Pho Anthony T, Bates Nancy, Snow Ava, Zhang Adary, Logan Rachel, Dastur Zubin, Lubensky Micah E, Flentje Annesa, Lunn Mitchell R, Obedin-Maliver Juno
The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, USA.
Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
SSM Qual Res Health. 2023 Dec;4. doi: 10.1016/j.ssmqr.2023.100344. Epub 2023 Sep 29.
Questions assessing sexual orientation and gender identity (SOGI) are not consistently asked on U.S.-based health surveys and, as a result, sexual and gender minority (SGM) people are often invisible, obscuring insight into their health. The purpose of this study was to explore how people across different sexual orientations and genders preferred to be asked about SOGI on U.S.-based health surveys. Using in-depth cognitive interviews with 14 non-SGM (cisgender heterosexual men and women) and 30 SGM participants (cisgender sexual minority people as well as transgender and gender diverse people of any sexual orientation), we identified four major themes relating to SOGI disclosure: (1) purpose for asking, (2) context of information collection, (3) distrust of the government, and (4) fear. While many participants were open to disclosing SOGI information on a federal health survey, non-SGM and SGM participants questioned the survey's purpose and expressed governmental distrust. However, unlike non-SGM participants, SGM participants indicated that they might change their answers depending on the survey context. SGM participants indicated they would be more willing to disclose SOGI information in a personal medical context or for a local community survey rather than a federal health survey. Further, unlike non-SGM participants, SGM participants expressed fear for their safety when disclosing SOGI information. Our study suggests that concerns regarding SOGI disclosure and what is disclosed differ between non-SGM and SGM people. Some SGM people may change their answers or not respond to SOGI questions depending on context and perceived safety. These findings have health and research implications as efforts are made to enhance understanding of SGM health and the health needs of SGM people by augmenting the use of SOGI questions.
在美国进行的健康调查中，关于性取向和性别认同（SOGI）的问题询问并不一致，因此，性与性别少数群体（SGM）常常被忽视，这使得对他们健康状况的了解变得模糊。本研究的目的是探讨不同性取向和性别的人群在美国健康调查中更倾向于如何被询问关于SOGI的问题。通过对14名非SGM（顺性别异性恋男性和女性）和30名SGM参与者（顺性别性少数群体以及任何性取向的跨性别和性别多样化人群）进行深入的认知访谈，我们确定了与SOGI披露相关的四个主要主题：（1）询问目的，（2）信息收集背景，（3）对政府的不信任，以及（4）恐惧。虽然许多参与者愿意在联邦健康调查中披露SOGI信息，但非SGM和SGM参与者对调查目的提出质疑，并表达了对政府的不信任。然而，与非SGM参与者不同，SGM参与者表示他们可能会根据调查背景改变答案。SGM参与者表示，他们更愿意在个人医疗背景下或为当地社区调查披露SOGI信息，而不是在联邦健康调查中。此外，与非SGM参与者不同，SGM参与者在披露SOGI信息时表达了对自身安全的担忧。我们的研究表明，非SGM和SGM人群在SOGI披露及披露内容方面的担忧存在差异。一些SGM人群可能会根据背景和感知到的安全性改变答案或不回答SOGI问题。这些发现对健康和研究具有启示意义，因为人们正在努力通过增加对SOGI问题的使用来加强对SGM健康状况和SGM人群健康需求的理解。
