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Identifying Basic Classes of Sexual Orientation with Latent Profile Analysis

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Identifying Basic Classes of Sexual Orientation with Latent Profile Analysis Archives of Sexual Behavior (2019) 48:1403–1422 https://doi.org/10.1007/s10508-018-1336-y ORIGINAL PAPER Identifying Basic Classes of Sexual Orientation with Latent Profle Analysis: Developing the Multivariate Sexual Orientation Classifcation System Nicole Legate1 · Ronald D. Rogge2 Received: 5 June 2017 / Revised: 19 October 2018 / Accepted: 21 October 2018 / Published online: 7 June 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Despite considerable progress, research on sexual minorities has been hindered by a lack of clarity and consistency in defning sexual minority groups. Further, despite recent recommendations to assess the three main dimensions of sexual orientation— identity, behavior, and attraction—it remains unclear how best to integrate such multivariate information to defne discrete sexual orientation groups, particularly when identity and behavior fail to match. The current study used a data-driven approach to identify a parsimonious set of sexual orientation classes. Latent profle analysis (LPA) was run within a large (N = 3182) and sexually diverse sample, using dimensions of sexual identity, behavior, and attraction as predictors. LPAs supported four fundamental sexual orientation classes not only in the overall sample, but also when conducted separately in men (n = 980) and women (n = 2175): heterosexual, homosexual, bisexual, and heterofexible (a class representing individuals who self- identify as heterosexual or mostly heterosexual but report moderate same-sex sexual behavior and attraction). Heterosexuals reported the highest levels of psychological functioning and lowest risk behaviors. Homosexuals showed similarly high levels of psychological functioning to heterosexuals, but higher levels of risk behaviors. Bisexuals and heterofexibles showed simi- larly low levels of psychological functioning and high risk taking. To facilitate applications of this classifcation approach, the study developed the Multivariate Sexual Orientation Classifcation System, reproducing the four LPA groups with 97% accuracy (kappa = .95) using just two items. Implications of this classifcation approach are discussed. Keywords Sexual orientation · Gay · Lesbian · Bisexual · Mostly heterosexual · Health disparities Introduction groups (for reviews, see Beaulieu-Prevost & Fortin, 2015; Sell, 1997; Wolf, Wells, Ventura-DiPersia, Renson, & Grov, 2016). Despite critical priorities as outlined by the Institute of Medi- Groupings of sexual orientation have ranged from simple binary cine (2011) and the US Department of Health and Human Ser- classifications (heterosexual vs. homosexual—considering vices (2010) to reduce health disparities of sexual minorities, sexual identifcation, attraction, and behavior as interchange- a more fundamental problem exists: developing a standardized able) to multidimensional approaches that posit over two dozen method of defning and classifying sexual orientation groups. diferent groups (allowing for the possibility that identifcation, This is due, in part, to a lack of methodological consistency in attraction, and behavior do not always align; Wolf et al., 2016). operationally defning sexual orientation, as studies often assess As a result, it has been difcult to establish accurate estimates diferent dimensions of sexuality (e.g., sexual identity vs. sex- of sexual minorities in the population (Purcell et al., 2012) and ual attraction vs. sexual behavior) to create sexual orientation compare fndings across studies and literatures. Although the feld is increasingly calling for multivariate assessment of sexual orientation, it remains unclear how to integrate information on * Nicole Legate sexual identity, attraction, and behavior into basic classes of [email protected] sexual orientation, particularly when those diferent dimensions 1 Department of Psychology, Illinois Institute of Technology, are not aligned (i.e., sexual orientation branching; van Anders, 3424 S. State St., Chicago, IL 60616, USA 2015). 2 Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA Vol.:(0123456789)1 3 1404 Archives of Sexual Behavior (2019) 48:1403–1422 Unidimensional versus Multidimensional Forming Sexual Orientation Groups Approaches to Sexual Orientation In response to the evolving understanding of sexual diversity Although many dimensions have been proposed, the general and the prevalence of sexual branching (e.g., Brewster & Till- consensus is that there are three key dimensions of sexual ori- man, 2012; Copen, Chandra, & Febo-Vazquez, 2016), there have entation (for reviews, see Beaulieu-Prevost & Fortin, 2015; Sell, been calls for researchers to broaden their assessment of sexual 1997; Wolf et al., 2016). Sexual identity refers to how individu- orientation (Badgett, 2009; Gates, 2011, 2012; Sell, 2007; Wolf als classify or label their own sexuality, corresponding to cat- et al., 2016). The Institute of Medicine (2011) included this as egories such as heterosexual, gay, lesbian, bisexual, and queer, the frst of fve most pressing areas for lesbian, gay, bisexual, among others. Sexual behavior refers to the gender match (same and transgender (LGBT) research, and recommended measur- gender and/or opposite gender) of individuals’ sexual activity ing sexual orientation in a multidimensional, standardized way. partners. Finally, sexual attraction refers to the degree of sexual However, even when assessed in a multidimensional way, no desire toward individuals of the same sex and opposite sex.1 guidelines exist for integrating sexual identity, behavior, and Despite the widely accepted multidimensional conceptual attraction into distinct sexual orientation groups, particularly for defnition of sexual orientation, most studies assess sexual ori- individuals reporting large amounts of sexual branching. entation using a single dimension. Sexual identity is most com- monly selected to measure sexual orientation, particularly in the Strategies for Forming Groups public health and psychology literatures (e.g., Cochran, Mays, & Sullivan, 2003; Lindley, Walsemann, & Carter, 2012; Sell, Studies that assessed sexual orientation in a multivariate way 2007). Sexual behavior is the next most-frequently used method have implemented markedly diferent strategies for categoriz- of measuring sexual orientation and is often used in research ing groups. For example, Rosario et al. (2014) collected data that focuses on sexually transmitted diseases and risky behaviors on sexual identity, behavior, and attraction, and used that mul- (e.g., Grov, Hirshfeld, Remien, Humberstone, & Chiasson, 2013; tivariate data to create just two groups: a non-sexual minor- for a review, see Purcell et al., 2012). Although less frequently ity group (reporting consistent heterosexual identity, behavior, assessed, when included, sexual attraction tends to be measured and attraction) and a sexual minority group (consisting of all along with one or both of the other dimensions (Chung & Katay- other individuals in the study, including bisexuals, homosexu- ama, 1996; for exceptions, see Austin et al., 2004a, 2004b). als, and all individuals reporting sexual branching). While this One of the risks of operationalizing and assessing sexual ori- research did fnd higher cancer-related risk behaviors among entation with a single dimension is that researchers may miss sexual minority youth as compared to heterosexual youth, we individuals showing a diferent pattern across measures of sex- would argue that their method of grouping the sample may have ual identity, behavior, and attraction. For example, an individual obscured meaningful and important risk diferences across spe- may identify as bisexual, but be predominantly attracted to and cifc sexual orientation groups (e.g., Semlyen, King, Varney, & engage in sexual activity with opposite-sex partners. Recent Hagger-Johnson, 2016). At the other extreme, Wolf et al. (2016) fndings suggest a sizeable minority of men who have sex with proposed constructing over two dozen categories of sexual ori- men (MSM) also identify as heterosexual (e.g., Xu, Sternberg, & entation to capture the full diversity and branching possible Markowitz, 2010a). Termed sexual orientation branching (van across sexual identity, behavior, and attraction. Unfortunately, Anders, 2015), these diferent patterns highlight the impor- this approach would be logistically untenable in all but the larg- tance of assessing all three dimensions of sexual orientation. est of population surveys, requiring tens of thousands of partici- Assessing sexual orientation with a single dimension efectively pants to support analyses of so many distinct and rare groups. ignores these individuals in datasets, and this is particularly sali- ent as sexual branching has been found to predict higher risk Sexual Orientation Groups Typically Analyzed of adverse health outcomes (e.g., Corliss, Austin, Roberts, & Molnar, 2009; Przedworski, McAlpine, Karaca-Mandic, & Many published studies have examined sexual orientation groups VanKim, 2014). corresponding to the three most common groups: heterosexuals, bisexuals, and homosexuals. Although such a consistent con- ceptual strategy helps to maximize the feld’s ability to integrate 1 Given its clarity of meaning and widespread use throughout the lit- fndings across studies, even research examining these three main erature, we have chosen to use the term “opposite sex” when we are groups is limited by divergent operational defnitions across stud- referring
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