# An Experimental Evaluation of How Survey Measurement of Sexual Identity Affects Population Estimates of Identity-Based Differences in the Prevalence of Adverse Health Outcomes

> **NIH NIH R03** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $79,950

## Abstract

ABSTRACT
 A large body of research has presented evidence of significant differences among subgroups of individuals
defined by sexual identity in terms of the prevalence of adverse health outcomes, where subgroups of
individuals who identify as sexual minorities (e.g., lesbian, gay, bisexual) have been shown to be at higher risk
of substance use disorders, mental health disorders, suicidality, discrimination, and risky sexual behaviors.
This research has led to the implementation of public health policies designed to understand and reduce these
differences at the local, state and national levels. The majority of this research has utilized secondary analyses
of large national survey data sets that collect measures of both sexual identity and the various health
behaviors, so the validity of the estimated differences reported in these studies therefore relies heavily on high-
quality measurement of the construct of sexual identity. Despite a large amount of recent qualitative work on
methods for improving this measurement, much of our existing knowledge about these differences is based on
surveys that collected relatively simple closed-ended measures of this construct. This practice introduces a risk
of survey respondents being misclassified in terms of their sexual identity, especially if respondents do not
perceive that the small number of sexual identity options provided apply to them. This misclassification will
ultimately attenuate population estimates of the associations between sexual identity and health outcomes,
potentially understating differences or providing misleading estimates of the directions of the differences. The
proposed PI and co-I recently published a demonstration of this significant problem at the national level in a
preliminary study using novel experimental data from the NICHD-funded National Survey of Family Growth
(NSFG).
 This proposed secondary analysis project aims to build on this preliminary work, consistent with the
purpose and scope of Notice of Special Interest NOT-HD-20-022. By conducting secondary analyses of data
collected from five years of the NSFG (2015-2019), where two large national half-samples were randomly
assigned to receive different versions of a question about sexual identity, and also conducting parallel analyses
of identical data from the National Survey of Drug Use and Health (2015-2019) for replication purposes, this
project will evaluate the possibility of attenuation in estimates of the differences between sexual identity
subgroups in the distributions of additional health outcomes of interest to NICHD, and extend the study of the
attenuation problem to socio-demographic subgroups and the potential moderation of these differences by
state-level policies related to the protection of sexual minorities. Results from the proposed work will inform
existing policies and motivate future experimental research further evaluating improved tools for the
measurement of sexual identity in national surveys.

## Key facts

- **NIH application ID:** 10526008
- **Project number:** 1R03HD107236-01A1
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Brady T West
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $79,950
- **Award type:** 1
- **Project period:** 2022-09-20 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10526008

## Citation

> US National Institutes of Health, RePORTER application 10526008, An Experimental Evaluation of How Survey Measurement of Sexual Identity Affects Population Estimates of Identity-Based Differences in the Prevalence of Adverse Health Outcomes (1R03HD107236-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10526008. Licensed CC0.

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