Focus Group Data on SOGI
Focus Group on Sexual Orienation and Gender Identity Items_20170105.docx
Behavioral Risk Factor Surveillance System (BRFSS)
Focus Group Data on SOGI
OMB: 0920-1061
Submitted
to: Division
of Population Health National
Center for Chronic Disease Prevention and Health Promotion Centers
for Disease Control and Prevention Submitted
by: 126
College Street, Suite 2 Burlington,
VT 05401
Centers
for Disease Control and Prevention Behavioral Risk Factor
Surveillance System Sexual Orientation and Gender Identity Items:
Results
of Two Focus Group Final
Report
January
5, 2017
Carol
Pierannunzi
ICF
Table of Contents
I. Background 1
II. Study Design and Methodology 2
1. Screening Criteria 2
2. Recruitment 2
3. Participant Demographics 3
4. Focus Group Format 3
III. Analytic Process 4
IV. Summary of Findings 4
1. Overall Findings 4
Question Clarity 4
Response Option Clarity 4
Response Option Adequacy 5
Comfort Level 5
2. Findings for SOGI Items 6
Question 1- Behavioral Risk Factor Surveillance Survey Sexual Orientation Question 6
Question 2- National Health Interview Survey Sexual Orientation Question 7
Question 3- National Survey on Drug Use and Health Sexual Orientation Question 8
Question 4- National Crime Victimization Survey Sexual Orientation Question 8
Comparison of All Four Questions on Sexual Orientation 9
Question 5- Gender Identity in U.S. Surveillance Two Step Questions 9
Question 6- Gender Identity in U.S. Surveillance Current Gender Identity Question 10
Question 7- Gender Identity in U.S. Surveillance Transgender Question 11
Comparison of All Three Questions on Gender Identity 12
Question 8- Gender Identity in U.S. Surveillance LGBT Identity Questions 12
Comparison of Separate Sexual Orientation and Gender Identity Questions with Combined Question 13
Order of Sexual Orientation and Gender Identity Questions 14
V. Conclusions and Recommendations 14
Appendix 1: Semi-Structured Discussion Guide for Focus Group with LGBT Community Members 16
Appendix 2: Semi-Structured Discussion Guide for Focus Group with Straight, Cisgender Community Members 26
The Behavioral Risk Factor Surveillance System (BRFSS) is the nation's premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. The BRFSS collects data in all 50 states as well as the District of Columbia and three U.S. territories (Palau, Guam, and the Virgin Islands) and completes more than 400,000 adult interviews each year, making it the largest continuously conducted health survey system in the world. BRFSS data have led to changes related to individual behaviors, changes in public health practices, and new or revised health policies and statutes. The foundation for these changes can be attributed to the structure of the BRFSS Core and Modules, which has facilitated the tracking of trends in health and disease. The BRFSS is overseen by the Centers for Disease Prevention and Control (CDC), but administered at the state level on behalf of State Health Departments. To ensure that questions and query patterns in the BRFSS instrument are current and valid, BRFSS routinely tests new questions proposed for addition to the BRFSS survey and new methodologies intended to enhance the functioning of the instrument. The Division of Population Health, of the CDC National Center for Chronic Disease Prevention and Health Promotion contracted with ICF in 2015 to conduct cognitive testing of items for various modules within the survey.
As part of this contract, ICF was asked to conduct two focus groups in order to explore how adults interpret and respond to questions about sexual orientation and gender identity (SOGI) in government surveys. One focus group was to include participants who self-identified as members of the lesbian, gay, bisexual, and transgender (LGBT) community, while the second focus group was to include participants who self-identified as members of the straight, cisgender community.
CDC provided ICF with eight specific SOGI items to be discussed during each focus group, including four items that inquired about sexual orientation, three items that inquired about gender identity, and one item that inquired about both. All items had undergone previous cognitive testing. Some items were currently being used in national surveys, while some had been developed and recommended for use in national surveys. SOGI items came from:
Behavioral Risk Factor Surveillance Survey (BRFSS)
National Health Interview Survey (NHIS)
National Survey on Drug Use and Health (NSDUH)
National Crime Victimization Survey (NCVS)
Gender Identity in U.S. Surveillance (GenIUSS) Group
The specific research questions for this work included the following:
How do individuals who self-identify as members of the LGBT community interpret and respond to demographic questions about sexual orientation and gender identity (SOGI) in federally-sponsored surveys?
How do individuals who self-identify as members of the straight, cisgender community interpret and respond to demographic questions about sexual orientation and gender identity (SOGI) in federally-sponsored surveys?
To what extent are demographic questions about sexual orientation and gender identity, and their answer choices, clearly worded so as to make sense to both members of the LGBT community and members of the straight, cisgender community?
Which of a series of possible demographic questions best allows both members of the LGBT community and members of the straight, cisgender community to describe themselves?
How might these questions be reworded or improved?
ICF sought to recruit a mix of individuals for both focus groups, including participants:
In different age ranges (18-40 years old, 41-64 years old, and 65 years of age and older)
From a variety of racial/ethnic backgrounds, including Hispanic/Latino, Caucasian, Black/African American Asian Pacific Islander, and American Indian/Alaska Native;
With differing educational backgrounds, including less than a high school degree, high school graduate, some college or technical school, college graduate, graduate degree, or medical degree;
From a variety of household incomes;
Not part of the same household.
For the focus group with members of the LGBT community, ICF endeavored to include a mix of sexual orientations and gender identities.
For the focus group with members of the straight, cisgender community, ICF used the following recruitment stratification plan:
Table 1. Gender and Age Stratification for Focus Group with Straight, Cisgender
|
18-40 yrs. |
41-64 yrs. |
65 plus |
Total |
Male |
2 |
2 |
1 |
5 |
Female |
2 |
1 |
1 |
4 |
Total |
4 |
3 |
2 |
9 |
Although we did not stratify by race, education, or income we attempted to obtain a mix of respondents based on race/ethnicity, education, and income to the extent possible.
ICF convened the focus group with members of the LGBT community in our Atlanta, GA office, and the focus group with members of the straight, cisgender community in our Rockville, GA office.
For each focus group, ICF developed a Craigslist advertisement to recruit people to the in-person focus group. Craigslist was identified as an approach that would present the least selection bias in terms of education and other factors. The recruitment advertisement briefly described the study intent and directed potential participants to complete an online recruitment screener created using SurveyMonkey. The online screener screened potential participants according to age, sexual orientation, and gender identity, and also gathered key demographics, including race/ethnicity, education, and income. In order to expand the pool and ensure a diverse mix of people participated in each focus group, ICF staff in Atlanta and Rockville shared each Craigslist advertisement within personal networks. Potential participants were screened out if they did not meet the eligibility criteria. Those who met the criteria were contacted about the focus group. All selected participants received an incentive of $75 for participating in the focus group.
Every attempt was made to recruit nine participants for each focus group. However, in each case, several confirmed participants failed to show on the day of the focus group. Thus, each group was conducted with eight participants.
Participants in the focus group with members of the LGBT community included two individuals who self-identified as gay men, two who self-identified as lesbians, one who self-identified as a queer woman, two who self-identified as bisexual women, and one who self-identified as a transgender man. In terms of ethnicity, two participants self-identified as Hispanic. In terms of race, five participants self-identified as black or African American, three self-identified as white, one self-identified as American Indian or Alaska Native, and two self-identified as Other (participants were able to identify more than one race). All participants were between 18 and 40 years of age.
Participants in the focus group with members of the straight, cisgender community included four men and four women. In terms of ethnicity, one participant self-identified as Hispanic. In terms of race, six participants self-identified as white, and two participants self-identified as black or African American. Additionally, four participants were between 18 and 40 years of age, three participants were between 41 and 64 years of age, and one participant was older than 65 years of age.
Each focus group was facilitated by experienced moderators using a semi-structured moderator guide (Appendices 1 and 2). Each focus group lasted approximately 90 minutes and was audio-recorded. In addition, a web-enabled camera was used to facilitate observation of each focus group by CDC staff. All participants were asked to sign or verbally agree to an informed consent statement. A scribe took notes as the moderator conducted each focus group.
After each moderator welcomed the participants and introduced herself, she set some ground rules to make participants feel comfortable and allow the group to run smoothly. Each moderator then asked participants to introduce themselves to the group; after these introductions, she asked them about their prior experience receiving calls requesting their participation in a survey. Each moderator then led the focus group through the series of eight items. As the items are generally part of phone surveys, the moderators read each item to the participants and engaged them in a discussion about the item. For each item, moderators asked participants for initial thoughts, to consider the clarity of the question wording, to consider the clarity and adequacy of the response options, and to consider how comfortable they would be responding to the item as part of a phone survey. Additionally, when discussing sexual orientation items in the focus group with members of the LGBT community, the moderator asked the group whether or not transgender individuals would have any hesitation or concerns answering the questions.
After discussing each of the four items on sexual orientation, each moderator asked the focus group participants to compare the items. To best facilitate this comparison, at this point participants were asked to review the four items by reading them silently from a provided handout. Participants were asked to select their preferred item and explain what made it the most preferable. After discussing each of the three items on gender identity, participants were similarly asked to compare these items.
Finally, in the Wrap Up portion of each focus group, participants were asked whether it made a difference to ask about sexual orientation and gender identity in two separate questions as opposed to combing both into one question, and whether or not it made a difference to ask about sexual orientation or gender identity first.
ICF used a notes-based thematic analysis. Notes were corroborated against the audio recordings, typed into Microsoft Word and uploaded and saved on a shared drive to facilitate analysis. No qualitative software was used to facilitate analysis. Following both focus groups, each moderator and scribe discussed the major points expressed, which the scribes incorporated into the notes. One author (an observer of the LGBT focus group and the scribe of the straight, cisgender focus group) reviewed both sets of notes (and audio as necessary) to conduct the analysis to identify patterns and themes in the data and identify recommendations.
Question Clarity
Participants across both focus groups found all eight of the presented questions to be clear as written. However, participants did not find the questions to be perfect as written, and offered a number of suggestions for improving questions, such as not to use the word “consider.”
Response Option Clarity
Participants in the focus group with members of the LGBT community also found all eight sets of response option to be clear as written. However, as with the question language, participants did note some improvements that could be made, such as removing the explanation that “straight” means “not gay”.
Participants in the focus group with members of the straight, cisgender community found all response options concerning sexual orientation to be clear. However, they struggled with many of the response options concerning gender identity. Only one question on gender identity—Question 5—included a set of response options that straight, cisgender participants found to be clear. These participants were unfamiliar with many of the terms for different gender identities included in other sets of response options (though these straight, cisgender participants did recognize that these options were not intended for them).
Response Option Adequacy
Participants in the focus group with members of the LGBT community stated definitively that the response options concerning sexual orientation, while clear, were insufficient. These participants stated many other response options would need to be added, such as asexual, questioning, and pansexual. Alternatively, LGBT participants generally found the response options on gender identity to be adequate as written (though some suggestions were still made).
Participants in the focus group with members of the straight, cisgender community generally found response options to be adequate for their purposes, in that there was generally a clear option for a straight and/or cisgender individual. However, some of these participants did experience some confusion when the straight or cisgender option was not the first option, as they were expecting it to be.
Additionally, participants across both groups stated phrasing a response option as “other” or “something else” was off-putting and possibly offensive. Participants suggested this be revised to something like “another sexual orientation.”
Comfort Level
Participants in the focus group with members of the LGBT community expressed that they would be comfortable responding to any of the questions reviewed as part of the phone survey. However, participants in the LGBT group also noted that it might be difficult for someone still figuring out their gender identity to answer a question about sexual orientation.
Participants in the focus group with members of the straight, cisgender community generally voiced comfort with answering any of the questions on sexual orientation as part of a phone survey. These participants were noticeably less comfortable with the idea of answering the questions on gender identity as part of a phone survey. The discomfort seemed primarily to flow from the lack of familiarity with the terms for different gender identities (though in one case discomfort seemed to flow from a cisgender individual’s rejection of the validity of nonbinary gender identities). Furthermore, some straight, cisgender focus group participants described some frustration about the time it took to listen to, and struggle to interpret, different gender identities that did not apply to them.
Additionally, a few straight, cisgender participants noted some general privacy concerns related to sharing this kind of information. In particular, one participant stated she would not want to answer any questions about sexual orientation and gender identity over the phone. Participants in the LGBT focus group did not raise such concerns.
Question 1- Behavioral Risk Factor Surveillance Survey Sexual Orientation Question
The first question presented to the focus groups on sexual orientation was from the BRFSS.
Do you consider yourself to be: MODERATOR NOTE: Please say the number before the text response. Respondent can answer with either the number or the text/word. 1 = Straight 2 = Lesbian or gay 3 = Bisexual 4 = Other |
Participants in both focus groups found the wording of the question to be clear. However, some participants in both focus groups reacted negatively to the word “consider” in the question. Some straight, cisgender participants suggested alternative language along the lines of “How do you identify?”
Concerning the response options, LGBT focus group participants found the four response options to be clear. However, participants did not find the response options to be adequate. Participants stated there could be more options, such as asexual, transsexual, questioning, or pansexual. One participant also suggested adding short descriptions of the response options. Participants were also put off by the final response option being stated as “other.”
Straight, cisgender focus group participants found the response options to be clear and to be adequate for their purposes. However, some participants wondered whether the response options heterosexual and homosexual might be preferable in place of the response options “straight” and “lesbian or gay”. Additionally, for various reasons, some straight, cisgender focus shared the other group’s dissatisfaction with the “other” response option. Like the LGBT focus group participants, some straight, cisgender participants felt that stating “other” was an off-putting way to ask about a different sexual orientation. However, one straight, cisgender participant expressed reservations about including an “other” option at all. This participant questioned the need to ask about other sexual orientations, or even the legitimacy of sexual orientations other than straight, gay or lesbian, or bisexual.
Participants in the LGBT focus group expressed that they would be comfortable answering this question as part of a phone survey. However, LGBT focus group participants also noted that it might be difficult for someone still questioning their gender identity to answer a question about sexual orientation. Participants in the straight, cisgender focus group were somewhat less comfortable with the question, but most stated they would answer it. However, a few participants voiced general privacy concerns related to sharing this kind of information, and one participant firmly stated she would not want to answer questions about sexual orientation and gender identity as part of a phone survey.
Question 2- National Health Interview Survey Sexual Orientation Question
The second question on sexual orientation was from the NHIS.
Which of the following best represents how you think of yourself? 1 = Gay 2 = Straight, that is, not gay 3 = Bisexual 4 = Something else |
Participants in both focus groups found the question to be clear. Participants in the LGBT focus group preferred the wording “best represents” as opposed to the wording “consider” in the previous question. However, participants in the straight, cisgender focus group noted the question was much longer than the previous question and thought this question was overly wordy.
Participants in the LGBT focus group stated the response options were clear, but again not adequate. Participants stated the response options should include both “gay” and “lesbian”. Additionally, it was unnecessary to add “that is not gay” to explain “straight”. Participants knew what was meant by straight. Finally, participants were again put off by the fourth response option being written as “something else”, with some expressing this was an offensive way to present the response option.
Participants in the straight, cisgender focus group also found the four response options to be clear. Again, some participants wondered if heterosexual and homosexual might be better response options than gay and straight. One participant suggested heterosexual and homosexual might be “more clinical terminology.” As with the LGBT participants, straight, cisgender participants found it unnecessary to explain “straight” with “that is, not gay”. Additionally, straight, cisgender participants were surprised that the “straight” response option was not the first response option in this item. Some participants suggested that the “straight” response option should be made the first response option, as it will be the most commonly selected option nationwide.
As with the first Question, all LGBT focus group participants and most straight, cisgender participant were comfortable answering the question as part of a phone survey. Some participants in the straight, cisgender focus group suggested making the “straight” response option the first response options might make it easier for them to answer the question. Additionally, participants in the LGBT focus group noted that the response option “something else” might be particularly offensive for transgender individuals.
Question 3- National Survey on Drug Use and Health Sexual Orientation Question
The third question on sexual orientation was from the NSDUH. The text of the question is very similar to Question 1 (from BRFSS: “Do you consider yourself to be”), and the response choices are also similar to Question 1 (with the addition of the word “heterosexual” and the elimination of the fourth response option).
Which one of the following do you consider yourself to be? 1 = Heterosexual, that is, straight 2 = Lesbian or Gay 3 = Bisexual |
Participants in both focus groups found the wording of the question to be clear. Again, most participants reacted negatively to the word “consider” in the question (though upon further thought, one member of the LGBT group supposed that the word “consider” might be appropriate for someone who is questioning their sexual orientation.) Participants in the straight, cisgender group appreciated that this question was less wordy than the previous question. However, some of these participants cautioned that a question could be offensive if it is too short.
Participants in both focus groups found the response options to be clear. Some participants in the LGBT focus group suggested survey respondents should be able to select all answers that apply, instead of having to select one response option. Additionally, consistent with earlier comments, straight, cisgender participants stated the term “heterosexual” did not need to be explained. These participants also noted there was not an “other” type response option, and suggested LGBT participants might need such an option.
Again, LGBT participants and most straight, cisgender participants were comfortable answering this question.
Question 4- National Crime Victimization Survey Sexual Orientation Question
The fourth question on sexual orientation was from the NCVS. The text of the question is identical to that the text of Question 2 (from NHIS), and the response choices are also similar to Question 2 (with the addition of the word “lesbian”).
Which of the following best represents how you think of yourself?
|
Participants in the LGBT focus group felt the question was clear, with many participants reacting very positively to the wording of this question. Alternatively, a number of participants in the straight, cisgender group found the question to be clear but still believed it could be improved. As stated in response to Question 2 above, these participants expressed that the question was too wordy. Additionally, some participants specifically reacted negatively to the wording “best represents.” These participants expressed that they don’t think of being straight as a “best representation”, but rather as the complete, or only representation. For these participants, the response option “straight” adequately defines their sexual orientation, so it is somewhat inaccurate or inappropriate to ask for a “best representation.”
LGBT participants noted that the response options were clear but, as with previous items, voiced that there were not enough response options, that “gay”, “lesbian”, and “straight” did not need to be explained, and that “something else” was an offensively worded response option. Straight, cisgender participants agreed that the response options were clear as written, and that there was no need to explain “straight”. Again, LGBT participants expressed that they would be comfortable answering this question. Straight, cisgender participants were generally comfortable with the thought of answering the question (if somewhat less comfortable than LGBT participants), though a few continued to voice privacy concerns.
Comparison of All Four Questions on Sexual Orientation
Participants in the two focus groups did not agree on which of the four sexual orientation questions was best.
Participants in the LGBT group preferred the wording of Questions 2 and 4, “Which of the following best represents how you think of yourself?” Furthermore, of the four sets of response options reviewed, LGBT participants would select the options from Question 1: Gay; Straight, that is, not gay; Bisexual; Other. However, LGBT participants consistently expressed the inadequacy of these response options. Participants much preferred that the response options for a question on sexual orientation be expanded beyond those four to include such options as queer, bisexual, pansexual, asexual, and polysexual.
Conversely, all but one of the participants in the straight, cisgender group preferred the wording of Question 1, “Do you consider yourself to be,” out of the four Questions. These participants appreciated that the wording of this Question was “short”, “straightforward”, and “to the point.” While participants found the response options to be adequate as written, and appreciated that “straight” was the first response option, most thought the response options could be improved, such as by replacing the word “other” with something like “other classification or sexual orientation.”
Question 5- Gender Identity in U.S. Surveillance Two Step Questions
The first question on gender identity was a “two step” approach recommended by the Gender Identity in U.S. Surveillance (GenIUSS) Group that includes measures of self-reported assigned sex at birth and current gender identity.
Part a. What sex were you assigned at birth, on your original birth certificate?
Part b. How do you describe yourself? (select one)
|
Participants in the LGBT focus group all thought the wording of the first part of the question was clear.
Alternatively, some participants in the straight, cisgender focus group found the word “assigned” to be strange. They felt this word pitched the question more towards transgender respondents. Cisgender participants proposed a shorter, similar question, such as “What sex were you at birth?” All participants stated the first set of response options were clear.
Participants in both focus groups reported the wording of the second part of the question to be clear. However, one straight, cisgender participant suggested the word “describe” should be changed to “classify”, as gender is a classification and not a description. Additionally, one straight, cisgender participant thought the question did not need the word “describe” or “classify”. That participant did not think as a classification and favored a question along the lines of “What is your gender now?”
Participants in both focus groups felt all the response options were clear. One LGBT participant suggested the final response option could be revised to read “gender nonconforming/nonbinary,” but also acknowledged that some survey respondents would not be familiar with those terms.
As with the questions on sexual orientation, LGBT focus group participants were comfortable answering the questions. Most straight, cisgender participants were comfortable answering the questions, thought at least one participant seemed like he would be more comfortable if the questions were more straightforward or shorter, and one participant reiterated that privacy concerns would prevent her from answering any questions about sexual orientation or gender identity over the phone.
Question 6- Gender Identity in U.S. Surveillance Current Gender Identity Question
The second question on gender identity was noted by the (GenIUSS) Group as a promising measure for inquiring about current gender identity.
What is your current gender identity? (Select all that apply)
|
Participants in the LGBT focus group felt the question was clear and politely phrased. These participants were very positive about the question. Participants in the straight, cisgender focus group likewise felt the question was clear as written. However, one participant suggested that the question could be shortened to “what is your current gender?”
Participants in the LGBT focus group stated the response options were clear and adequate as written. Participants appreciated the response option “different identity” in place of previous response options “other” or “something else.” Alternatively, a majority of the participants in the straight, cisgender focus group expressed unfamiliarity with some or many of the terms included in these response options. These participants had not heard many of these words before, and it was not clear to the respondents what these words meant. Participants also noted that the list of unfamiliar words seemed very long to them, especially since most of the responses on the list did not apply to them.
Participants in the LGBT focus group stated they would be comfortable answering the question. Participants in the straight, cisgender group noted that the response options presented them with a lot of new information, which was difficult to absorb and process while listening to the question. This lack of familiarity with the terms would make them somewhat uncomfortable answering the question. Furthermore, some cisgender participants suggested that struggling to understand a series of terms that ultimately would not apply to them might make them frustrated with the question.
Question 7- Gender Identity in U.S. Surveillance Transgender Question
The third question on gender identity was recommended by the (GenIUSS) Group as a question that addresses transgender/cisgender status in a single-item.
Some people describe themselves as transgender when they experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender?
|
Participants in the LGBT focus group voiced that the question was clear. Moreover, participants appreciated the explanation included in the question. However, consistent with earlier comments, participants did not like the word “consider” in the question. Conversely, participants in the straight, cisgender focus group found the question to be long and confusing. One participant suggested that the average American would not be able to understand the question.
Furthermore, participants in the LGBT focus group stated the response options were clear. Nonetheless, participants did state that “nonbinary” should be added as a response option, as it is not the same as “nonconforming”. Participants in the straight, cisgender group were again unfamiliar with many of the terms used in some of the response options. Some participants expressed uncertainty as to whether there was an appropriate response for a cisgender individual. Other respondents stated a cisgender individual could respond “No” to this question, but it was easy to miss the “No” response as it was so much shorter than the other response options and located at the end of the list. Again, participants were surprised to find the response option for cisgender individuals at the end of the list (and not at the beginning as they would expect).
As was the case for the prior question, participants in the LGBT group were comfortable answering the question, while participants in the straight, cisgender group were less comfortable. Lack of familiarity with the terms, and lack of personal relevance of the terms, again seemed to engender some discomfort in cisgender participants.
Comparison of All Three Questions on Gender Identity
Participants in the LGBT group were split between preference for Question 5 and preference for Question 6. However, all but one of the straight, cisgender participants preferred Question 5. These participants expressed that the question was to the point, straightforward, and most easy for them to understand. On the whole, cisgender participants had difficulty understanding the other questions on gender identity.
Question 8- Gender Identity in U.S. Surveillance LGBT Identity Questions
The final question discussed in the focus group was recommended by the (GenIUSS) Group as a question that addresses LGBT identity by enquiring about both sexual orientation and gender identity.
Part a: Do you think of yourself as (please select all that apply):
Part b: If you selected the transgender, transsexual, or gender non-confirming response, are you:
|
Participants in the LGBT focus group considered the wording of this question to be clear. Moreover, participants felt that, while this wording was superior to “consider,” it still might be improved by instead asking “Do you identify yourself as.” Participants in the straight, cisgender group did not make any comments on the wording of this question.
LGBT participants reported that the response options in both parts of the question were clear. However, these participants explained that the word “transsexual” was more commonly used by older generations and currently has a lot of negative connotations. Participants suggested the word be removed, or only used to survey individuals of a certain age (assuming such surveying is possible).
Participants in the straight, cisgender group where somewhat confused by the instruction in the first part of the question to select all response options that apply, and by the number of the response options in both parts of the question. Participants also again noted the presence of unfamiliar terms in the response options for this question.
Moreover, participants in the straight, cisgender focus group initially expressed dismay at the length of the question across both parts. These participants suggested that listeners will get lost in the question due to its length. However, participants then realized that cisgender respondents will not get the second part of the question. Upon realizing this, participants better appreciated the two-part structure of the question that would both allow cisgender individuals to finish faster and allow transgender individuals to provide more information or “better tell their story.”
Participants in the LGBT group would generally be comfortable answering the question. Participants in the straight, cisgender group felt comfortable with the question after they realized they would not be asked the second part.
Comparison of Separate Sexual Orientation and Gender Identity Questions with Combined Question
Participants in the LGBT focus group felt that the questions should be asked separately. However, participants in the straight, cisgender focus group favored a combined question such as Question 8. The major appeal of this kind of question was that it would allow some branching that straight, cisgender participants thought would be best for both the straight, cisgender respondents and the LGBT respondents. Straight, cisgender participants stated they want to be able report their sexual orientation and gender identity as simply and quickly as possible. They expressed that they would feel some frustration at being asked to think through terms that they did not understand and ultimately didn’t apply to them. These participants further expressed that having to work through these terms would make the survey more burdensome, and a combined, branching question would help minimize the burden. At the same time, straight, cisgender participants acknowledged that the response options on sexual orientation and gender identity were important and relevant to the LGBT community. Furthermore, they recognized that LGBT respondents might even want more options than were presented in the questions reviewed. A combined, branching question would allow for additional, detailed LGBT specific questions.
Order of Sexual Orientation and Gender Identity Questions
Finally, participants in both focus groups were asked whether or not it made a difference if the questions asked about sexual orientation first or asked about gender identity first. Participants in the LGBT focus group felt that questions about gender identity should come first. These participants felt that asking about gender identity was a good lead in, as asking about sexual orientation might be too personal to start with. Alternatively, the straight, cisgender participants had no strong feelings about the order.
There was not consensus between the two focus groups as to whether surveys should include two separate questions or one combined question about sexual orientation and gender identity. There was also not consensus between the two groups as to which sexual orientation question was best, nor was there true consensus as to which gender identity question was best (as the focus group with members of the LGBT community was divided between Question 5 and Question 6.)
In the absence of consensus, this report makes recommendations that consider all findings and that attempt (as possible) to meet the needs of all potential future respondents.
Survey length is a concern all researchers grapple with (as articulated by some members of the focus group with members of the straight, cisgender community). We believe that Question 8, the GenIUSS combined question on LGBT identity, most efficiently and adequately enquires about sexual orientation and gender identity. As voiced by members of the straight, cisgender community, this question meets their needs by presenting “straight” as the first option and by allowing them to skip the second part on gender identity. Though members of the LGBT community did not voice preference for a combined question, as structured, Question 8 functions similarly to two separate questions for members of this community. Question 8 also addresses some concerns raised by members of the LGBT community. Firstly, by allowing respondents to select all, those with fluid identities can select as many or as few response options as they wish. Secondly, concerns about order are addressed as the question asks about both sexual orientation and gender identity. As this item addresses concerns raised in both focus groups, we believe this item best allows both members of the LGBT community and members of the straight, cisgender community to describe themselves.
However, some surveys do have space and need for two completely separate items on sexual orientation and gender identity. Alternatively, some surveys may need only an item on sexual orientation or an item on gender identity. In addition to the above overall recommendation of Question 8, and acknowledging that members of the LGBT focus group did prefer separate questions, we recommend below which of the items on sexual orientation and gender identity might best meet the needs of all potential future survey participants.
Unfortunately, members of the two focus groups preferred different questions on sexual orientation. As written, we would recommend Question 4 as the item that best allows both members of the LGBT community and members of the straight, cisgender community to describe their sexual orientation. Members of the LGBT community voiced clear and consistent opposition to including the word “consider” in a sexual orientation question. Additionally, LGBT focus group members noted that response options should include both “gay” and “lesbian”, as Question 4 does. While Question 4 is not the shortest, and its response options did not begin with “straight”, members of the straight, cisgender community were able understand it and most were sufficiently comfortable with the question to answer it.
However, if given the ability to improve the Question and response options, per the suggestions of the LGBT participants, it might best read as follows:
Which of the following do you identify as?
Straight or heterosexual
Lesbian
Gay
Bisexual
Pansexual
Queer
Asexual
Polysexual
Questioning
A different sexual orientation
Such a revision might also better meet the needs of the straight, cisgender community by making “Straight or heterosexual” the first response.
Finally, we would recommend Question 5 as the item that best allows both members of the LGBT community and members of the straight, cisgender community to describe their gender identity. While the members of the LGBT focus group were split between Question 5 and Question 6, nearly all members of the straight, cisgender focus group preferred Question 5. Judged against the other preferences of the two groups, this represents some form of consensus that Question 5 could meet the needs of all future potential survey respondents. Additionally, as written, focus group participants did not advocate for major revisions to Question 5.
Appendix 1: Semi-Structured Discussion Guide for Focus Group with LGBT Community Members
Focus Group Discussion Guide: Sexual Orientation and Gender Identity
Introduction
Thank you for taking the time to join our discussion today.
I am Ashani Turbes-Johnson, and I work at ICF, a research and consulting firm headquartered in northern Virginia. I am moderating this focus group on behalf of the CDC. Additionally, colleagues from ICF and CDC may be watching and listening via this camera.
Before we begin, let’s take a moment to review the consent form. Please open the packets in front of you to the first page.
Informed Consent
Consent Form text pasted here:
ICF, a research and consulting firm, is conducting research on behalf of the Centers for Disease Control and Prevention (CDC). We are interested in exploring how individuals from the LGBT community interpret and respond to demographic questions about sexual orientation and gender identity (SOGI) in national surveys. Your feedback today, in combination with other sources of feedback, will help us to improve these questions. Before you consent to join in this focus group, please review and consider the conditions listed below:
Procedures
This focus group will last between 60 and 90 minutes.
You will be asked to consider questions about sexual orientation and gender identity.
This focus group will be audio recorded.
This focus group may be observed via a live streaming video visible to ICF and CDC staff.
Confidentiality
This focus group is confidential. Your name or other personal information will not be attached to the recording or the written record of this focus group.
All comments made during the focus group will be kept confidential, except as otherwise required by law.
Voluntary Participation
Your participation today is completely voluntary.
You may choose not to answer questions that you do not want to answer, and you are free to leave this discussion at any time.
Risks and Benefits of Participation
To protect your privacy, we will keep all records in private files and only study staff will be allowed to use them. Your name and other personal information will be stored separately, will not be linked to what you say during the focus group, and will not be reported when we deliver results to CDC.
You are expected to respect and protect the privacy of other group participants and to not discuss anything you hear today with anyone outside of this group. We cannot guarantee, however, that other participants will honor this expectation.
Through your participation, you will help to ensure that national surveys adequately capture the sexual orientation and gender identity of all survey respondents.
Incentive
To compensate for your time and effort, you will be given a $75 Visa Gift Card at the end of this session.
For More Information
If you have any concerns about your participation in this focus group or have any questions about the project, please contact the ICF Project Director, Naomi Freedner via telephone at 802-264-3730 or via email at [email protected].
Are there any questions about the Consent Form?
If you agree to participate, please sign and date the form. There is an additional blank copy of the form if you wish to take a copy home with you. However, please don’t look at any of the other pages in the packet just yet.
Thank you. I will now collect the signed forms.
As I said before, we are conducting this focus group to learn more about how individuals from the LGBT community interpret and respond to demographic questions about sexual orientation and gender identity (SOGI) in national surveys. In order to do this, I am going to read you a series of sexual orientation and gender identity questions, some of which are currently being used in national surveys and some of which are currently under consideration. Because these surveys are usually conducted over the phone, I am going to read you each question and all response options. Then I will ask you a series of follow up questions. I will ask you to talk about the question itself, such as whether or not the way it is worded makes sense to you. I will ask you to talk about the response choices, including whether the choices make sense and whether or not the choices are adequate. Finally, I will ask you to compare certain questions and to let me know which you prefer and why.
Please keep the following ground rules in mind:
We want to hear from everyone, but please remember to speak one at a time.
Please speak loudly and clearly so that our microphones can pick up your voice.
There are no right or wrong answers.
We respect and value differences of opinions.
Please avoid sidebar conversations.
Do you have any questions before we start?
Moderator: If none, start the session.
Introduction to FG/Icebreaker
Let’s get started.
I would first like to go around the room and have everyone briefly introduce themselves. Please say your name, your hometown, and how you like to spend your free time.
Thank you.
Now I’d like to ask some questions about your previous experience with surveys over the phone:
How many of you have been contacted about participating in a survey over the phone before?
(show of hands)
Did any of those surveys include questions on sexual orientation or gender identity?
What do you remember about those questions?
[Ask probes if necessary]
Generally speaking, how clearly were the questions worded?
How well did the response options work for you?
How comfortable were you in answering these questions? What, if anything, made you feel comfortable or uncomfortable about the questions that you were asked?
Now we are going to go through the series of questions. The first four are about sexual orientation. Please remember that we are interested in your thoughts and opinions about the questions themselves. We are NOT asking you to answer the questions, but rather to tell us what you think about them.
Question 1- Behavioral Risk Factor Surveillance Survey Sexual Orientation Question
Here is the first question.
Do you consider yourself to be:
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
Consider the wording of the question: Do you consider yourself to be?
How clear is the wording of the question?
[If question is unclear] How could the question be reworded or improved?
Let’s consider the response options: Straight, Lesbian or gay, Bisexual, Other.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
[For LGBT Group] We realize that this question is about sexual orientation, and not about gender identity. Would someone who is transgender have any hesitation or concerns answering this question?
Why?
Question 2- National Health Interview Survey Sexual Orientation Question
Let’s move on to the second sexual orientation question.
Which of the following best represents how you think of yourself?
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous question. If participants don’t remember previous, simply move on.]
Let’s consider the wording of the question: Which of the following best represents how you think of yourself?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the response options: Gay; Straight, that is, not gay; Bisexual; Other.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
[For LGBT Group] We realize that this question is about sexual orientation, and not about gender identity. Would someone who is transgender have any hesitation or concerns answering this question?
Why?
Question 3- National Survey on Drug Use and Health Sexual Orientation Question
Now I will read the third sexual orientation question.
Which one of the following do you consider yourself to be?
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous questions. If participants don’t remember previous, simply move on.]
Let’s consider the wording of the question: Which one of the following do you consider yourself to be?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the response options: Heterosexual, that is, straight; Lesbian or Gay; Bisexual.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
[For LGBT Group] We realize that this question is about sexual orientation, and not about gender identity. Would someone who is transgender have any hesitation or concerns answering this question?
Why?
Question 4- National Crime Victimization Survey Sexual Orientation Question
There is one more question about sexual orientation for us to discuss.
Which of the following best represents how you think of yourself?
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous questions. If participants don’t remember previous, simply move on.]
Let’s consider the wording of the question: Which of the following best represents how you think of yourself?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the response options: Gay (for males)/ Lesbian or gay (for females); Straight, that is, not gay; Bisexual; Something else.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
[For LGBT Group] We realize that this question is about sexual orientation, and not about gender identity. Would someone who is transgender have any hesitation or concerns answering this question?
Why?
Review of All Four Questions on Sexual Orientation
Now I would like to ask you which of the four questions about sexual orientation you think is the best. In order to help you remember and compare the four questions, you will find them written out on the next page of your packet.
Which of the four questions, including both the question text and the response options, do you prefer?
Why do you prefer this question?
[Moderator: Note if there is consensus around a particular question. If there is consensus, participants will be asked about this question in Wrap Up section.]
[If time permits]
Which of the four questions, including both the question text and the response options, do you like the least?
Why do you not like this question?
Question 5- Gender Identity in U.S. Surveillance Two Step Questions
Next, we are going to consider three questions about gender identity. Again, please remember that we are interested in your thoughts and opinions about the questions themselves. We are NOT asking you to answer the questions, but rather to tell us what you think about them. The first of these questions has two parts. Here is the two-part question.
Part a. What sex were you assigned at birth, on your original birth certificate?
Part b. How do you describe yourself? (check one)
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
Let’s consider the wording of the first part: What sex were you assigned at birth, on your original birth certificate?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the first set of response options: Male, Female.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
Let’s consider the wording of the second part: How do you describe yourself?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the second set of response options: Male; Female; Transgender; Do not identify as female, male, or transgender.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
What do you think about having this question in two parts?
How comfortable would you be answering these questions as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 6- Gender Identity in U.S. Surveillance Current Gender Identity Question
Here is another question about gender identity.
What is your current gender identity? (Check all that apply)
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous question. If participants don’t remember previous, simply move on.]
Let’s consider the wording of the question: What is your current gender identity?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the response options: Male, Female, Trans male/ Transman, Trans female/Transwoman, Genderqueer/Gender non-conforming, Different identity.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
To what extent would you be comfortable answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 7- Gender Identity in U.S. Surveillance Transgender Question
Now I will read the third question about gender identity.
Some people describe themselves as transgender when they experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender?
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous questions. If participants don’t remember previous, simply move on.]
Let’s consider the wording of the question, which includes a definition of being transgender and an example: Some people describe themselves as transgender when they experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the response options: Yes, transgender, male to female; Yes, transgender, female to male; Yes, transgender, gender non-conforming; No
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Review of All Three Questions on Gender Identity
Now I would like to ask you which of the three questions about gender identity you think is the best. In order to help you remember and compare the three questions, you will find them written out on the next page of your packet.
Which of the three questions, including both the question text and the response options, do you prefer?
Why do you prefer this question?
[Moderator: Note if there is consensus around a particular question. If there is consensus, participants will be asked about this question in Wrap Up section.]
[If time permits]
Which of the three questions, including both the question text and the response options, do you like the least?
Why do you not like this question?
Question 8- Gender Identity in U.S. Surveillance LGBT Identity Questions
The final question we will review is a two part question about both sexual orientation and gender identity.
Part a: Do you think of yourself as (please check all that apply):
Part b: If you checked the transgender, transsexual, or gender non-confirming response, are you:
|
Let’s talk about what you think of that question.
What are your first thoughts about that question?
Let’s consider the wording of the first part: Do you think of yourself as:
How clear is the wording?
[If question is unclear] How, if at all, could the question be reworded or improved?
Let’s consider the first set of response options: Straight; Gay or lesbian; Bisexual; Transgender, transsexual, or gender non-conforming
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
Let’s consider the second set of response options: Transgender or transsexual, male to female; Transgender or transsexual, female to male; Gender non-conforming
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
What do you think about having this question in two parts?
How comfortable would you be answering these questions as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Wrap Up
[Moderator: If there was consensus around one sexual orientation question, and one gender identity question, ask the following.]
Earlier, the group seemed to agree that the [fill in first through fourth] question on sexual orientation was best, and that the [fill in first through third] question on gender identity was best. [Participants can refer to the packet to remember these questions.]
These two questions could be added to a national survey. However, you just considered a two part question that asked about both sexual orientation and gender identity. So, which do you prefer, the two separate questions on sexual orientation and gender identity, or the combined question? Why? [Participants can refer to the last page of the packet to review the final question that asked about both sexual orientation and gender identity.]
[Moderator: If there was NO consensus around one sexual orientation question, and/or one gender identity question, ask the following.]
Do you think it is better to ask about sexual orientation and gender identity:
Together, in one question, as was done in the last question? Or
Separately, as was done in the first seven questions [Participants can refer to the packet to remember all questions.]
Why?
[Moderator: Ask all participants.]
Does it make a difference whether the questions ask about sexual orientation first or ask about gender identity first? Or does it not make a difference?
Why?
Is there anything else about the questions that you would like share with me?
Do you have any questions for me?
Thank you for helping us to learn more about demographic questions on sexual orientation and gender identity.
We appreciate your time and thoughtful comments.
Please see our hostess, Shilin, on your way out to get your Visa Gift Card.
Appendix 2: Semi-Structured Discussion Guide for Focus Group with Straight, Cisgender Community Members
Focus Group Discussion Guide: Sexual Orientation and Gender Identity
Introduction
Thank you for taking the time to join our discussion today.
I am Suzanne Lederer, and I work at ICF, a research and consulting firm headquartered in northern Virginia. I am moderating this focus group on behalf of the Centers for Disease Control (CDC). My colleague, Matt McDonough, is taking notes. Additionally, colleagues from ICF and CDC may be watching and listening via this camera.
Before we begin, let’s take a moment to review the consent form. Please open the packets in front of you to the first page.
Informed Consent
Consent Form text pasted here: (no need to read verbatim)
ICF, a research and consulting firm, is conducting research on behalf of the Centers for Disease Control and Prevention (CDC). We are interested in exploring how individuals from the straight community interpret and respond to demographic questions about sexual orientation and gender identity (SOGI) in national surveys. Your feedback today, in combination with other sources of feedback, will help us to improve these questions. Before you consent to join in this focus group, please review and consider the conditions listed below:
Procedures
This focus group will last between 60 and 90 minutes.
You will be asked to consider questions about sexual orientation and gender identity.
This focus group will be audio recorded.
This focus group may be observed via a live streaming video visible to ICF and CDC staff.
Confidentiality
This focus group is confidential. Your name or other personal information will not be attached to the recording or the written record of this focus group.
All comments made during the focus group will be kept confidential, except as otherwise required by law.
Voluntary Participation
Your participation today is completely voluntary.
You may choose not to answer questions that you do not want to answer, and you are free to leave this discussion at any time.
Risks and Benefits of Participation
To protect your privacy, we will keep all records in private files and only study staff will be allowed to use them. Your name and other personal information will be stored separately, will not be linked to what you say during the focus group, and will not be reported when we deliver results to CDC.
You are expected to respect and protect the privacy of other group participants and to not discuss anything you hear today with anyone outside of this group. We cannot guarantee, however, that other participants will honor this expectation.
Through your participation, you will help to ensure that national surveys adequately capture the sexual orientation and gender identity of all survey respondents.
Incentive
To compensate for your time and effort, you will be given a $75 Visa Gift Card at the end of this session.
For More Information
If you have any concerns about your participation in this focus group or have any questions about the project, please contact the ICF Project Director, Naomi Freedner via telephone at 802-264-3730 or via email at [email protected].
Are there any questions about the Consent Form?
If you agree to participate, please sign and date the form. There is an additional blank copy of the form if you wish to take a copy home with you. However, please don’t look at any of the other pages in the packet just yet.
Thank you. Matt will now collect the signed forms.
As I said before, we are conducting this focus group to learn more about how individuals from the LGBT community interpret and respond to demographic questions about sexual orientation and gender identity (SOGI) in national surveys. In order to do this, I am going to read you a series of sexual orientation and gender identity questions, some of which are currently being used in national surveys and some of which are currently under consideration. Because these surveys are usually conducted over the phone, I am going to read you each question and all response options. Then I will ask you a series of follow up questions. I will ask you to talk about the question itself, such as whether or not the way it is worded makes sense to you. I will ask you to talk about the response choices, including whether the choices make sense and whether or not the choices are adequate. Finally, I will ask you to compare certain questions and to let me know which you prefer and why.
Please keep the following ground rules in mind:
We want to hear from everyone, but please remember to speak one at a time.
Please speak loudly and clearly so that our microphones can pick up your voice.
There are no right or wrong answers.
We respect and value differences of opinions.
Please avoid sidebar conversations.
Do you have any questions before we start?
Moderator: If none, start the session.
Introduction to FG/Icebreaker
Let’s get started.
I would first like to go around the room and have everyone briefly introduce themselves. Please say your name, your hometown, and how you like to spend your free time.
Thank you.
Now I’d like to ask some questions about your previous experience with surveys over the phone:
How many of you have been contacted about participating in a survey over the phone before?
(show of hands)
Did any of those surveys include questions on sexual orientation or gender identity?
What do you remember about those questions?
[Ask probes if necessary]
Generally speaking, how clearly were the questions worded?
How well did the response options work for you?
How comfortable were you in answering these questions? What, if anything, made you feel comfortable or uncomfortable about the questions that you were asked?
Now we are going to go through the series of questions. The first four are about sexual orientation. Please remember that we are interested in your thoughts and opinions about the questions themselves. We are NOT asking you to answer the questions, but rather to tell us what you think about them.
Question 1- Behavioral Risk Factor Surveillance Survey Sexual Orientation Question
Here is the first question.
Do you consider yourself to be:
MODERATOR NOTE: Please say the number before the text response. Respondent can answer with either the number or the text/word.
1 = Lesbian or gay 2 = Straight 3 = Bisexual 4 = Other |
Let’s talk about the question.
What are your first thoughts about that question?
Consider the wording of the question: Do you consider yourself to be?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the response options: Lesbian or gay, Straight, Bisexual, Other. (fingers)
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 2- National Health Interview Survey Sexual Orientation Question
Let’s move on to the second sexual orientation question.
Which of the following best represents how you think of yourself?
1 = Straight, that is, not gay 2 = Gay 3 = Bisexual 4 = Something else |
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous question. If participants don’t remember previous, simply move on.]
Consider the wording of the question: Which of the following best represents how you think of yourself?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the response options: Straight, that is, not gay; Gay; Bisexual; Other.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 3- National Survey on Drug Use and Health Sexual Orientation Question
Now I will read the third sexual orientation question.
Which one of the following do you consider yourself to be?
1 = Lesbian or Gay 2 = Heterosexual, that is, straight 3 = Bisexual |
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous questions. If participants don’t remember previous, simply move on.]
Consider the wording of the question: Which one of the following do you consider yourself to be?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the response options: Lesbian or Gay; Heterosexual, that is, straight; Bisexual.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 4- National Crime Victimization Survey Sexual Orientation Question
There is one more question about sexual orientation for us to discuss.
Which of the following best represents how you think of yourself?
1 = Straight, that is, not gay 2 = Gay (for males)/ Lesbian or gay (for females) 3 = Bisexual 4 = Something else |
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous questions. If participants don’t remember previous, simply move on.]
Consider the wording of the question: Which of the following best represents how you think of yourself?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the response options: Straight, that is, not gay; Gay (for males)/ Lesbian or gay (for females); Bisexual; Something else.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Review of All Four Questions on Sexual Orientation
Now I would like to ask you which of the four questions about sexual orientation you think is the best. In order to help you remember and compare the four questions, you will find them written out on the next page of your packet.
Which of the four questions, including both the question text and the response options, do you prefer?
Why do you prefer this question?
[Moderator: Note if there is consensus around a particular question. If there is consensus, participants will be asked about this question in Wrap Up section.]
[If time permits]
Which of the four questions, including both the question text and the response options, do you like the least?
Why do you not like this question?
Question 5- Gender Identity in U.S. Surveillance Two Step Questions
Next, we are going to consider three questions about gender identity. Again, please remember that we are interested in your thoughts and opinions about the questions themselves. We are NOT asking you to answer the questions, but rather to tell us what you think about them. The first of these questions has two parts. Here is the two-part question.
Part a. What sex were you assigned at birth, on your original birth certificate? 1 = Female 2 = Male
Part b. How do you describe yourself? (check one) 1 = Female 2 = Male 3 = Transgender 4 = Do not identify as female, male, or transgender |
Let’s talk about what you think of that question.
What are your first thoughts about that question?
Consider the wording of the first part: What sex were you assigned at birth, on your original birth certificate?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the first set of response options: Female, Male.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
Consider the wording of the second part: How do you describe yourself?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the second set of response options: Female; Male; Transgender; Do not identify as female, male, or transgender.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
What do you think about having this question in two parts?
How comfortable would you be answering these questions as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 6- Gender Identity in U.S. Surveillance Current Gender Identity Question
Here is another question about gender identity.
What is your current gender identity? (Check all that apply) 1 = Female 2 = Male 3 = Trans female/Transwoman 4= Trans male/Transman 5 = Genderqueer/Gender non-conforming 6 = Different identity (please state): _______ |
What are your initial thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous question. If participants don’t remember previous, simply move on.]
Consider the wording of the question: What is your current gender identity?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the response options: Female, Male, Trans female/Transwoman, Trans male/ Transman, Genderqueer/Gender non-conforming, Different identity.
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
To what extent would you be comfortable answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Question 7- Gender Identity in U.S. Surveillance Transgender Question
Now I will read the third question about gender identity.
Some people describe themselves as transgender when they experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender? 1 = Yes, transgender, female to male 2 = Yes, transgender, male to female 3 = Yes, transgender, gender non-conforming 4 = No |
Let’s talk about what you think of that question.
What are your first thoughts about that question?
What did you notice was different about this question? [Moderator: Don’t repeat previous questions. If participants don’t remember previous, simply move on.]
Consider the wording of the question, which includes a definition of being transgender and an example: Some people describe themselves as transgender when they experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender?
How clear is the wording of the question?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the response options: Yes, transgender, female to male; Yes, transgender, male to female; Yes, transgender, gender non-conforming; No
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
How comfortable would you be answering this question as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Review of All Three Questions on Gender Identity
Now I would like to ask you which of the three questions about gender identity you think is the best. In order to help you remember and compare the three questions, you will find them written out on the next page of your packet
Which of the three questions, including both the question text and the response options, do you prefer?
Why do you prefer this question?
[Moderator: Note if there is consensus around a particular question. If there is consensus, participants will be asked about this question in Wrap Up section.]
[If time permits]
Which of the three questions, including both the question text and the response options, do you like the least?
Why do you not like this question?
Question 8- Gender Identity in U.S. Surveillance LGBT Identity Questions
The final question we will review is a two part question about both sexual orientation and gender identity.
Part a: Do you think of yourself as (please check all that apply): 1 = Gay or lesbian 2 = Straight 3 = Bisexual 4 = Transgender, transsexual, or gender non-conforming
Part b: If you checked the transgender, transsexual, or gender non-conforming response, are you: 1 = Transgender or transsexual, female to male 2 = Transgender or transsexual, male to female 3 = Gender non-conforming |
Let’s talk about what you think of that question.
What are your first thoughts about that question?
Consider the wording of the first part: Do you think of yourself as:
How clear is the wording?
[If question is unclear] How, if at all, could the question be reworded or improved?
Consider the first set of response options: Gay or lesbian; Straight; Bisexual; Transgender, transsexual, or gender non-conforming
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
Consider the second set of response options: Transgender or transsexual, female to male; Transgender or transsexual, male to female; Gender non-conforming
How clear are the response options?
Are the response options adequate for your purposes?
[If response options are unclear and/or inadequate] What, if anything, could be added to, removed from, or otherwise changed about the response options?
What do you think about having this question in two parts?
How comfortable would you be answering these questions as part of a phone survey?
What, if anything, would make you feel comfortable or uncomfortable?
Wrap Up
[Moderator: If there was consensus around one sexual orientation question, and one gender identity question, ask the following.]
Earlier, the group seemed to agree that the [fill in first through fourth] question on sexual orientation was best, and that the [fill in first through third] question on gender identity was best. [Participants can refer to the packet (pages 3 and 4) to remember these questions.]
These two questions could be added to a national survey. However, you just considered a two part question that asked about both sexual orientation and gender identity (i.e., Q8). So, which do you prefer, the two separate questions on sexual orientation and gender identity, or the combined question? Why? [Participants can refer to the last page of the packet (page 5) to review the final question that asked about both sexual orientation and gender identity.]
[Moderator: If there was NO consensus around one sexual orientation question, and/or one gender identity question, ask the following.]
Do you think it is better to ask about sexual orientation and gender identity:
Together, in one question, as was done in the last question? Or
Separately, as was done in the first seven questions [Participants can refer to the packet to remember all questions.]
Why?
[Moderator: Ask all participants.]
Does it make a difference or not whether the questions ask about sexual orientation first or ask about gender identity first?
Why?
Is there anything else about the questions we reviewed that you would like share with me?
Do you have any questions for me?
Thank you for helping us to learn more about demographic questions on sexual orientation and gender identity.
We appreciate your time and thoughtful comments.
Please see Matt on your way out to get your Visa Gift Card.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Report Template Blue |
| Author | Microsoft Office User |
| File Modified | 0000-00-00 |
| File Created | 2021-01-21 |
© 2024 OMB.report | Privacy Policy