The Utility of the Two-Step Gender Measure Within Trans and Cis Populations.

It has been acknowledged that more research into the health and well-being of trans people is needed in order to identify important health issues. While recent studies have suggested using a two-question gender status measure to assess assigned sex at birth and gender identity, it is not well understood how participants understand and subsequently answer the questions. The study recruited a convenience sample of 50 people (25 trans and 25 cis) from the general population of Cleveland and Akron, OH. The study used cognitive interviewing methods with scripted, semi-structured and spontaneous probes when appropriate. Participants were asked to read questions out-loud, answer the questions, and explain why they answered the way they did. Interviews were audio recorded and transcribed prior to analysis. The gender status questions were found to be easy to use and understood by both trans and cis participants. The two-question gender status measure was able to encompass a diversity of identities within a trans sample and be consistently answered by the study's cis participants. The measures were able to differentiate between trans and cis groups. The two-step gender measure can be a useful tool in examining gender diversity within general population studies.