Noah C Riley1, John R Blosnich1, Todd M Bear1, Sari L Reisner1. 1. At the time of the study, Noah C. Riley was with the Department of Health Promotion, Carnegie Mellon University, Pittsburgh, PA. John R. Blosnich was with the Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, and US Department of Veterans Affairs, Center for Health Equity Research and Prevention, VA Pittsburgh Healthcare System, Pittsburgh. Todd M. Bear was with The Evaluation Institute for Public Health, Graduate School of Public Health, University of Pittsburgh. Sari L. Reisner was with the Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, and the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
Abstract
OBJECTIVES: To characterize the conflict of sex and gender identity variables in the 2014 Behavioral Risk Factor Surveillance System (BRFSS) sample and examine how this may affect the administration of sex-related health behavior items to transgender participants. METHODS: We conducted a secondary analysis of the 2014 BRFSS gender identity, sex, and sex-related health behavior variables. Twenty states administered the gender-identity variables (n = 154 062), and 691 respondents identified as transgender in the survey (0.4%). We examined conflict among sex, gender identity, and gender-related variables, and compared conflicting and nonconflicting groups across 4 sociodemographic characteristics. RESULTS: Nearly one third of respondents (27.8%; n = 171) who identified as transgender received sex-specific items that conflicted with their natal sex, thereby reducing the already small subsample of valid responses. There were no significant differences between conflicting and nonconflicting groups on the basis of region, age, race/ethnicity, or type of interview. CONCLUSIONS: Public health surveys should ask respondents to self-identify their sex and gender identity. Interviewer assumptions of respondents' sex may lead to erroneous collection of sex- and gender-based items, inhibit survey administration, and create problems in data quality.
OBJECTIVES: To characterize the conflict of sex and gender identity variables in the 2014 Behavioral Risk Factor Surveillance System (BRFSS) sample and examine how this may affect the administration of sex-related health behavior items to transgender participants. METHODS: We conducted a secondary analysis of the 2014 BRFSS gender identity, sex, and sex-related health behavior variables. Twenty states administered the gender-identity variables (n = 154 062), and 691 respondents identified as transgender in the survey (0.4%). We examined conflict among sex, gender identity, and gender-related variables, and compared conflicting and nonconflicting groups across 4 sociodemographic characteristics. RESULTS: Nearly one third of respondents (27.8%; n = 171) who identified as transgender received sex-specific items that conflicted with their natal sex, thereby reducing the already small subsample of valid responses. There were no significant differences between conflicting and nonconflicting groups on the basis of region, age, race/ethnicity, or type of interview. CONCLUSIONS: Public health surveys should ask respondents to self-identify their sex and gender identity. Interviewer assumptions of respondents' sex may lead to erroneous collection of sex- and gender-based items, inhibit survey administration, and create problems in data quality.
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