Sexual and gender minority (SGM) adolescents and young adults (AYA) in the U.S. experience substantial health inequities due to minority stress. Research documenting SGM health inequities has been limited by inadequate methods to measure sexual fluidity (i.e., changes over time in identity and attraction dimensions of sexual orientation) retrospectively and prospectively, particularly among AYA. Measures of sexual orientation that ignore sexual fluidity may lead to incorrect assumptions about who comprises the AYA SGM population, and in turn to inaccurate estimates of population health inequities. Accurate research on SGM health inequities is critical to the allocation of resources to improve the health of SGM communities. Research documenting sexual fluidity and related SGM health inequities has been limited by methodological issues, including: (1) assessing fluidity in only one dimension of sexual orientation (either identity or attractions); (2) examining differences in fluidity by assigned sex at birth rather than by gender identity and excluding transgender and nonbinary individuals; and (3) using cross-sectional study designs with retrospective measures of sexual fluidity that may be subject to recall bias and have not been rigorously tested. Both retrospective and prospective measures of fluidity that assess multiple dimensions of sexual orientation are needed to accurately characterize health inequities among SGM AYA in cross-sectional and longitudinal research. MyVoice, a national U.S. prospective cohort of AYA (N=1280; ages 14-24 years), provides an unprecedented opportunity to measure sexual fluidity both prospectively and retrospectively among SGM and non-SGM AYA. This existing cohort study will allow us to collect measures of both sexual orientation identity and attractions at multiple time points (every 2 months across 12 months; 7 total waves) using quantitative and qualitative measures. The proposed research will use multiple sociodemographic characteristics available from MyVoice participants at the time of enrollment to consider subgroup differences in fluidity.
Our specific aims are to: 1) Compare prospective and retrospective measures of fluidity in sexual orientation identity and attractions, including frequency, direction, and order of occurrence.
This aim will allow us to examine changes in identity and attractions, and whether participants? retrospective recall of sexual fluidity is consistent with their prospective report of changes in sexual orientation dimensions. 2) Examine interpretations of measures of sexual orientation and sexual fluidity.
This aim will allow us to refine prospective and retrospective measures of sexual fluidity based on how participants interpret and respond to these measures, as well as increasing knowledge about how participants understand changes in sexual orientation dimensions. This research will inform prospective and retrospective measurement of sexual fluidity for use in cross-sectional and longitudinal research to improve accuracy in identifying AYA SGM populations and related health inequities, which will inform intervention efforts to improve AYA SGM health.
Measures of sexual orientation that ignore sexual fluidity (i.e., changes over time in identity and attraction dimensions of sexual orientation) may lead to incorrect assumptions about who comprises the population of adolescents/young adults (AYA) who are sexual and gender minorities (SGM), and in turn to inaccurate estimates of population health inequities. Both retrospective and prospective measures of fluidity that assess multiple dimensions of sexual orientation are needed to accurately characterize health inequities among SGM AYA in cross-sectional and longitudinal research. This research will inform prospective and retrospective measurement of sexual fluidity to improve precision in identifying AYA SGM populations and related health inequities, which will inform intervention efforts to improve AYA SGM health.
