Adolescent patient forms should use more inclusive language for sexual, gender identity

Study findings indicate that epidemiologic surveys and patient forms for adolescents should include broader options for sexual orientation and gender identity, researchers reported in Pediatrics.

The conclusion was based on data collected during the 2019 Minnesota Student Survey from 124,778 students in grades 8, 9 and 11. Respondents used a broader set of sexual and gender identity terms to describe themselves than the response options typically provided in surveys and forms, the researchers reported.

They found that 9.4% of the surveyed high schoolers identified as lesbian, gay, bisexual, queer, or pansexual, with 4.5% of those reporting their sex as male and 14.2% of those reporting their sex as female. An additional 2.1% of the students — 1% of respondents reporting male sex and 3.2% reporting female sex — questioned their sexual orientation.

Further, 1.4% of the survey respondents indicated they were transgender, genderqueer or genderfluid. Another 1.7% reported being “unsure” of their gender identity.

“Respondents also reported their experiences of bullying on the basis of (1) sexual orientation (‘because you are gay, lesbian, bisexual or because someone thought you were’) and (2) gender (‘your gender [being male, female, transgender, etc.]’) in the past 30 days,” they wrote.

The researchers also reported that, “unexpectedly,” 8.4% of youth selected an “I don’t describe myself in any of these ways” option for sexual orientation.

“Results demonstrated that youth selecting this option were much more similar in terms of depression and bias-based bullying to straight youth and youth who did not understand the sexual orientation question than they were to any other group of LGBQ+ youth,” they wrote.

The authors suggested that physicians support the inclusion of a broader set of sexual and gender identity response options — such as pansexual and nonbinary, in epidemiologic surveys and patient forms — and further recommended that clinicians screen for additional services and support these youth may need to thrive.

“Clinicians should familiarize themselves with the range of sexual and gender identities used by youth and attend to bias or bullying experiences and emotional distress among all LGBTQ+ youth but particularly pansexual and queer youth and transmasculine and nonbinary youth who indicate their sex as female,” they wrote. “Accurate measurement of sexual orientation and gender identity including diverse response options among adolescents is critical to documenting prevalence, identifying and monitoring health disparities, and ultimately developing interventions to promote health among LGBTQ+ youth.”