# Project Recognize: Improving Measurement of Alcohol Use and Other Disparities by Sex, Sexual Orientation, and Gender Identity through Community Engagement

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2021 · $718,321

## Abstract

PROJECT SUMMARY
Researchers and health practitioners use data from federal health surveys, electronic health records (EHRs),
and research studies to monitor the health of sexual and gender minority (SGM) populations. Compared to
non-SGM populations, SGM populations are disproportionately affected by poor health, including disparities in
alcohol use, substance use, and mental illness. Substantial prior work has supported the minority stress
framework to contextualize SGM health disparities; stressors related to discrimination and victimization tied to
SGM status are strongly associated with disparities. The ability to accurately identify such disparities and
potential causal pathways is vital to ensure that public health and health care research, policy, and practice are
appropriately equipped to address the health needs of marginalized populations such as SGM individuals. This
is particularly true in the case of alcohol, which remains one of the most commonly used and abused drugs
nationwide, particularly among both adolescent and adult SGM. However, measurement of demographic
characteristics associated with SGM identity and stigmatization – e.g., sex, sexual orientation, and gender
identity (SSOGI) – remains poorly defined and inconsistently used across health research and practice
settings. For example, despite evident limitations, most studies, providers, and national surveys continue to
use a binary framework (male vs. female) to assess sex assigned at birth. This approach fails to capture a
substantial population of intersex individuals (estimated prevalence of 1-2 per 1,000 live births). Further, most
surveys continue to use the non-recommended practice of conflating sex and gender identity by asking about
only one of these constructs, thereby failing to appropriately identify or characterize transgender, non-binary,
and gender nonconforming individuals. While a growing number of surveys ask about sexual orientation, they
frequently do not account for its multidimensional nature: many items conflate identity (e.g., gay, bisexual), with
behavior (e.g., sex with only same-sex partners) and attraction (e.g., only attracted to male-presenting
individuals). This is especially concerning as research has shown that a substantial number of individuals
would only be classified as a sexual minority based on one category, but not another (e.g., a person who
identifies as heterosexual but has sex with same-sex partners). Furthermore, current measures often are not
comprehensive, exclude understudied or emerging orientations (e.g., asexual, pansexual, queer), lack the
ability to select multiple options, and fail to account for changes in identity over time. Without comprehensive,
validated measures to assess SSOGI, the ability to understand the magnitude of SGM disparities or how best
to intervene to promote SGM health equity is limited. Therefore, it is vital to develop standardized, flexible
measures for use across diverse demographics and regions. Th...

## Key facts

- **NIH application ID:** 10177415
- **Project number:** 1R01AA029076-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Lauren Brittany Beach
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $718,321
- **Award type:** 1
- **Project period:** 2021-09-21 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10177415

## Citation

> US National Institutes of Health, RePORTER application 10177415, Project Recognize: Improving Measurement of Alcohol Use and Other Disparities by Sex, Sexual Orientation, and Gender Identity through Community Engagement (1R01AA029076-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10177415. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*