OBJECTIVES: Historically, sex and gender demographic characteristics have not been collected consistently or inclusively within health research, due to the use of binary response options (such as male and female). It is important that sex (biological characteristics) and gender (societal construct) demographic information is asked for, and appropriately, to ensure the accurate collection of data, and inclusion of commonly marginalized groups, such as the transgender community. This study aimed to explore the understanding and wording preferences of sex and gender demographic questions within both the general population and the LGBTQ+ community.

METHODS: An online survey was developed by Adelphi Values’ Diversity, Equity, Inclusivity and Belonging team on Sogolytics and hosted on Prolific, an online research hosting website, targeting US respondents. The survey consisted of both closed and open-ended questions to assess understanding, preferences, and opinions on terminology across three sex and gender demographic question options. Quantitative data were analyzed using descriptive statistics, and thematic analysis of open-ended responses was performed.

RESULTS: Three-hundred participants completed the survey (aged: 18-82; 56% female:44% male; 19% gender identity differed to sex assigned at birth; 60% identified as members of the LGBTQ+ community). Participants preferred separate questions for sex and gender identity, with space to self-describe their gender identity. Most participants (73%) felt a ‘prefer not to say’ option should be included in sex and gender questions; 56% would like to specify their gender if it wasn’t listed, with a slight preference for the term “not listed” (36%) over “other” (30%).

CONCLUSIONS: This study highlighted the importance of identifying and using inclusive language to ensure the LGBTQ+ community are inclusively represented in demographic questions within health research. Results are applicable to studies being conducted in the US, however, it is acknowledged that cultural sensitivities should be considered when asking about sex and gender and local guidance should be consulted.