New guidance on including LGBTQ people in reproductive health research

There’s growing awareness that lesbian, gay, bisexual, transgender and queer (LGBTQ) people have unique reproductive health needs. Researchers are considering whether and how to include them in research about abortion and contraception. New research from ANSIRH and CSU East Bay provides guidance on ways to evaluate inclusion of LGBTQ people in that research.

Asking questions about sexual orientation and gender identity is not enough to achieve inclusion. The researchers designed a survey that also made language gender neutral and added new questions to assess sexual behavior and pregnancy risk. They gave the survey to participants who were assigned female at birth and identified as LGBTQ and followed up with interviews to determine how they felt about the survey.

Participants were happy with existing questions that assessed sexual orientation and gender identity and felt validated. hey were pleased to see “queer” listed as an option for sexual orientation, which was chosen by 64% of participants. They did criticize the questions about sexual attraction that only asked about their attraction to men and women with no options for choosing non-binary or genderqueer people.

They also responded well to the use of gender neutral terminology and sexual behavior questions that focused on anatomy rather than identity. One participant described a question about whether sexual partners had sperm as “crucial.” When asked to assess their own pregnancy risk, almost all of them took that to mean biological capability to become pregnant rather than their specific behavior that could lead to pregnancy. There were mixed responses to questions about contraception and pregnancy intentions, with some feeling like skip patterns left out people who use contraception for reasons other than pregnancy prevention.

This research provides a much-needed framework for evaluating research for effective inclusion of LGBTQ participants in research on abortion and contraception. Culturally sensitive inclusion or exclusion of LGBTQ people should be a priority for reproductive health researchers.