic Review 2008Sexual orientation and adolescent substance use: a meta‐analysis and methodological review*1989The Formation of Homosexual Identities 2010A Population-Based Study of Sexual Orientation Identity and Gender Differences in Adult Health 2009Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States 2005The Trouble With “MSM” and “WSW”: Erasure of the Sexual-Minority Person in Public Health Discourse

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2016Scrutinizing Immutability: Research on Sexual Orientation and U.S. Legal Advocacy for Sexual Minorities 2018Association of Religiosity With Sexual Minority Suicide Ideation and Attempt 2016Sexual orientation trends and disparities in school bullying and violence-related experiences, 1999–2013.2017Substance Use among Sexual Minorities: Has it Actually Gotten Better?

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