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 this, the ABCD consortium has made 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. Ongoing evaluation of the study assessments across multiple domains are needed to ensure that the study adequately captures risks that may be increased in sexual and gender minority participants. The supplemental funding has established the Gender Identity and Sexual Health (GISH) workgroup with membership from the ABCD investigator group, NIH, and CDC. 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, an d share all data collected within the ABCD Study. Continued funding is needed for ongoing protocol revision to improve measurement of gender and sexuality in ABCD, ensuring the validity and youth acceptance of proposed protocol revisions, and to offset costs to the centers and sites of including these assessments within the current ABCD study design. This year’s funding includes an equity audit (detailed in the research plan), where contract SGM scholars from NORC at the University of Chicago, will work with the GISH workgroup to review the ABCD protocol, gather information from ABCD stakeholders, and prepare a report informing the consortium of protocol areas that have the potential to be experienced differently by sexual and gender minority participants. This work is intended to inform future qualitative data collection (focus-groups) from non-ABCD adolescents (oversampling SGM adolescents) on the GISH measures and other identified protocol elements to improve data collection methods.