Using Ancillary Sociodemographic Data to Identify Sexual Minority Adults Among Those Responding "Something Else" or "Don't Know" to Sexual Orientation Questions

Published in: Medical Care (2019). doi: 10.1097/MLR.0000000000001190

Posted on on September 19, 2019

by Marc N. Elliott, James M. Dahlhamer, Sarah MacCarthy, Megan K. Beckett, Nathan Orr, Paul Guerino, Denis Agniel, Catherine L. Saunders, Mark A. Schuster, Judy H. Ng, et al.

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General population surveys are increasingly offering broader response options for questions on sexual orientation—for example, not only gay or lesbian, but also "something else" (SE) and "don't know" (DK). However, these additional response options are potentially confusing for those who may not know what the terms mean. Researchers studying sexual orientation-based disparities face difficult methodological trade-offs regarding how best to classify respondents identifying with the SE and DK categories.


Develop respondent-level probabilities of sexual minority orientation without excluding or misclassifying the potentially ambiguous SE and DK responses. Compare 3 increasingly inclusive analytic approaches for estimating health disparities using a single item: (a) omitting SE and DK respondents; (b) classifying SE as sexual minority and omitting DK; and (c) a new approach classifying only SE and DK respondents with > 50% predicted probabilities of being sexual minorities as sexual minority.

Materials and Methods

We used the sociodemographic information and follow-up questions for SE and DK respondents in the 2013–2014 National Health Interview Survey to generate predicted probabilities of identifying as a sexual minority adult.

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