Abstract
This survey study queried children and parents on the child’s sexual orientation and gender identity.
Sexual and gender minorities (ie, individuals who do not identify as heterosexual and those whose gender identities differ from their birth sex) experience significantly elevated physical and mental health morbidities compared with heterosexual and cisgender individuals.1 By collecting sexual orientation and gender identity (SOGI) data in a US representative cohort of 9- to 10-year-old children, the recently released Adolescent Brain Cognitive Development (ABCD) Study2 provides an opportunity to understand the development of health disparities and resilience by SOGI at earlier ages than previous research. Both children and parental figures reported SOGI data, bolstering measurement rigor. Baseline analysis of ABCD Study SOGI data can contextualize the opportunities afforded by the data set for epidemiologic surveillance.
Methods
The ABCD Study currently provides 2 SOGI-related measures, self-identification and identity-related stress. Baseline data collection began September 1, 2016; the present study used ABCD annual release data from February 12, 2018. Children self-reported whether they self-identify as gay or bisexual and whether they identify as transgender (Table 1 displays question and response options) via researcher-administered computer-assisted interviews. A response of yes or maybe for each question, indicating probable sexual or gender minority identity, triggered follow-up questions about identity-related stress (Table 2 displays question and response options). A parental figure reported on the child’s identity and stress with similar questions. Parents also reported on their child’s potential gender minority identity via a 2-step process based on the child’s sex assigned at birth and current gender identity. The ABCD Study used complex sampling to recruit youth representative of 9- to 10-year old children in the United States (eg, regarding race/ethnicity, income, and family relationships).2 Thus, results display raw observations and population-weighted estimates.
Table 1. Minority Sexual Orientation and Gender Identity at Ages 9 to 10 Years From the ABCD Study, 2016-2017a.
| Report | No. (%) | |
|---|---|---|
| Raw | Weighted | |
| Child Self-report | ||
| Sexual orientation | ||
| Are you gay or bisexual? | n = 4519 | n = 8204014 |
| Yes | 11 (0.2) | 19 554 (0.2) |
| Maybe | 32 (0.7) | 51 398 (0.6) |
| No | 3402 (75.3) | 6 188 308 (75.4) |
| Did not understand | 1074 (23.8) | 1 944 754 (23.7) |
| Gender identity | ||
| Are you transgender? | n=4520 | n=8205599 |
| Yes | 5 (0.1) | 6610 (0.1) |
| Maybe | 18 (0.4) | 26 965 (0.3) |
| No | 2768 (61.2) | 4 873 466 (59.4) |
| Did not understand | 1729 (38.3) | 3 298 558 (40.2) |
| Parent Report | ||
| Sexual orientation | ||
| Is your child gay? | n = 4523 | n = 8 208 302 |
| Yes | 1 (0) | 2358 (0.02) |
| Maybe/don’t know | 331 (7.3) | 552 316 (6.7) |
| No | 4158 (91.9) | 7 596 612 (92.5) |
| Decline to answer | 33 (0.7) | 57 016 (0.7) |
| Gender identity | ||
| Is your child transgender? | n = 4523 | n = 8 208 302 |
| Yes | 2 (0) | 3269 (0.04) |
| Maybe/don’t know | 49 (1.1) | 95 463 (1.2) |
| No | 4453 (98.5) | 8 072 322 (98.3) |
| Decline to answer | 19 (0.4) | 37 249 (0.5) |
| 2-Step gender identification | ||
| Current gender identity (sex assigned at birth) | n = 4524 | n = 8 201 374 |
| Female (male) | 1 (0) | 1313 (0.02) |
| Trans female (male) | 1 (0) | 1683 (0.02) |
| Male (female) | 3 (0) | 5300 (0.06) |
| Different identity (female) | 1 (0) | 954 (0.01) |
| Female (intersex male) | 2 (0) | 3251 (0.04) |
Abbreviation: ABCD, Adolescent Brain Cognitive Development.
Raw values represent observation in the ABCD Study data set. Poststratification weights were used to match the 2010 US Census. Percentages reported herein are based on population-level estimates.
Table 2. Sexual Orientation– and Gender Identity–Related Stress at Ages 9 to 10 Years From the ABCD Study, 2016-2017a.
| Report | No. (%) | |
|---|---|---|
| Raw | Weighted | |
| Child Self-report | ||
| Sexual orientation | ||
| Has this caused problems for you with your family or at school? | n = 43 | n = 70 952 |
| Not at all | 41 (95.3) | 68 257 (96.2) |
| Some | 2 (4.7) | 2695 (3.8) |
| A lot | 0 | 0 |
| Gender identity | n = 23 | n = 33 575 |
| Has this caused problems for you with your family or at school? | ||
| Not at all | 22 (95.7) | 31 891 (95.0) |
| Some | 1 (4.3) | 1683 (5.0) |
| A lot | 0 | 0 |
| Parent Report | ||
| Sexual orientation | ||
| Has this caused problems for you/your child with your family or with kids at school? | n = 332 | n = 554 674 |
| Not at all | 306 (92.2) | 504 347 (90.9) |
| Some | 21 (6.3) | 39 083 (7.0) |
| A lot | 0 | 0 |
| Decline to answer | 5 (1.5) | 11 244 (2.0) |
| Gender identity | ||
| Has this caused problems for you/your child with your family or with kids at school? | n = 51 | n = 98 732 |
| Not at all | 43 (84.3) | 79 955 (81.0) |
| Some | 7 (13.7) | 15 089 (15.3) |
| A lot | 0 | 0 |
| Decline to answer | 1 (2.0) | 3687 (3.7) |
Abbreviation: ABCD, Adolescent Brain Cognitive Development.
Raw values represent observations in the ABCD Study data set. Poststratification weights were used to match the 2010 US Census. Percentages reported herein are based on population-level estimates.
The institutional review board at the University of California, San Diego, approved the overall ABCD Study protocol. Approval of secondary analysis of SOGI data was obtained from the institutional review board of San Diego State University. Parents and children participated after providing informed consent/assent, and were reimbursed for their participation.
Results
Coding yes and maybe responses as probable minority SOGI identities, approximately 0.86% (raw, n = 43; weighted, n = 70 952) of children self-identified as gay or bisexual. Nearly a quarter of children (raw, n = 23.8%; weighted, n = 23.7%) indicated that they did not understand the sexual orientation question. By contrast, 6.7% of parents (raw, n = 332; weighted, n = 554 674) indicated their child might be gay. For gender identity, 0.4% (raw, n = 23; weighted, n = 33 575) of children self-identified as transgender; 40.2% did not understand the question (raw, n = 1729; weighted, n = 3 298 558). A total of 1.2% (raw, n = 51; weighted, n = 98 732) of parents indicated that their child might identify as transgender. The 2-step gender identification method identified 0.15% of youth (raw, n = 8; weighted, n = 12 501) whose current gender identity differs from their birth sex.
Most children reported that their minority sexual orientation and/or gender identity was not a source of problems with family or school. Parents reported slightly more variance, with 7.0% reporting some problems related to sexual orientation (raw, n = 21; weighted, n = 39 083), and 15.3% reporting some problems with gender identity (raw, n = 7; weighted, n = 15 089). Neither children nor parents reported a lot of problems related to SOGI.
Discussion
The ABCD Study data indicate that less than 1% of US youth report minority sexual orientation or gender identities at age 9 to 10 years; youth and parent reports of SOGI information were generally discordant. A substantial number of youth indicated not understanding the SOGI questions, which may be attributed to measurement design1,3 or youth’s age and developmental stage.3,4,5 The study does not yet include other dimensions of SOGI (eg, same-gender attraction; gender expression) or other sexual orientation identities that youth may report (eg, pansexual)6; future inclusion or availability of such assessments may enhance identification of sexual and gender minority youth. Identifying as a sexual minority typically occurs in midadolescence4,5; thus, more youth in the ABCD Study cohort will likely identify as sexual minorities as the cohort ages. Contrary to prior research on minority stress,5 parents and youth indicated that minority sexual orientation and gender identity were not sources of substantial familial and school stress. However, this study did not examine SOGI indicators in association with health indicators. Future researchers should analyze the rich data available in the ABCD Study to understand how minority SOGI development is associated with health and resilience across adolescence.
References
- 1.Institute of Medicine The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: The National Academies Press; 2011. http://www.nap.edu/openbook.php?record_id=13128. [PubMed]
- 2.Volkow ND, Koob GF, Croyle RT, et al. . The conception of the ABCD Study: from substance use to a broad NIH collaboration. Dev Cogn Neurosci. 2018;32:4-7. doi: 10.1016/j.dcn.2017.10.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Igartua K, Thombs BD, Burgos G, Montoro R. Concordance and discrepancy in sexual identity, attraction, and behavior among adolescents. J Adolesc Health. 2009;45(6):602-608. doi: 10.1016/j.jadohealth.2009.03.019 [DOI] [PubMed] [Google Scholar]
- 4.Calzo JP, Masyn KE, Austin SB, Jun H-J, Corliss HL. Developmental latent patterns of identification as mostly heterosexual versus lesbian, gay, or bisexual. J Res Adolesc. 2017;27(1):246-253. doi: 10.1111/jora.12266 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Saewyc EM. Research on adolescent sexual orientation: development, health disparities, stigma, and resilience. J Res Adolesc. 2011;21(1):256-272. doi: 10.1111/j.1532-7795.2010.00727.x [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Kosciw JG, Greytak EA, Giga NM, Villenas C, Danischewski DJ. The 2015 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual, Transgender, and Queer Youth in Our Nation’s Schools. New York: GSLEN; 2016. [Google Scholar]