Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors

Abstract Purpose: Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. Methods: Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. Results: Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as “not sure” also had in...