Measuring Fluidity in Sexual Orientation Dimensions Prospectively and Retrospectively in a National Cohort of Adolescents and Young Adults

项目摘要/摘要 美国的性少数和性别少数(SGM)青少年和年轻人(Aya)经历了大量的 少数群体压力造成的健康不平等。记录SGM健康不平等的研究受到以下因素的限制 测量性流动性的方法不充分(即，身份和吸引力维度随时间的变化 性取向)，特别是在Aya中。性取向的衡量标准 忽视性流动性可能会导致对谁构成Aya SGM人群的错误假设， 进而导致对人口健康不平等的不准确估计。对SGM健康不平等的准确研究 对于分配资源以改善特别报告员社区的健康至关重要。研究记录 性流动性和相关的SGM健康不平等一直受到方法学问题的限制，包括：(1) 仅评估性取向的一个维度的流动性(身份或吸引力)；(2)检查 流动性的差异按出生时指定的性别而不是性别认同和排除变性人和 非二元个体；以及(3)使用具有回溯性措施的横断面研究设计 流动性可能会受到回忆偏差的影响，而且没有经过严格的测试。回顾和 需要前瞻性的流动性测量来评估性取向的多个维度，以准确地 在横断面和纵向研究中描述SGM-Aya之间的健康不平等。我的声音，a 美国全国预期的Aya队列(N=1280；年龄14-24岁)，提供了前所未有的机会 对SGM和Non-SGM Aya的性流动性进行前瞻性和回溯性测量。这是现有的 队列研究将允许我们在多个时间段收集性取向身份和吸引力的测量 使用定量和定性测量方法(12个月中每2个月进行一次积分；共7次)。这个 拟议的研究将使用MyVoice参与者提供的多种社会人口特征，网址为 考虑到亚组流动性差异的注册时间。我们的具体目标是：1)比较 在性取向认同和吸引力方面的前瞻性和回溯性测量， 包括发生的频率、方向和顺序。这一目标将使我们能够检查 身份和吸引力，以及参与者对性流动性的回顾是否与他们的 性取向维度变化的前瞻性报告。2)审查对下列措施的解释 性取向和性流动性。这一目标将使我们能够改进前瞻性和回溯性 根据参与者对这些措施的解释和反应来衡量性流动性，以及 增加关于参与者如何理解性取向维度变化的知识。这 研究将提供前瞻性和回溯性流动性的测量，用于横断面和 进行纵向研究，以提高确定Aya SGM人群和相关健康不平等的准确性， 这将为改善Aya SGM健康的干预努力提供信息。

PROJECT SUMMARY/ABSTRACT 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.