Sex, Sexual Orientation, and Gender Identity Measurement in Health Research: A Systematic Review and Narrative Synthesis.

Abstract

Purpose: Toward the goal of developing standardized sex, sexual orientation, and gender identity (SSOGI) measures that can be used across demographics and regions, this review aimed to synthesize and summarize how SSOGI have been assessed within health research, including the quality and validity of these measures. Methods: We conducted a systematic review of peer-reviewed research developing or evaluating SSOGI measures in PubMed, PsycInfo, CINAHL, and Health and Psychosocial Instruments bibliographic databases. Eligible studies reported original peer-reviewed research focused on SSOGI measurement in adult populations in the United States from 2012 through June 7, 2022. In consultation with librarians, search results were screened for inclusion using an innovative multiple-phase method of stratification, supervised clustering, and supervised machine learning. We conducted manual screening and data extraction in Covidence. Results: In total, 17,814 citations were returned from all databases, with 30 studies eligible for final inclusion in the review. Gender identity measurement was the focus of half of the included studies (51%), followed by sexual orientation (40%), with little asexuality-specific measurement research (n = 1 study), and beyond sexual orientation, research on sex or variations in sexual characteristics (n = 1 study, each). Conclusions: Although the field of sexual and gender minority health research has grown exponentially over the past decade, there remains a dearth of literature focused on the development and evaluation of SSOGI measures. We found heterogeneity across the SSOGI measurement literature including by study design, sampling strategy, and study population. Important identified gaps include the need for attention to the measurement of sex, variations in sex characteristics, and asexuality-inclusive sexual orientation measures.