BEST PRACTICES FOR ASKING QUESTIONS TO IDENTIFY TRANSGENDER AND OTHER GENDER MINORITY RESPONDENTS ON POPULATION-BASED SURVEYS Created by the Gender Identity in U.S. Surveillance (GenIUSS) group, a multi-disciplinary and multi-institutional collaboration SEPTEMBER 2014 UCLA, SCHOOL OF LAW BOX 951476 Los Angeles CA, 90095 www.williaminstitute.law.ucla.edu SUGGESTED CITATIONS ACKNOWLEDGEMENTS FULL REPORT The GenIUSS group thanks each individual who has The GenIUSS Group. (2014). Best Practices for Asking been involved in this effort, including those who Questions to Identify Transgender and Other Gender participated in the studies that informed this report. Minority Respondents on Population-Based Surveys. We thank Ryan Nelson, Elaine Harley, Brad Sears, Matt J.L. Herman (Ed.). Los Angeles, CA: The Williams Strieker, and Laura Rodriguez for their contributions. Institute. We also sincerely thank the anonymous donor who provided generous support for this multi-year effort. INDIVIDUAL CHAPTER Chapter author(s). (2014). Title of chapter. In J.L. Herman (Ed.), Best Practices for Asking Questions to Identify Transgender and Other Gender Minority Respondents on Population-Based Surveys (pages of chapter). Los Angeles, CA: The Williams Institute. DESIGNED BY: HARLEY GRAPHIC DESIGN www.harleygraphicdesign.com ABOUT THE GENIUSS GROUP AND THIS REPORT In 2011, the Williams Institute at the UCLA School of view of analytic considerations, including sample size Law convened a multi-disciplinary and multi-institu- and standard error, variable construction, and aggre- tional group of experts to increase population-based gation of data. data about transgender people and other gender minorities by advancing the development of sex and GENIUSS GROUP STEERING COMMITTEE gender-related measures (i.e., sex assigned at birth, • Kerith Conron, The Fenway Institute; Department gender identity, gender expression, transgender of Health Sciences, Northeastern University, Boston; Heller School of Social Polity, Brandeis status) for population-based surveys, with a particu- Univeristy lar consideration for publicly-funded data collection efforts. To achieve this goal, between 2011 and 2013 • Gary J. Gates, Williams Institute, UCLA School of this group, known as the Gender Identity in U.S. Law Surveillance (GenIUSS) group, mapped the landscape of current practices to identify transgender and other • Jody L. Herman, Williams Institute, UCLA School of Law gender minority respondents in population research, assessed challenges to collecting data on gender-re- • Scout, LGBT HealthLink lated aspects of individual identity, and developed strategies for establishing consistent, scientifically rig- REPORT AUTHORS orous procedures for gathering information relevant • M.V. Lee Badgett, Center for Public Policy & to the needs and experiences of transgender people Administration, University of Massachusetts and other gender minorities. Amherst; Williams Institute, UCLA School of Law • Kellan E. Baker, Center for American Progress This report is the culmination of the work of the Ge- nIUSS group and serves as a companion to the 2009 • Kerith Conron, The Fenway Institute; Department report from the Sexual Minority Assessment Research of Health Sciences, Northeastern University, Team (SMART), also coordinated by the Williams Boston; Heller School of Social Polity, Brandeis Institute, entitled Best Practices for Asking Questions Univeristy about Sexual Orientation on Surveys. In Chapter 1 of • Gary J. Gates, Williams Institute, UCLA School of this report, we review some of the largest and most Law important federally-supported surveys that are top priorities for adding sex and gender-related measures • Alison Gill, Human Rights Campaign to identify transgender and other gender minority respondents. Chapter 2 presents approaches to iden- • Emily Greytak, GLSEN (Gay, Lesbian & Straight Education Network) tifying transgender people and other gender minori- ties through surveys using measures of sex assigned • Jody L. Herman, Williams Institute, UCLA School at birth, gender identity, gender expression, and of Law transgender status. Chapter 3 describes which ques- tions may be most appropriate for different kinds of • Stewart Landers, John Snow, Inc. surveys, where in the survey to place these questions, and how different modes of survey administration • Emilia Lombardi, Department of Public Health, may affect the number and validity of responses. School of Health Sciences, Baldwin Wallace Chapter 4 provides special considerations for data col- University lection with sex and gender-related measures related to age, race and ethnicity, socioeconomic status, and • Phoenix Alicia Matthews, College of Nursing, intersex status. Finally, Chapter 5 provides an over- University of Illinois at Chicago i • Sari Reisner, The Fenway Institute; Department • Paisley Currah, Department of Political Science, of Epidemiology, Harvard School of Public Health Brooklyn College, CUNY • Masen Davis, Transgender Law Center • Scout, LGBT HealthLink • Gary J. Gates, Williams Institute, UCLA School of • Anne Tamar-Mattis, Advocates for Informed Law Choice • Alison Gill, Human Rights Campaign • Hida Viloria, Organisation Intersex International • Emily Greytak, GLSEN (Gay, Lesbian & Straight Education Network) (OII) and OII-USA • Jody L. Herman, Williams Institute, UCLA School REPORT REVIEWERS of Law • Kylar Broadus, National Gay and Lesbian Task Force • JoAnne Keatley, Center of Excellence for Transgender Health, University of California, San Francisco • Paisley Currah, Department of Political Science, Brooklyn College, CUNY • Mara Keisling, National Center for Transgender Equality • Kristen Schilt, Department of Sociology, University of Chicago • Shane R. Landrum, Department of History, Florida International University REPORT EDITOR • Emilia Lombardi, Department of Public Health, • Jody L. Herman, Williams Institute, UCLA School School of Health Sciences, Baldwin Wallace of Law University GENIUSS GROUP MEMBERS APPROVING • Phoenix Alicia Matthews, College of Nursing, THIS REPORT University of Illinois at Chicago S. Bryn Austin, Social and Behavioral Sciences, • Sari Reisner, The Fenway Institute; Department Harvard School of Public Health; Pediatrics, • of Epidemiology, Harvard School of Public Health Harvard Medical School, Division of Adolescent and Young Adult Medicine, Boston Diego M. Sanchez, PFLAG National Children’s Hospital • Kristen Schilt, Department of Sociology, M.V. Lee Badgett, Center for Public Policy & • • University of Chicago Administration, University of Massachusetts Amherst; Williams Institute, UCLA School of Law Gunner Scott, Pride Foundation • • Kellan E. Baker, Center for American Progress • Scout, LGBT HealthLink Kylar Broadus, National Gay and Lesbian • Ben Singer, Women’s Studies Department, Task Force • Kansas State University David H. Chae, Department of Epidemiology and • Susan Stryker, Gender and Women’s Studies, Biostatistics, University of Maryland, School of • University of Arizona Public Health Bali White, MA Kerith Conron, The Fenway Institute; Department • • of Health Sciences, Northeastern University, Boston; Heller School of Social Policy, Brandeis University ii TABLE OF CONTENTS iv EXECUTIVE SUMMARY ix GLOSSARY xii ABBREVIATIONS USED IN THIS REPORT xiv A LETTER TO GENDER MINORITY COMMUNITIES FROM THE GENIUSS GROUP CHAPTER 1 IDENTIFYING TRANSGENDER AND OTHER GENDER 01 MINORITY RESPONDENTS ON POPULATION-BASED SURVEYS: WHY ASK? CHAPTER 2 IDENTIFYING TRANSGENDER AND OTHER 09 GENDER MinoRITY RESPONDENTS ON PoPulaTion-BasED SURVEYS: APPROACHES ChapTEr 3 IdEnTIfyIng TransgEndEr and OThEr gEndEr 19 MINORITY RESPONDENTS ON POPULATION-BASED SURVEYS: HOW AND WHERE TO ASK CHAPTER 4 IDENTIFYING TRANSGENDER AND OTHER GENDER MINORITY RESPONDENTS ON POPULATION-BASED SURVEYS: 29 SPECIAL CONSIDERATIONS FOR ADOLESCENTS, RACE/ETHNICITY, SOCIOECONOMIC STATUS, AND INTERSEX STATUS 44 CHAPTER 5 IDENTIFYING TRANSGENDER AND OTHER GENDER MINORITY RESPONDENTS ON POPULATION-BASED SURVEYS: CONSIDERATIONS FOR ANALYSIS iii EXECUTIVE SUmmARY WHY ASK SURVEY QUESTIONS TO the American Community Survey (ACS), the Current IDENTIFY TRANSGENDER AND OTHER Population Survey (CPS), the Survey of Income and GENDER MINORITIES IN SURVEYS? Program Participation (SIPP), the National Crime Vic- timization Survey (NCVS), the National Health Inter- Transgender and other gender minority individuals view Survey (NHIS), and the National Survey of Veter- come from a wide range of geographic and demo- ans (NSV). A few surveys (the Behavioral Risk Factor graphic backgrounds. Transgender and other gender Surveillance System (BRFSS), the Youth Risk Behavior minority people are diverse in such factors as age, Surveillance System (YRBS), and the National Inmate race, ethnicity, income, sexual orientation, socioeco- Survey (NIS)) do have measures to identity transgen- nomic status, and immigration status. Despite their der and/or other gender minority respondents, but differences, gender minority people from all back- either more consistent addition of these measures is grounds face common experiences of discrimination needed across surveys administered in the states or in a wide array of settings across the United States these surveys should consider revised measures. today. The consequences of discrimination can be severe. According to the 2011 National Healthcare WHAT ARE THE RECOMMENDED AP- Disparities Report, transgender people, particularly PROACHES FOR IDENTIFYING TRANS- those who are visibly gender non-conforming,