Out of the Closet and Into Our Data: An Analysis of LGBTQIA+ Inclusion Questions in National Health Surveys

Introduction: To assess the extent to which federal survey questionnaires include items pertaining to LGBTQIA + identities and experiences, and identify the domains covered by relevant survey items.Methods: Survey questionnaires were included for review if they were federally administered, related to health, provided in English, cited at least 300 times in PubMed, and fielded at least once every five years. We reviewed the most recent iteration of questionnaires. We deductively coded each questionnaire to ascertain whether they included questions about Sex, Gender Identity, Gender Expression, Sexual Attraction/Orientation, Romantic Attraction/Orientation, Partnership, and Sexual Activities/Behaviors.Results: We identified 11 survey instruments from 2022 for inclusion in our analysis. The most prevalent domains included in surveys were Sex (n = 9) and Partnership (n = 9). No surveys included items about Gender Expression, Romantic Attraction, or Romantic Orientation. Other domains were inconsistently captured, including Gender Identity (n = 6), Sexual Attraction (n = 3), Sexual Orientation (n = 7), and Sexual Activities/Behaviors (n = 2).Conclusion: Federally sponsored U.S. health surveys in 2022 did not include the full range of items pertaining to LGBTQIA + identities and experiences. This limits the ability of researchers and policymakers to understand health experiences, outcomes, and disparities of LGBTQIA + peoples.Out of the Closet and Into Our Data: An Analysis of LGBTQIA + Inclusion Questions in National Health Surveys