Measuring Sex, Gender, and Sexual Orientation in National Disease Surveillance Systems: A Pilot Study

ABSTRACT

The study sought to determine participants’ preferred methods for self-reporting biological sex, gender identity, and sexual orientation in national surveillance studies. An online, cross-sectional survey was conducted with n = 255 adults, 18 years old or older and currently living in the US. After completing a series of questions and question sets related to biological sex, gender identity, and sexual orientation, participants were asked which question or question set they preferred to use to identify their identifying characteristic. Two “no preference options,” one stating that all the questions were good and another stating that all the questions were bad, were included as response options. A majority (53.8%) preferred “What sex were you at birth?” to identify their biological sex. A plurality (42.3%) preferred “Are you male, female, or transgender?” to identify their gender identify. For sexual orientation, there were no clear question preferences. Biological sex question preference significantly differed by age (p = .001) and political affiliation (p = .01). Gender identity question preference significantly differed by marital status (p = .006) and political affiliation (p = .005). The results suggest there may be disagreement in question preference in self-reporting biological sex, gender identity, and sexual orientation in surveillance systems. More research is needed.

Conflicts of Interest

The authors declare they have no conflicts of interest.

Additional information

Funding

Dr. Noel was supported by a Faculty Research Grant provided by Johnson & Wales University. Dr. Lutz was supported in part, by funding from the U.S. Department of Health and Human Services, Administration for Community Living (#90DDUC0071). The opinions expressed, however, are those of the authors and do not necessarily reflect the official position of the Department.