Measuring sexual orientation in adolescent health surveys: Evaluation of eight school-based surveys

doi:10.1016/j.jadohealth.2004.06.002

Journal of Adolescent Health

Volume 35, Issue 4, October 2004, Pages 345.e1-345.e15

https://doi.org/10.1016/j.jadohealth.2004.06.002 Get rights and content

Purpose

To examine the performance of various items measuring sexual orientation within 8 school-based adolescent health surveys in the United States and Canada from 1986 through 1999.

Methods

Analyses examined nonresponse and unsure responses to sexual orientation items compared with other survey items, demographic differences in responses, tests for response set bias, and congruence of responses to multiple orientation items; analytical methods included frequencies, contingency tables with Chi-square, and ANOVA with least significant differences (LSD)post hoc tests; all analyses were conducted separately by gender.

Results

In all surveys, nonresponse rates for orientation questions were similar to other sexual questions, but not higher; younger students, immigrants, and students with learning disabilities were more likely to skip items or select “unsure.” Sexual behavior items had the lowest nonresponse, but fewer than half of all students reported sexual behavior, limiting its usefulness for indicating orientation. Item placement in the survey, wording, and response set bias all appeared to influence nonresponse and unsure rates.

Conclusions

Specific recommendations include standardizing wording across future surveys, and pilot testing items with diverse ages and ethnic groups of teens before use. All three dimensions of orientation should be assessed where possible; when limited to single items, sexual attraction may be the best choice. Specific wording suggestions are offered for future surveys.

Section snippets

The surveys

The eight surveys included in this analysis are school-based surveys of adolescent health and risk behaviors, from the United States and Canada. They were conducted from 1986 through 1999; we included older surveys because they had more than one measure of orientation, or represented the largest survey of a particular ethnic group to date, i.e., the National American Indian Adolescent Health Survey. Some surveyed different cohorts of youth in the same geographic region. For regularly

Evaluation

Table 3 shows the nonresponse and “not sure” response rates for the sexual orientation measures within each of the surveys. These formed the basis of many analyses used to evaluate the measures. Because rates vary significantly by gender in all the surveys, results are reported separately for boys and girls. The evaluations of response rates by other demographic characteristics were not amenable to presentation in a single table, given extreme variation in items in the various surveys, so we

Discussion

One of the developmental tasks of adolescence is establishing a sexual identity, including orientation, a process that appears to begin in late childhood and continues through the teen years. Because this is a developmental process, at any one point during adolescence the number of teens who actually identify as gay, lesbian, or bisexual tends to be small, between 1% and 8% 23, 35. Six of the eight surveys we examined included a measure that used orientation labels, and although those labels

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Citation Excerpt :
The response could capture individuals who are unsure of their sexual identity or who do not fully understand the concept of sexual identity. However, being unsure of sexual identity for adolescents at this age is common (Saewyc et al., 2004). Fourth, the sample size issues prevent us from examining the intersection between sex and race/ethnicity.
The literature on tobacco advertising among sexual minorities is relatively scarce. This study examined the association between exposure to tobacco products and e-cigarettes advertisements and sexual identity.
Data were from the 2020 National Youth Tobacco Survey (n = 7223). The prevalence of exposure to tobacco marketing through various channels was estimated among high school students and by sexual identity subgroups. Multivariable logistic regressions were used to examine the association between sexual identity status and exposure to tobacco and e-cigarette advertisements.
The proportion of sexual minority adolescents who reported exposure to tobacco and e-cigarette advertisements was higher than heterosexuals. In multivariable analysis, gay or lesbian youth (aOR 1.45, 95% CI, 1.04–2.02) had higher odds of any exposure to tobacco and e-cigarette advertisement than heterosexuals. Regarding the channel of advertisement exposure, sexual minorities were more likely to be exposed via newspapers/magazines for cigarettes or other tobacco products. Likewise, gay or lesbian youth and those not sure about their sexual identity had higher odds of exposure via newspapers/magazines for e-cigarettes. Analysis stratified by sex showed significant differences, with gay or lesbian males more likely to be exposed to any tobacco and e-cigarette advertisements via the internet, newspapers/magazines, and TV/streaming services. Males not sure about their sexual identity are more likely to be exposed to tobacco and e-cigarette advertisements via newspapers/magazines.
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Original articleMeasuring sexual orientation in adolescent health surveys: Evaluation of eight school-based surveys

Purpose

Methods

Results

Conclusions

Section snippets

The surveys

Evaluation

Discussion

Pediatrics

Aust N Z J Public Health

J Adolesc Health

J Adolesc

Healthy People 2010

Sexual orientation data collection and progress toward Healthy People 2010

Am J Public Health

The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths

Dev Psychol

Voice of Connecticut Youth: Report of the Statewide Adolescent Health Survey

Demographics of sexual orientation among American Indian adolescents

Am J Orthopsychiatry

HIV risk among homosexual, bisexual, and heterosexual male and female youths

Arch Sex Behav

Sexual intercourse, abuse and pregnancy among adolescents: Does sexual orientation make a difference?

Fam Plann Perspect

Same-sex romantic attraction and experiences of violence in adolescence

Am J Public Health

Associations between health risk behaviors and opposite-, same-, and both-sex sexual partners in representative samples of Vermont and Massachusetts high school students

Arch Pediatr Adolesc Med

Adolescent suicide attempts: Risks and protectors

Pediatrics

Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population

Am J Epidemiol

Lesbian, gay, and bisexual youth and their families: Disclosure of sexual orientation and its consequences

Am J Orthopsychiatry

Original article
Measuring sexual orientation in adolescent health surveys: Evaluation of eight school-based surveys