The Longitudinal Measurement of Sexual Orientation and Gender Identity: A Study of Identity Change in a Nationally Representative Sample of U.S. Adults and Adolescents.

Purpose: Research and lived experience demonstrate that sexual orientation and gender identity (SOGI) can change over the life course; however, little empirical work exists to understand the prevalence of such changes. To address this gap, we used data from a large nationally representative panel of adults and adolescents to assess changes in self-reported SOGI over time and identify trends by sex assigned at birth, age, race and ethnicity, and survey mode. Methods: We reviewed SOGI data collected between 2014 and 2022 for a sample of 19,469 adults and 970 adolescents. Up to eight SOGI measurements per panelist were available over the nine-year period, collected through a combination of panel recruitment and demographic refresh surveys and topic-specific surveys. Results: Among adults older than 18 years, 4.1% reported a change in sexual orientation and 3.6% reported a change in gender identity. Among teens, who are developmentally more apt to change identity, 13.5% reported a change in sexual orientation and 9.3% reported a change in gender identity. Conclusions: Findings demonstrate that SOGI can change over time, particularly for adolescents, so it is important to re-ask SOGI questions to ensure current information. We recommend re-asking SOGI questions at least every three years of adults and every two years of adolescents. Potential undercounting of sexual and gender minority (SGM) respondents decreases visibility and our ability to understand health and economic disparities affecting these populations. Improvements in SOGI measurement can help advance data quality and, ultimately, evidence-based interventions in support of SGM communities that these data help to inform.

Adverse Childhood Experiences Among US Adolescents Over the Course of the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVE: A national, longitudinal survey of US adolescents assessed adverse childhood experiences (ACEs) twice during the COVID-19 pandemic. Adolescents with more Wave 1 ACEs were expected to be more likely to experience additional ACEs at Wave 2. METHODS: Adolescents aged 13 to 18 (n = 727, Fall 2020; n = 569, Spring 2021) recruited via a national, probability-based panel (survey completion rate Wave 1, 62.1%; Wave 2, 78.3%) responded to questions about household challenges, violence or neglect, and community ACE exposure at Wave 1 and Wave 2 (since Wave 1). Unweighted frequencies and 95% confidence intervals of demographic characteristics and individual ACEs were calculated by using weighted data. Odds ratios examined associations between ACEs by Wave 1 and Wave 2. RESULTS: Among respondents of both survey waves (n = 506), 27.2% experienced violence or abuse, 50.9% experienced a household challenge, and 34.9% experienced a community ACE by Wave 1. By Wave 2, 17.6% experienced 1 new ACE, 6.1% experienced 2 new ACEs and 2.7% experienced 4 or more new ACEs. Those with ≥4 ACEs by Wave 1 were 2.71 times as likely as those with none to report a new ACE at Wave 2 (confidence interval: 1.18-6.24). CONCLUSIONS: This nationwide, longitudinal study of US adolescents measured exposure to ACEs early in and during the COVID-19 pandemic. Nearly one-third of adolescents experienced a new ACE between survey waves. Prevention and trauma-informed approaches in clinical, school, and community settings may be helpful.

Substance Misuse and Condomless Sex Among Transgender Youth.

Purpose: The purpose of this research is to explore the relationship between substance use and sexual risk behaviors among transgender youth. Methods: Data from the transgender subsample of the Survey of Today's Adolescent Relationships and Transitions (n=1567) were analyzed to assess associations between substance misuse (binge drinking, prescription drug misuse, illicit drugs) and sexual risk behaviors (condom use during sex). Multivariate logistic regression models calculated adjusted odds ratios (AORs) for substance use by sexual risk behavior controlling for race/ethnicity, gender identity (transgender male, transgender female, genderqueer/gender nonconforming), age, sexual identity, and region. Results: Among participants, lifetime marijuana use (AOR=0.45), cocaine use (AOR=0.46), prescription drug misuse (AOR=0.52), and injecting substances with a needle (AOR=0.45) were all associated with lower odds of reporting condom use during the last act of receptive anal sex. Similarly, marijuana use in the last 30 days (AOR=0.46), lifetime marijuana use (AOR=0.25), heroin use (AOR=0.29), methamphetamine use (AOR=0.32), misuse of prescription drugs (AOR=0.40), and injecting substances with a needle (AOR=0.17) were all associated with lower odds of reporting condom use during the last act of insertive anal sex. No associations between substance use and condom use during last act of receptive frontal (vaginal) sex were found. Conclusion: We found that transgender youth who reported any lifetime substance use were more likely to report condomless sex during receptive and insertive anal sex than those who did not report substance use. Significant differences exist among demographic groups, type of substance use, and sexual risk behaviors for respondents based on gender identity.

Awareness and Willingness to Use Biomedical Prevention Strategies for HIV Among Sexual and Gender Minority Youth: Results From a National Survey.

PURPOSE: Sexual and gender minority youth (SGM), an umbrella term encompassing gay, bisexual, and transgender youth, experience disproportionately high rates of new HIV infections, and recent advances in biomedical HIV prevention modalities hold promise in reducing new infections. However, the extent to which SGM youth are aware of and willing to use these modalities is unknown. METHODS: Using data from the Survey of Today's Adolescents Relationships and Transitions, we analyze awareness of and willingness to take HIV pre-exposure prophylaxis (PrEP), nonoccupational HIV post-exposure prophylaxis, and rectal microbicides among adolescent sexual minority males aged 13-18 years and transgender youth aged 13-24 years. RESULTS: Overall, we found a majority of our respondents were not aware of any of these prevention modalities. Across both subsamples, age and outness to a health care provider were associated with increased PrEP awareness, and any anal sex was associated with PrEP willingness. CONCLUSIONS: These findings highlight the importance of provider education on how to discuss SGM issues with patients and educate them about HIV prevention options.

Social Media Recruitment for a Web Survey of Sexual and Gender Minority Youth: An Evaluation of Methods Used and Resulting Sample Diversity.

Purpose: The purpose of this study was to assess the feasibility and efficacy of using advertisements (ads) on Facebook, Instagram, and Snapchat to recruit a national sample of adolescent sexual minority males ages 13-18 and transgender youth ages 13-24 for a web survey. Methods: The Survey of Today's Adolescent Relationships and Transitions (START) used targeted ads as survey recruitment tools. We assessed the efficacy of these varied forms of recruitment ads in reaching our target population. To understand how our sample differed from a national probability sample targeting the general adolescent population, we compared START respondents with sexual minority men identified from the 2017 Youth Risk Behavior Survey (YRBS). Results: The use of targeted language produced higher rates of completes per click compared with ads without targeted language. Video ads (compared with static images) were more effective at recruiting younger respondents. START and YRBS samples differed along lines of sexual identity, race and ethnicity, and age. The START sample had a greater percentage of Hispanic/Latino and Other/Multiracial respondents relative to the YRBS sample, thus providing additional data on these underserved sexual minority youth. Conclusion: The factors associated with design decisions for a hard-to-reach, non-probability sample impact the likelihood that respondents engage in and complete a survey. The ads proved to be effective and efficient at recruiting the targeted population.

Home-based anthropometric, blood pressure and pulse measurements in young children by trained data collectors in the National Children's Study.

OBJECTIVE: The current study assessed whether home-based data collection by trained data collectors can produce high-quality physical measurement data in young children. DESIGN: The study assessed the quality of intra-examiner measurements of blood pressure, pulse rate and anthropometric dimensions using intra-examiner reliability and intra-examiner technical error of measurement (TEM). SETTING: Non-clinical, primarily private homes of National Children's Study participants in twenty-two study locations across the USA. SUBJECTS: Children in four age groups: 5-7 months (n 91), 11-16 months (n 393), 23-28 months (n 1410) and 35-40 months (n 800). RESULTS: Absolute TEM ranged in value from 0·09 to 16·21, varying widely by age group and measure, as expected. Relative TEM spanned from 0·27 to 13·71 across age groups and physical measures. Reliabilities for anthropometric measurements by age group and measure ranged from 0·46 to >0·99 with most exceeding 0·90, suggesting that the large majority of anthropometric measures can be collected in a home-based setting on young children by trained data collectors. Reliabilities for blood pressure and pulse rate measurements by age group ranged from 0·21 to 0·74, implying these are less reliably measured with young children when taken in the data collection context described here. CONCLUSIONS: Reliability estimates >0·95 for weight, length, height, and thigh, waist and head circumference, and >0·90 for triceps and subscapular skinfolds, indicate that these measures can be collected in the field by trained data collectors without compromising data quality. These estimates can be used for interim evaluations of data collector training and measurement protocols.