Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Psychiatry, University of Rochester, Rochester, New York ; VISN-2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York.
LGBT Health. 2014 Mar;1(1):42-9. doi: 10.1089/lgbt.2013.0002.
Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors.
Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior.
Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as "not sure" also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors.
Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations.
关注女同性恋、男同性恋和双性恋（LGB）群体的健康问题，需要对调查中的性取向测量方法进行谨慎考虑。然而，操作这些变量也需要大量的思考。本研究旨在通过研究健康风险行为的差异，记录性取向的不同操作定义所带来的后果。
本研究使用马萨诸塞州青年风险行为调查数据，考察了性行为和性认同的不同操作性定义如何影响三种已知对 LGB 群体有不同影响的健康风险行为：吸烟、自杀风险和冰毒使用。还同时考察了性行为和性认同，以探索它们是否能捕捉到行为中独特的可变性来源。
由于使用性行为或性认同的不同，健康差异的估计值发生了变化。报告性认同为“不确定”的青年也有更高的健康风险行为的几率。将双性恋认同和行为与同性认同和行为分开，经常会导致本应归因于完全的同性性少数群体的健康差异的减弱或消除。最后，性行为和性认同解释了所有三种健康行为中独特且显著的可变性来源。
即使分析的是相同的数据，使用不同的性取向操作定义的研究人员也可能得出不同的结论，这取决于他们在分析中选择如何表示性取向。我们讨论了这些操作对数据解释的影响，并为从青少年群体中收集性取向数据的最佳实践提供了具体建议。
