title: Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors.
abstract: OBJECTIVE
  Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors.
  
  
  METHODS
  Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior.
  
  
  RESULTS
  Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as "not sure" also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors.
  
  
  CONCLUSIONS
  Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Derrick D
authors.initials: DD
authors.lastname: Matthews
authors.affiliation: Department of Psychiatry, University of Rochester, Rochester, New York ; VISN-2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, New York.
authors.forename: John R
authors.initials: JR
authors.lastname: Blosnich
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health & Social Justice, St. Louis, Missouri.
authors.forename: Grant W
authors.initials: GW
authors.lastname: Farmer
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Adams
keywords: adolescents; data analysis; health behavior; measurement; sexual orientation
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