Defining sexual orientation: Research on lesbian alcohol use as an illustration of the need for conc

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Defining sexual orientation Research on lesbian
alcohol use as an illustration of the need for
conceptual clarity

• Cheryl A. Parks, MSW, Ph.D.
• University of Connecticut
• June 23-24, 2005
• Washington, DC.

Presentation is based on Parks, C. A., Hughes,
T.L. Werkmeister-Rozas, L. (in press). Defining
sexual identity and orientation in research with
lesbians and gay men. In J. Martin B. Meezan
(eds.) Handbook of Research with Gay, Lesbian,
Bisexual and Transgender Populations. Binghamton
NY Haworth Press.
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Outline of Presentation

• The problem
• Its impact on research
• Examples from lesbian alcohol use studies
• Recommendations

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Alternative Conceptualizations

• Sexual orientation as a separate construct,
  distinct from sexual identity and behavior e.g.,
  a predisposition to experience sexual attraction
  or desire for persons of the same gender, the
  other gender, or both genders (Diamond, 2000)
• versus
• Sexual orientation as an overarching construct
  e.g., one comprised of cognitive (identity),
  behavioral, and affective (desire/attraction)
  dimensions (Laumann, Gagnon, Michael, Michaels,
  1994).

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A Wealth of Terminology
lesbian
homoerotic
questioning
homosexual
MSM
queer
gay
WSW
transgendered
bisexual
LGB.. LGBT.. LGBTQ.. LGBTQQ ...
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An Assortment of Different Measures

• Self-identification as lesbian, gay, or bisexual
• Reported same-gender behavior
• Reported same-gender attraction, fantasy, or
  desire
• Association with or involvement in social
  relationships or community groups that are
  identified as homosexual
• Some combination of any of the above

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Resulting in Different Population Estimates
Data based on 1992 National Health and Social
Life Survey (NHSLS Laumann, et al,1994)

• 10.1 of men and 8.6 of women may be
  considered gay/lesbian or bisexual, depending on
  how sexual orientation is measured
• 7.7 of men and 7.5 of women acknowledge any
  same-sex attraction or desire
• 5.3 of men and 3.5 of women report any
  same-gender sexual behavior since age 18
• 2.8 of men and 1.4 of women self-identify as
  lesbian, gay or bisexual

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With only Limited Overlap Between Groups
Of those who acknowledge any same-sex desire,
behavior or identity
Behavior Only (17)
Attraction/Desire Only (51.5)
Behavior Desire (10)
Desire, behavior and identity (20.5)
Identity Only (0)
Attraction and identity (1)
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So Why or Does It (Really) Matter?
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Yes! Because

• Although multiple terms seem to suggest a more
  nuanced understanding of sexual orientation and
  the people that are the focus of our research,
• That research also reflects an enduring
  conceptual confusion about the nature or
  meaning of sexual orientation (Chung Katayama ,
  1996 Sell Petrulio,1996)
• With often inadequate definitions and
  inconsistently applied measures appearing in
  published reports
• Leading to concerns and criticism regarding the
  validity, comparability and generalizability of
  findings reported.

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Thus, the challenge Who are we really studying?

• Each dimension samples a different population
• Identity and behavior may change (in response to
  social, cultural, and historical factors)
  attraction is less likely to do so (particularly
  among men)
• Responses may vary depending on
• Age at the time of interview
• Birth cohort
• Gender
• Race/ethnicity
• Time frame of interest (e.g., current vs.
  lifetime)

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Examples Measures of Sexual Identity

• Single item asking if respondent considers
  him/herself to be heterosexual, lesbian or gay,
  bisexual (McCabe et al, 2003 a probability
  sample of male and female college students)
• How do you define your sexual identity? Only
  homosexual/lesbian/gay mostly bisexual mostly
  heterosexual only heterosexual other. (Parks
  Hughes, 2005 convenience sample of
  self-identified lesbian adults)
• Which of the following statements best describe
  your sexual orientation? Heterosexual, that is
  straight, or prefer to have sex with people of
  the opposite sex Bisexual, that is, prefer to
  have sex with people of either sex Homosexual,
  that is gay or lesbian, or prefer to have sex
  with people of your own sex. (Drabble, et al 2005
  probability sample of U.S. adults)

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Strengths/Limitations

• Least prevalent yet most visible and accessible
• At greatest risk for stressors associated with
  minority status
• More access to sources of support and affiliation
• Good source for focus on risk and protective
  factors, access to care, couple and family
  dynamics, other issues affected by social context

• Limits access to people open or out enough to
  self-identify
• Respondents are generally young, white,
  well-educated and middle class
• Inadequate representation of older adults,
  racial/ethnic minorities and those who are not
  out

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Example Measures of Same-sex Behavior

• Specify the gender of any sexual partners within
  12 months preceding study labeled homosexually
  active if any same-gender partners were reported
  (Cochran et al, 2000 probability study of U.S.
  adults)
• Ever had sex with another person? If yes, with
  men only, women only, or with both men and women.
  (Scheer, et al 2003 probability study of young
  women in CA)

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Strengths /Limitations

• Not as stigmatizing as identity may increase
  number of potential respondents
• Most salient definition when investigating
  physical health issues rather than concerns
  related to minority stress

• Behavioral terminology open to interpretation
• Concordance with identity is less than 50
• Cannot assume identification as LGB and findings
  cannot be compared directly with self-identified
  groups

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Example Measures of Same-sex Attraction

• How would you describe your sexual orientation?
  Heterosexual (sexually attracted only to the
  opposite sex), homosexual (sexually attracted
  only to your own sex) or bisexual (sexually
  attracted to both men and women).(Mays Cochran,
  2001 probability study of U.S. adults)
• Which of the following best describes your
  feelings? Response set ranges from I am only
  attracted to boys/men (or girls/women) and I will
  only be sexual with boys/men (or girls/women) to
  mostly, equally, or not at all. (Noell Ochs,
  2001 non-probability sample of homeless
  adolescents)

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Strengths/Limitations

• Largest pool of potential respondents
• Least stigmatizing dimension
• May be best source for data on identity
  development processes, stressors encountered and
  coping strategies employed

• Definitions within this dimension are highly
  variable, lack comparability
• Very low concordance with identity (25) and
  behavior (31)
• Influence on health and psychosocial outcomes may
  be weak

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Lesbian Alcohol Research Outcomes
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Recommendations

• Provide explicit and consistent conceptual and
  operational definitions in all reported research
• Be consistent in use of terminology, temporal
  periods, and response categories
• Allow for confidential administration of
  measures
• Report the measures used in referenced materials
  
• Work for inclusion of sexual orientation
  measures in national studies