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Insensitivity affects responses of sexual and gender minority research participants

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As it is, sexual and gender minority (SGM) people — including members of the LGBTQIA community — remain underrepresented in health research due to poor collection of sexual orientation and gender identity (SOGI) data. But a newer study has found that — even when LGBTQIA people are included in researches – data derived from them may not be completely accurate, affected by insensitivity coming from the researchers.

The research – “Do Ask, Tell, and Show: Contextual Factors Affecting Sexual Orientation and Gender Identity Disclosure for Sexual and Gender Minority People” by Leslie W. Suen, et al – appeared in LGBT Health.

In this research, “we sought to understand the contextual factors affecting how SGM research participants interact with SOGI questions to enhance participant experience and increase the accuracy and sensitivity of research findings,” stated the researchers.

They then recruited 74 SGM adults for in-person semi-structured focus groups or online cognitive interviews from 2016 to 2018. During focus groups and cognitive interviews, they asked participants to respond to SOGI question sets. They employed template analysis to describe the contextual factors that affected SGM participants’ responses to SOGI questions.

Two main themes surfaced, i.e.:

  1. the need to know the relevance (of why SOGI questions are asked); and
  2. the importance of environmental and contextual cues (communicating physical safety and freedom from discrimination that influenced SOGI disclosure).

As stressed by the researchers, “participants emphasized the importance of knowing why questions are being asked and how information is relevant.”

This may be because “SGM people are significantly more likely to face discriminatory practices in health care and research settings, including being misgendered, having sexual behaviors and preferences assumed, or being subjected to inappropriate health service recommendations by providers (e.g., absent/diminished pap testing for cisgender women who have sex with women).”

Many SGM participants also perceive voyeurism when asked about SOGI and other questions that seem irrelevant to the purpose of the visit and more to satisfy staff curiosity, exacerbating experiences of discrimination. 

And so the researchers recommended for researchers and health care providers to understand and explain the reasons for SOGI questions may improve experiences for SGM participants and, thus, enhance SOGI disclosure.

Participants also drew on their experiences in other contexts to inform how research settings can become inclusive. Here, attention toward environmental and relational cues within the context can convey safety, provide reassurance, and help SGM participants decide what identity labels to use.

The researchers recommended that:

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  • Researchers consider sharing reasons for SOGI data collection to increase the perceptions of safety and discretion during studies. “We recommend including SOGI questions as general demographic questions and using introductory statement(s) describing reasons for data collection and how data will be used at the beginning of demographic sections to avoid drawing attention to and inadvertently stigmatizing SOGI questions.”
  • The use of introductory statements in qualitative studies, especially with sensitive topics.
  • Partnering with LGBTQ-identified organizations.
  • Ensuring recruitment materials feature SGM people of various backgrounds and use inclusive language.
  • Hiring and valuing SGM staff;.
  • Normalizing pronoun sharing.

“Attention to these practices could improve research experiences for SGM people and enhance the likelihood of future participation, while improving the accuracy and sensitivity of research methodologies,” the researchers ended.

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