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editorial
. 2023 Nov;113(11):1153–1156. doi: 10.2105/AJPH.2023.307387

Two-Spirit Identity and Adolescent Survey Measures: Considerations of Appropriation, Transparency, and Inclusion

Lenny Hayes 1, Anne LaFrinier-Ritchie 1, Nicole Matthews 1, Beth O’Keefe 1, Nigel Perrote 1, G Nic Rider 1, Camille Brown 1, Montana Filoteo 1, Katie Johnston-Goodstar 1,, Barbara J McMorris 1, Lauren Martin 1
PMCID: PMC10568506  PMID: 37590914

The Minnesota Youth Sex Trading (MYST) project is a collaborative of faculty, staff, and students at the University of Minnesota working in partnership with nonprofit organizations and service providers, government entities, and people with lived experience. This commentary is written by various members of the collaborative across many professional and personal identities, including members of our Native American community advisory board.

The MYST team conducts actionable research to identify prevention opportunities, guide systems change, and promote wellness among youths. In particular, the team analyzes self-report data from youths who completed the Minnesota Student Survey (MSS), a triennial, anonymous, statewide school-based survey conducted in collaboration with local schools and four State of Minnesota agencies. In 2019, the MSS added a new question: “Have you ever traded sex or sexual activity to receive money, food, drugs, alcohol, a place to stay or anything else?” Our team has produced some of the first school-based prevalence estimates of youth sex trading. Sexual exploitation and trafficking of youths cause myriad harms. MYST’s research shows disproportionate and intersectional impacts of these harms for youths of color; Indigenous youths; youths experiencing homelessness and poverty; lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ+) youths; and youths in foster care (https://bit.ly/44GoBiH).1,2

NATIVE+ COMMUNITY RESEARCH ADVISORY BOARD

In 2020, the MYST project established a number of community advisory processes to assist researchers, including an intertribal, Native American community advisory board, which consists of six tribally identified service providers working in the field of sexual violence and exploitation. This engagement was particularly meaningful to the research team, given Native youths are often represented by hyper-deficit research narratives3 or dismissed as statistically insignificant or what Garland refers to as “an asterisk” on a data table.4 Cautious of this, the collaborative engaged in intense consultation to establish an accurate prevalence rate of sex trading for Native youths that was contextually informed and could guide policy and practice in meaningful ways.

Using available self-reported data on students’ race and ethnicity from the 2019 MSS, we cocreated two unique variables to better understand prevalence among Native youths. First, we expanded our definition of Native American youths to “Native+,” including those students who selected that they identified as “only” American Indian or Alaska Native (AIAN), AIAN plus an additional race (+), “only” Native Hawaiian or Pacific Islander (NHPI), and NHPI+.

This community-designed definition honors the sovereignty of Indigenous nations to determine community membership that recognizes individuals of mixed racial background and lineal descent. It further reflects the racial diversity present in American Indian communities in our geographic area, and it includes the shared experiences of Indigenous peoples with colonialism, which has been linked to sexual exploitation.5 This aligns with recommendations in statewide discussions with tribal representatives. These decisions resulted in more than a threefold increase in our sample size.

Second, we created a related variable that was intended to capture Two- Spirit/2-Spirit identity, history, and community-based definitions. To do so, we combined the Native+ variable, gender modality, and sexual orientation to create a dichotomized variable (Two-Spirit/2-Spirit or not Two-Spirit/ 2-Spirit). This variable was labeled “LGBTQ+2S.” Specifically, Native+ youth who self-reported identifying as “transgender, genderqueer, or genderfluid” or unsure of their gender identity (inclusive of all sexual orientations) and those who reported identifying as bisexual, gay or lesbian, questioning, pansexual, queer, or using a different sexual orientation label but not identifying as “transgender, genderqueer, or genderfluid” were included in LGBTQ+2S. We aimed to make this variable inclusive but recognized it was dependent on the pre-established Western conceptualizations of gender and sexuality that informed what questions are typically asked of students on the MSS.

Separate from our collaborative work, a decision was made at the state level to add Two-Spirit as a response option for their item asking about gender identity in the 2022 MSS. This decision contributed to significant discussion among our community advisory members who were appreciative of the inclusive intention but expressed concerns over a lack of understanding of the term Two-Spirit, its history, and the potential for appropriation and harm. When the MYST project team began data analyses of the 2022 MSS data, we followed up on the community advisory board’s concerns. Of the 395 students who selected Two-Spirit as their gender identity, less than a quarter (24.1%) were Native+. In comparison, among students who selected Two-Spirit as their gender identity, 45.8% identified their racial identity as exclusively White, and 26.2% identified their racial identity as neither exclusively White nor Native+ (in total 72% of those identifying as Two-Spirit were non-Native+). These response rates provided support for the concerns and led us to write this commentary; yet, we wish to recognize that this is not an effort to criticize our state partners, who have been positively responsive to these findings and have committed to engaging with them. Rather, we use this commentary to advance awareness and scholarly discussion in the field and among our fellow researchers.

TWO-SPIRIT DEFINITION AND APPROPRIATION

While an expansive history of colonialism in the Americas is beyond the scope of this commentary, it is without question that Indigenous peoples were, and still are, subject to a series of colonial acts of violence, treaty-making (and breaking), laws, and policies6 that sought or seek to dispossess Native people of land and erase cultural, spiritual, political, and intellectual presence. Lewis Meriam, author of the federal report, The Problem of Indian Administration (https://bit.ly/3Kgk3Hu), declared that Indians must be advanced “along the white man’s road” (p. 552) so that they may be “absorbed into the prevailing civilization or be fitted to live in the presence of that civilization at least in accordance with a minimum standard” (p. 554). These civilizing efforts were based on assumptions of European racial, religious, and economic superiority and included the heteropaternal organization of citizens “into nuclear families, each expressing a ‘proper,’ modern sexuality.”7(p13) This forced assimilation sought to erase complex notions of gender and sexuality and their associated cultural, spiritual, and familial roles. As Lugones described, “[g]ender itself is a colonial introduction, a violent introduction consistently and contemporarily used to destroy peoples, cosmologies, and communities.”8(p186) This construct and subsequent marginalization contributes to disproportionate rates of substance use disorder and mental health challenges because of multiple minority oppressed status and exposure to stress and trauma.9

The term Two-Spirit is a direct reflection of this history and refers to a person of a culturally and spiritually distinct gender exclusively recognized by Native American Nations (Lenny Hayes, e-mail communication, October 18, 2021). It affirms the “interrelatedness of all aspects of identity including sexuality, gender, culture, community and spirituality.”10(p304‒305) Two-Spirit people were “seen as being neither men nor women, but as belonging to genders of their own within cultural systems of multiple genders”11(p114) and often occupied highly respected social and ceremonial roles.12 Organizations, such as Gay American Indians, which was founded more than 48 years ago, were started to build safe circles, support one another, and reclaim these roles and relations. By 1990, Native American community members coined the term, Two-Spirit, with a clear intention to distance themselves from non-Native gays and lesbians and historically inaccurate and insulting terminology used by non-Native researchers.13

The reclamation of gender(s), sexuality, and Indigenous people’s traditional knowledge about gender(s) and sexuality roles and practices is a political, cultural, and spiritual act to define one’s self and one’s experience. Two-Spirit is a “term of resistance to colonization and non-transferable to other cultures.”14(p125) Furthermore, “It is part of our counter hegemonic discourse and reclamation of our unique histories. Aboriginal people coined the term Two-Spirit and are using it to reflect our past, and the direction of our future. We are using the term. It is ours.”14(p123) For additional discussion of the distinction and relationship between Two-Spirit and Native LGBTQ+ communities, please refer to Indigenizing Love: A Toolkit for Native Youth to Build Inclusion (https://bit.ly/3Qew9oc).

CONSIDERATIONS FOR RESEARCH MOVING FORWARD

The addition of the Two-Spirit response option on the 2022 MSS provided an unexpected opportunity to gather empirical evidence that supports community-based concerns. Given this history, one can understand how an appropriation of the term Two-Spirit is problematic within the context of society and particularly within the context of research, which includes an extensive history of extraction and harm in Indigenous communities.15 As researchers, we ask the following questions: How do we balance our desire to build measurement tools that are expansive and inclusive but also take heed of these critical histories and definitions? What is our responsibility if respondents lack the information or prudence to take heed themselves? How do the “discursive and material practices of [the] academy writ large participate in the dispossession of Indigenous peoples’ lands, livelihoods, and futures” and how can we “divest from these practices”7(p25) and avoid perpetuating epistemological violence?

Using data based on a significant cultural term poses a number of considerations that are social and scientific in nature, including the generalizability of results, confusion over whom the results are applicable to, and continued harm to communities who have claimed exclusive use of a term that has deep spiritual and cultural significance. Additional limitations are that Native+ people may prefer to use their own distinct tribal terms to define themselves, which may not necessarily be the term, Two-Spirit. As Indigenous peoples recover language, notions of gender, and associated roles, health researchers must be flexible and continue to exercise caution. This requires ongoing consultation in regard to identity (e.g., our lead author often uses “Do you know the word in your language that would identify someone like me?” in his practice) and commitment to nuance and flexibility.

We use this commentary to shine a light on our constructs and engage in scholarly dialogue at the intersection of inclusion and marginalization. We recognize that these considerations do not map well onto the landscape of survey research and perhaps present more questions than answers, but we believe they are critical to consider nonetheless. As we navigate data analyses and future survey and research designs, we encourage careful use of the term Two-Spirit and that researchers use a community-engaged approach. It is crucial to partner with community advisory boards to explore and develop better practices for using survey design tools (e.g., conditional branching) to ensure that only Native American and Indigenous respondents have the option to select this identity.

ACKNOWLEDGMENTS

MYST research was supported by the World Childhood Foundation USA and Carlson Family Foundation.

This commentary resulted from ongoing efforts associated with the MYST project and includes authors who are academic researchers with the University of Minnesota and expert community members who make up the MYST Native+ community advisory board. The work reported in this opinion editorial was derived from research projects combined with community expertise and wisdom. The authors thank AJPH reviewers and editors.

This editorial is following community-engaged principles where we have a community–university partnership, and this is reflected in the authorship team. We would like to honor the multiple sources of knowledge that our team uses and comes from—all of which are important to us.

CONFLICTS OF INTEREST

The authors report no conflicts of interest.

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