PROJECT SUMMARY Here we request funds to continue work to pursue the following augmented aims that expand the original scope of the ABCD study: · Address important questions about the possible roles of gender identity, sexual identity, and sexual health in modifying important health, mental health, and other outcomes measured in ABCD. · Enhance the capacity within ABCD to answer important questions about sexual health in adolescents, particularly about normative trajectories of gender and sexuality. To accomplish these new aims, the ABCD consortium must make modifications to the design of the study, adding, and sometimes developing, new methods for measuring, in a developmentally sensitive and developmentally informed manner, the gender identity, sexual identity, and sexual health of participants in the ABCD study. Other modifications of the assessments across multiple domains are needed to ensure that the study can adequately assess risks that may be increased in sexual and gender minority teens in the ABCD study; risks that may contribute to health disparities previously reported in this group of youth. Since receiving supplemental funding for this project, a new Gender Identity and Sexual Health (GISH) workgroup was established, with membership from the ABCD investigator group, NIH, and CDC. As such this workgroup functions like other expert workgroups in ABCD with responsibility for a specific set of interactions with the CC, DAIRC, and other advisory and oversight groups within and external to the consortium. In the proposal, we describe the CC-DAIRC-workgroup interactions required to generate, evaluate, integrate, monitor, update, interpret, and share all data collected within the ABCD Study. Continued funding is needed to continue revising gender assessments in ABCD, ensuring youth acceptance and validity of proposed revisions, and to offset additional costs to the centers and sites of expanding their assessment processes to include this set of protocol elements within the current ABCD study design. As described above, the GISH workgroup relies on integrated support from both the CC and the DAIRC to accomplish these aims. This year funding to provide additional training to site personnel for administration of the more recent additions to the GISH protocol, arranged by the GISH workgroup, will also be expended, to address requests for augmented training from site personnel and PIs.