When Sexual Identity and Sexual Behaviors Do Not Align: The Prevalence of Discordance and its Physical and Psychological Health Correlates.

Although scholarly work on the complexity of human sexuality has increasingly been a focus of scholarship, comparatively little research has focused on the phenomenon of mismatch, or discordance, between different aspects of sexuality. This study used secondary data of sexually active adults (N=116,950) from a statewide representative survey which included both a measure of sexual identity (i.e., identifying as "heterosexual", "bisexual", etc.) and a measure of sexual behaviors (i.e., indicating the sex of your sexual partners). Using these data, we examined the prevalence and correlates of sexual identity-behavior discordance (IBD), and also included data from bisexual-identified individuals. In support of our hypotheses, we found that sexual IBD was particularly prevalent among young-adult women. However, we did not find sex differences in the prevalence of IBD overall. Furthermore, individuals who were categorized as IBD also tended to report poorer physical health and psychological functioning than both heterosexual- and gay/lesbian-identified concordant individuals, as well as more negative behaviors typically associated with poor psychological functioning (i.e., binge drinking and suicidal ideation.) Our findings highlight the need for more sensitive instruments and measures assessing sexual orientation in both research and practice, as well as the need for continued study into the area of discordance, and particularly across other dimensions of sexuality (e.g., attraction).