Category Archives: Methods

Experts Release New Report Highlighting the Lack of Population-Based Data about Transgender People and Other Gender Minorities

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Experts Release New Report Highlighting the Lack of Population-Based Data about Transgender People and Other Gender Minorities

Current survey practices fail to identify transgender and other gender minority respondents

Los Angeles—A new report released today by the Gender Identity in U.S. Surveillance (GenIUSS) group highlights the lack of survey measures to identify transgender and other gender minority respondents in most federally-supported population-based surveys. This groundbreaking report, entitled Best Practices for Asking Questions to Identify Transgender and Other Gender Minority Respondents on Population-Based Surveys, examines current practices in population-based surveys to see which surveys currently include measures to identify transgender and other gender minority respondents and offers expert recommendations for including sex and gender-related measures in population-based surveys.

The 2011 Institute of Medicine report on LGBT health specifically identified transgender health research as being a high priority.  However, without adequate measures to differentiate between trans and cis people such research would be very difficult to conduct.

The report offers best practices for identifying transgender and other gender minority respondents in population-based surveys. Among the best practices delineated in the report, the most effective is the “two-step” approach. This practice includes measures of self-reported assigned sex at birth (the birth recorded on one’s original birth certificate) and gender identity at the time of the survey. There are also recommendations on the best way to place and integrate sex and gender-related measures into population-based surveys in this report.

Among the federally supported population-based surveys that currently do not include measures to identify gender minority respondents are the American Community Survey, the Current Population Survey, and the National Health Interview Survey, and others.

The proposed guidelines are an important step in working toward the the development and inclusion of transgender health within national health studies.

The full report is available here: http://williamsinstitute.law.ucla.edu/wp-content/uploads/geniuss-report-sep-2014.pdf

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The Gender Identity in U.S. Surveillance (GenIUSS) Group is a multi-disciplinary and multi-institutional group of experts convened by the Williams Institute to increase population-based data about transgender people and other gender minorities by advancing the development of gender-related measures for population-based surveys, with a particular consideration for publicly-funded data collection efforts.

Teaching R to Undergraduates Part 1, Why R and How to Install it

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Teaching R to Undergraduates Part 1, Why R and How to Install it (work in progress)

 # This will be a rough draft of what I hope to provide for students in my research class in the fall.  Suggestions/questions welcome.

 First, what is R and why are we using it?

 ·        R is a free software environment for statistical computing and graphics.

·        Have I mentioned that its free and can be used on multiple platforms (windows, mac, linux)

 So it’s free, but is it any good?

 ·        R is used by many academics, and companies around the world.  Google and Health Canada both use R for example.   http://www.revolutionanalytics.com/companies-using-r

·        It is a living program, in that it has a community constantly building and adapting the program.  

·        It can provide very powerful tools for analyses and graphics. 

·        It is considered to be as useful if not better than SPSS or SAS

 Why don’t we just use SPSS or SAS since the University provides it for free on its computers?

 ·        If you just plan on using University computers for the rest of your life than that can work.  But what if you want to use your own computer or if you are working/interning somewhere that won’t let you move their data off of their computer, what will you use then?

·        SPSS and SAS are expensive programs and require yearly patches to continue working after its initial purchase.  You don’t really buy the software as rent it from year to year.  SPSS has a special student price, but you can’t use it after you graduate.

·        If you are working for a nonprofit or other small organization, expecting them to spend thousands of dollars on software per year may not be very sustainable.  That same amount could be used to provide direct services or develop other goods. 

 So how do I install it?

·        The first step is to download the latest version.  Case Western Reserve hosts a depository that you can access it and other needed packages (more on that later).

o   GO to http://cran.case.edu/ and click on the version for your system (window, mac, or linux) and install it onto your system using the direction provided.

o   Once installed, run the program you should see this.

 ·        Next, make sure that you have java installed on your computer, if you don’t have it or don’t know got to http://www.java.com and find the right version for your system.  If you have a 64 bit computer, make sure you have the 64 bit version of java.  This program will be needed to run the Graphic User Interface (GUI) that we will be using.

 ·        We will be using the Deducer GUI to work with R.  It’s not necessary, but it will be easier to work with for beginners.

 o   At the top of the R program you should see an option for Packages, click on that.

o   You should see an option for Install package(s), click on that.  You should be given a list of cran mirrors.  Scroll down and look for USA (OH) option.  Click on that and hit OK.

o   Next, you should see a list of Packages.  Scroll down and look for Deducer.  Click on that and hit OK.

o   That will install Deducer and any related package.

o   Once finished, go pack to Packages and look for Load package(s) and then click on it.  You will be given a list of packages available.  Look for Deducer and click on it, and then click OK.  The program will attach itself and you will see additional options available on the tool bar after Help on the right.  You should see Deducer, Data, Analysis, and Plots.  If you do that means that its installed and ready to go. 

 The next part will cover inputing data and simple statistics.

Faculty/Student Collaboration Examining the Affordable Care Act

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A student (Jesper Zuber) and I at Baldwin Wallace University are conducting a study examining the Affordable Care Act.

Understanding People’s Beliefs and Experiences with Health Insurance and The Affordable Care Act

If you are over the age of 18 and live in Ohio, we would like to know how you feel about the Affordable Care Act and how it is affecting your life. Please take a moment to answer the survey, all responses will be confidential. You can access the survey from any computer, tablet, or smartphone using this link: https://bwresearch.typeform.com/to/CtqyTO

We are especially interested to hear from those between the ages of 18-26.

For your participation you will be given an opportunity to enter your email into a drawing to win a $50 gift card to Amazon.com (three prizes will be awarded). Your email will not be linked with your survey responses in any way. If you have any questions please contact:  Emilia Lombardi, PhD at (440) 826-2243 or elombard@bw.edu.

Testing Gender Identity and Expression Measures in a Trans and Cis Sample

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These are the results to the study my colleagues and I conducted last year for the Williams Institute as part of their Gender Identity in U.S. Surveillance (GenIUSS) Project.  A PDF copy is available.

Abstract

Health research examining the disparities faced by gender minorities (transgender, transsexual, and other gender nonconforming individuals) has reached a stage where population based studies are needed in order to expand upon what smaller, community based studies have identified within the population.  One of the issues hindering the inclusion of measures needed to identify gender minority populations is the lack of measures that can effectively identify gender minority populations but can be understood by gender majority populations and provide data usable by researchers.  This study examined measures that can identify gender identity/gender transition and gender expression by conducting cognitive interviews with 50 people (25 gender minority, 25 gender majority).  The interviews asked people to read and answer the questions; afterwards they were interviewed about why they answered the way they did.  The gender identity/gender transition question was found to be understood by all participants and only requires small changes to improve its usage.  The researchers found gender minority and majority participants to have problems answering the gender expression questions.  The results show that the gender expression measures may not be effective when used in a population based study.    Researchers conclude that the gender identity/gender transition questions would be effective in quantitative studies and be useful in identifying health disparities among gender minority populations.

Examination of Gender Identity and Expression Measures within a Mid – West Sample: Report to the Williams Institute

#GLMA13 Poster Abstract: Questions to Identify Gender Diversity

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Questions to Identify Gender Diversity

Emilia Lombardi, PhD; Swagata Banik, PhD; Jesper Zuber; and Katherine Mitchell
Baldwin Wallace University, Berea, Ohio

The study was supported with a grant by the Williams Institute, UCLA School of Law as part of the Gender Identity in U.S. Surveillance (GenIUSS) Project

Background

Transgender has been defined generally as not conforming to societal norms of gender, or specifically to having a gender identity and/or expression that is contrary to one’s assigned sex at birth.  The term is used to refer to a broad range of identities and expressions within the United States and other English speaking countries.  There are efforts to identify study measures that are able to identify transgender populations, but little is known about how cisgender men and women will respond to those questions

Methods

The study interviewed 25 cisgender and transgender men and women to cognitively test how individuals respond to questions about transition status, gender nonconformity, and birth-sex assignment (the two-step and gender nonconformity measures).  The results will help assess the utility and understanding of quantitative measures designed to people’s transition status and gender nonconformity.

Results

Factors discussed include the understandability of the questions and participants ability to accurately identify people’s transition status and gender nonconformity in a manner that has high reliability and validity within quantitative analysis.  Generally, participants were able to easily answer questions relating to transition status but had more difficulty regarding gender expression

Discussion/Conclusion

Results will show that measures to identify transgender populations can be effectively used on cisgender populations, while still being able to identify transgender populations.

Lombardi GLMA poster

Project Summary: Finding Measures to Identify Gender Minority Populations

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Research examining health disparities among gender minorities (transgender, transsexual, and other gender nonconforming individuals) has reached a stage where population based studies are needed in order to expand upon what smaller, community based studies have found.

However, the diversity of terminology and operationalization of various gender minority groups has made it difficult to identify a measure that can be used globally.

At the same time, it will be necessary to create a measure that can be understood by gender majority populations and correctly differentiate between gender majority and minority populations.

One concept that stands out is gender identity/gender transition.  Gender identity/gender transition is defined by people’s answers to two questions, one asking about one’s sex assigned at birth and another about their current sex or gender.  This “two-step” question is being advocated by the Center of Excellence for Transgender Health.

A preliminary study utilizing the National Transgender Discrimination Survey (NTDS) conducted by the National Center for Transgender Equality and the National Gay and Lesbian Task Force examined the relationship between gender identity/gender transition and discrimination.  A dichotomous measure was based on two questions:

What sex were you assigned at birth
What is your primary gender identity Male      Female
Male/Man No          Yes
Female/Woman Yes         No
Part-time No          No
Other No          No

The measure identified those whose primary gender identity was consistently different from their sex assigned at birth (yes versus no).

Another concept is that of gender nonconformity.  Gender nonconformity was measured by a single question “People can tell I’m transgender/gender non-conforming even if I don’t tell them?”.  The variable ranged from zero (never) to four (always).

Plotting these two variables against people’s experiences with discrimination resulted in the following:

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Those who were identified as having a gender different from their assigned sex were found to report more experiences of discrimination; even at higher levels of gender nonconformity.

The above data was found to show that a two-step gender identity question could be useful in identifying those likely to experience greater social disparities among transgender populations.  The next step was to examine whether gender majority individuals can understand and answer these questions in a way that represents their gender majority status.

Another study (funded by the Williams Institute, UCLA) examined gender identity/gender transition measures by conducting cognitive interviews with 50 people (25 gender minority, 25 gender majority).  The interviews asked people to read and answer the questions; afterwards they were interviewed about why they answered the way they did.

The study utilized these questions:

1. What is your sex or gender? (Check ALL that apply)
  • Male
  • Female
  • Other: Please specify: _____________________
 2. What sex were you assigned at birth? (Check one)
  • Male
  • Female
  • Unknown or Question Not Asked
  • Decline to State

The results show that individuals within the gender majority group consistently answered these questions in a manner that identified their gender majority status.  If they answered male (or female) in the first question, they also answered male (or female) for the second; whereas, individuals within the gender minority group had different answers for both questions, and a small number used the “other” option for the first question.

Overall, the two-step question was effective and easily understood by both groups.

  • Individuals within the gender majority group were able to answer the question about sex assigned at birth even though they never heard the phrase before.  They knew what it was referring too.
  • Most people in both groups see gender as an identity
  • People generally felt these two questions were easy to answer.
  • Gender minority group generally saw a difference between the terms sex and gender, but the gender majority group tended to see the terms to be the same.

The next step is to utilize these measures in a quantitative study with gender majority and minority populations to see how effective they are in the field.