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Sexual Orientation Research Phase 1: A Review of Methodological Approaches

2 Definition and classification

2.1 Why definition and classification matter

Quantitative surveys require data to be classified into a limited number of categories in order to analyse and interpret data statistically. How data is grouped therefore has a direct impact on determining the format and distribution of research results and findings. While qualitative approaches can enable the range and variety of perceived meanings and labels to be explored, even qualitative studies need to be able to define, describe or group their population of interest.

This review, in keeping with the language used by the Consultative Steering Group for the Scottish Parliament and in the Scotland Act, uses terms such as sexual orientation, lesbian, gay, bisexual, transgender and gender identity. These terms are employed in much of the recent and current sexual orientation research being undertaken in Scotland. Not all studies use these same terms, and where they are used, they are not always derived in comparable ways. This Chapter will consider aspects of the debate over appropriate terminology to use (with respondents and in reporting) in different types of sexual orientation research and how these categories can be derived. The definitional complexities and historical perspectives that underline various terms will be considered.

This Chapter recommends that definitions need to be selected to be appropriate to the topic being researched; there needs to be clear descriptions in research reports regarding what particular categories were used with respondents and how the categories being reported were derived; and that definitions need to be regularly reviewed to ensure that they are currently relevant and meaningful to the population being studied or consulted, as well as to other users of the data. It is recommended that where appropriate and relevant, the terminology and meanings used in the Scotland Act should be employed to increase comparability across studies.

2.2 Sexual orientation

The term sexual 'orientation' has raised some objections; D'Augelli, for example, argues that it is deterministic. ¹⁰ Gonsiorek and Weinrich, however, reason that it is preferable to sexual 'preference' "which is misleading as it assumes conscious or deliberate choice and may trivialise the depth of the psychological processes involved."(1991) The difficulty of imposing a reductive categorisation onto a potentially complex, historically variable context dependent on individual construction, has long been appreciated by researchers working in 'sexual orientation research'.(Garnets, 2000)

"The world is not to be divided into sheep and goats. Not all things are black or all things white. It is a fundamental of taxonomy that nature rarely deals with discrete categories. Only the human mind invents categories and tries to force facts into separated pigeon-holes. The living world is a continuum in each and every one of its aspects. The sooner we learn this concerning human sexual behaviour the sooner we shall reach a sound understanding of the realities of sex." Kinsey, Sexual Behaviour of the Human Male, 1948

Kinsey recognised that a polarised model of homosexuality and heterosexuality as "discrete categories" did not fit "the realities of sex." He proposed an alternative model for a measure of sexual orientation on a continuum from 0 to 6, with exclusively heterosexual behaviour on one end (0) and exclusively homosexual behaviour on the other (6). Over the next 60 years many researchers have used this seven-point 'Kinsey scale' to quantify sexual orientation. However, introduction of the concept of 'discontinuities' in the development of sexual orientation has cast doubt on the simple use of a scale, and the fact that Kinsey's scale was derived from work primarily with white, middle class, American males has also lead to its universal applicability being questioned. (McWhirter, 1990)

Many recent research projects have cited respondents' own self-identification as 'gay', 'lesbian', 'bisexual', 'transgender' or 'other' as the definition used to establish eligibility for a study, and for analysis purposes. This means that different conceptions of what constitutes sexual orientation - including attraction, identity, lifestyle, partnership and community - may co-exist within a single study. While this sometimes may not matter, for particular policy areas the definition may be directly relevant to the topic being studied.

Sexual health research will be particularly interested in sexual behaviour, and in fact the research findings may be biased if potential respondents were excluded from the research on the basis that they did not identify as LGBT. In order to address this issue, particularly in health and service use research amongst men, the term 'men who have sex with men' (MSM) has become the norm. ¹¹ This also raises the question of what activities are counted as 'sex,' and with what frequency and recency they need to have occurred in order for someone to be eligible. ¹²

In research on housing, same-sex cohabitation may be an appropriate definition; partnership and family studies may be interested in those currently in, or who have been in, same-sex relationships; and research exploring the extent of homophobia might wish to include those who have been the victim of harassment because of the homophobia of an offender, irrespective of the victim's actual self-identity.

So while there have been calls for standardised sexual orientation definitions (e.g. Sell and Becker, 2001), definitions and eligibility criteria used need to be tailored to the subject area and able to generate a sufficient sample. In their review of secondary analyses of large-scale data sets, Black et al. illustrate how changing the definition of sexual orientation used can have an enormous impact on the size and characteristics of the sample obtained.(2000)

Sexual orientation is also likely to be fluid, changing within an individual over time, and felt differently by different individuals. Snape et al. in their 1995 study qualitatively explored with respondents how they had chosen to respond to a survey question about self-perceived sexual orientation: "Three distinct groups were identified: those with affirmed sexuality, where homosexuality is clearly recognised and accepted; those with emergent sexuality, where homosexuality has not yet been acknowledged or affirmed; and those with open sexuality, where sexual orientation is unfixed."(Snape et al., 1995) Grossman and Kerner (1998) argue that this is a particularly relevant distinction for studies of young people, and while some studies of young people have excluded those who report being undecided, uncertain or 'questioning', others have chosen to include them.(Pilkington, 1995)

Concepts and labels of self identity vary not only by age, but by a whole range of other social and demographic factors including ethnicity, immigration and socio-economic status and sex. Weatherburn et al. (2001) argue that the development of a gay identity is a "secondary socialisation process which follows entry into a gay social scene and entry to that gay social scene is differently available to middle class and better educated men." Lack of access to a community and a scene is also likely to be problematic for those living in rural communities, and so the meanings and terms associated with sexual orientation might again differ for this group.

The language of categories is also crucial. The UK Gay and Lesbian Census, carried out by I.D. Research in 2001, opens with a closed question on self-perceived sexuality; offering gay (male and female), homosexual, lesbian, queer, dyke, bisexual or other as categories. These categories are not necessarily exclusive but respondents are asked to tick one. More categories are offered than for many current classifications, but as Reynolds (2001) argues, it does leave out intersex, transgender or transsexual.

The identities covered… give a range of possible identities and the opportunity to specify an alternative. They reflect not simply different identities, but different self-identifying languages for example; homosexual is a term often used by older men or women not attached to contemporary sexual 'communities'…. Gay and lesbian are contemporary identifiers for men and women who love the same sex whilst queer and dyke are often used more often by more political individuals.

Reynolds, 2001

Reynolds goes on to note that 'Queer' presents an "anomaly," because queer theory and politics (from which the self-identification is derived) denies identity categories of any form as "'regulatory regimes'" and proposes 'queer' as a noncategorical identity.(Blasius, 2001; Reynolds, 2001) Martin, in an article on queer youth, uses the term "as an umbrella expression for gay, lesbian, bisexual, transgender, transsexual, and questioning individuals." (Martin, 1996) 'Queer' therefore may highlight a tension in the categorising of sexual identities as social identities. Likewise, the Gay and Lesbian Census excludes people who have sex with people of the same sex, but who self-perceive as heterosexual. In addition some may identify their sexual orientation as 'sub-dom' (sado-masochistic), where their identity stems from practice and not the sex of their partner.

GALOP's 1998 study of young lesbian, gay and bisexual Londoners used a multi-codable range of sexual orientation and identity definitions, including: Out Gay; Out Lesbian; Queer; On the Scene; Non-scene; Straight-looking; Dyke-looking; Camp; Into cruising; In a relationship; Political; Not Political; Discreet; Visible; Other (please specify). Given that it is a study of violence and harassment, aspects of identity relating to visibility are clearly important. However when sexuality is actually reported and analysed quantitatively the categories above are collapsed into: lesbians; bisexual women; gay men; bisexual men; did not define. This was done so that there were groups large enough to analyse statistically. However, re-coding a 'camp' or 'on the scene' male respondent to either the 'gay' or 'bisexual' categories requires certain assumptions to be made by the researcher about what the respondent intended.

While it is important to recognise that only partial bodies of knowledge can be produced, and that it is not possible to classify meaningfully every nuance of sexual identity (particularly in survey research), wherever possible difference and diversity should be acknowledged. It may be that using a label of sexual orientation is not necessary for a particular piece of research, for instance the National Survey of Sexual Attitudes and Lifestyles presents all its data cross tabulated by a whole range of different same sex behaviour variables, attraction and experience scales, and by demographic and other factors.(Natsal, 2001)

Weinrich et al. (1993) conducted statistical factor analyses on the overlaps between 21 different definitions of sexual orientation used in a survey, to test whether a large number of terms where required to capture the full diversity of the sample, or if a smaller number of terms could achieve the same thing:

Many researchers interested in sexual orientation can be separated into two camps: The lumpers, who try to reduce sexual classifications to as small a number of categories as possible, and the splitters, who try to show differences among groups and individuals that make classification schemes increasingly difficult and/or intricate.

They conclude that "both the lumpers and the splitters are correct." On the basis of this and other analyses, the benefits of comparability across different research studies suggest that use of the terms employed by the Scotland Act - lesbian, gay, bisexual and transgender - should be used unless the subject or availability of sample suggests otherwise. However, in the absence of standardised definitions of what is actually meant by these terms, research instruments and reports need to clearly indicate what criteria were used.

2.3 Transgender, transsexualism and gender identity

Sex is often either coded by an interviewer on the basis of observation, or asked through a closed question like 'what is your sex?', with male and female being the only available response categories. Reynolds, in his critique of the 2001 UK Census form, argues that this fails to acknowledge "small but significant minorities who are 'intersex' (born with elements of both male and female sexual organs and biology), transgendered (engaged in identity, behavioural or physical changes to what was their gender assignment at birth), or transsexuals (who have undergone sex change surgery and accompanying pharmaceutical/ therapeutic treatments)."(Reynolds, 2001) He argues that "a crude binary biological form" may not always be the categories of most relevance to how the data being collected is to be used. Instead of presenting two essential sexes, Reynolds suggests "a more sophisticated questioning that asked for self-identities and presented a more detailed range of categories for people to record their inclusion in or approximation to." However, he does not present any suggestions.

Researchers need to have an awareness of how data is to be used. If a purpose of the research is to estimate the prevalence of transgender or transsexual individuals in a population then a separate question on transgender status would be essential. If sex is being asked of an extremely large sample, or of a population likely to contain a number of transsexual or transgender individuals, then again including an additional code or a question makes sense. Without these criteria, and if the question of sex is asked in order to group the sample for purposes of statistical analysis, then asking about transsexual or transgender identity will not be of use in the analysis (given that for most samples the numbers generated will be too small). However, if it makes the respondent feel that the specifics of their situation are being recognised, they are likely to be more satisfied with the research process and give better quality data.

In the UK Gay and Lesbian Census an 'other please specify' option is included at the 'what is your sex?' question. While in many ways this is an improvement, Reynolds argues that this downgrades non-listed categories. "Whilst it might be argued that there is a range of identities within transgendered, from intersex to pre-operative/post-operative transsexuals to cross-dressers, some attempt to provide categories wider than male and female might have been appropriate."(2001) Without specific provision for transsexuals, some may identify as male or female according to their post-operative 'self' and others use the 'other' code. This means that the distinguishable transsexuals are likely to be an undercount, and this may have an impact on health care provision and understanding the composition of the broader categories. This suggests that, where appropriate given the sample, transsexual experience should be asked as a more detailed question, separately from any question about current sex.

Most of the research on transsexualism has not been with transsexuals and their sense of self-identity and self-categorisation, but with psychiatrists. In much of this literature there is an international agreement on diagnostic criteria.(e.g. Van Kesteren et al., 1996; Tsoi, 1998; Hoenig and Kenna, 1974; Ross, 1981) Wålinder's 1968 definition is cited by several of the prevalence studies, which tend to use the term 'transsexualism' and define it as meeting the following criteria:

1. a sense of belonging to the opposite sex, of having been born into the wrong sex, of being one of Nature's extant errors.[my emphasis]

2. A sense of estrangement from one's own body; all indications of sex differentiation are considered as afflictions and repugnant.

3. A strong desire to resemble physically the opposite sex via therapy, including surgery.

4. A desire to be accepted by the community as belonging to the opposite sex.

Ross, an Australian psychiatrist writing in 1981, asserted "transsexualism as an extreme case of cross-gender identification, with transvestism as a less extreme case and homosexuality even further down the continuum, with all three having their roots in hormonal imbalance at some period of development." (Ross et al., 1981) Van Kesteren refers to a different continuum with "gender dysphoria defined as the state, as subjectively experienced, of incongruity between the genital anatomy and gender identity. Transsexualism is its extreme end."(Van Kesteren et al., 1996) While these conceptualisations might be questioned by many, in much of the transsexualism research, especially work looking at prevalence, it is only the psychiatrists who have the power and the opportunity to provide a definition.

The US National Gay and Lesbian Task Force's Policy Institute recently brought out a comprehensive handbook on Transgender Equality. In it, Currah and Minter describe the contemporary term 'transgender' as arising in the mid-1990s from the grassroots community of gender-different people. They argue that 'transgender' is the preferable term for use in sexual orientation social research given that, unlike the term 'transsexual,' it is not a medical or psychiatric diagnosis. "In contemporary usage, transgender has become an 'umbrella' term that is used to describe a wide range of identities and experiences, including but not limited to: pre-operative, post-operative, and non-operative transsexual people; male and female cross-dressers…; intersexed individuals; and men and women, regardless of sexual orientation, whose appearance or characteristics are perceived to be gender atypical."(Currah and Minter, 2002). Transgender, as the more inclusive term, as independent from psychiatric diagnosis, and as consistent with contemporary usage in research and in the language of the Scotland Act, is the preferred term for most gender identity research.

2.4 LGBT community

Morrison and Mackay (2000) ask whether it is valid to use the concept of a 'gay community'. Within the context of a study based in Edinburgh, they answer that "the experience of community can be seen as a foundation for learning, change and empowerment and that, despite what might be seen as flaws or weaknesses, a diverse and vibrant gay community does exist." In an appendix Morrison and Mackay go on to describe this concept in detail.

Even more problematic than the notion of a 'gay community' is that of a 'LBGT community', compassing particularly different group memberships and life experiences. The term necessarily becomes political and about expressing what is shared. Ndofor-Tah, in an AIDS awareness survey of Africans living in Redbridge and Waltham Forest, discusses using the term African 'community' in preference to 'communities' because, despite their wide-ranging geographical origins and variety of culture and languages "the problems and challenges African people face as immigrants to the UK are markedly similar. While the term 'African communities' highlights differences, the inclusive term 'African community' reminds us of the similarities."(2000) Her comments also have ramifications for the politics of describing a 'LGBT community'.

2.5 Other concepts

Herek and Berill's (1992) work on violence research unpacks "the almost synonymous use of the terms homophobia and heterosexism." While it is not relevant to this particular review to explore the meanings of these terms in detail, they are examples of terms that may get used where a common understanding of meaning is incorrectly assumed. ¹³

Very common words like 'family' or 'couple' are also subject to different interpretations and assumptions. Languages have evolved within hetero-centrist cultures and societies. Unless words are actively claimed and defined, there is the risk that a respondent or the reader of an article or report will bring another, more conventional meaning to a term, a meaning that might not have been intended by the researcher. D'Augelli and Hart (1987) precisely define a whole range of terms in their article on 'Gay Women, Men, and Families in Rural Settings.' What was clearly of particular significance here was the frame within which the concept of family was being applied:

"Family is used broadly to include both nuclear and extended families of origin, intimate relationships (lovers, present and former spouses, children, close friends), and families of intimacies (e.g., a parent of a gay friend, a child of a partner)."

They, and Weston (1991), Heaphy et al. (2001), and Weeks et al. (2001) through their qualitative explorations, have contributed to the change in meaning of these terms and have brought the concept and meaning of 'families of choice' into the language.

2.6 Conclusion

Definitions and classifications are crucial, particularly where they are being used to describe a sample population. In keeping with the language of the Scotland Act, this review uses terms such as sexual orientation, lesbian, gay, bisexual, transgender and gender identity. These terms are used in the conduct, analysis and reporting of much of the recent sexual orientation research in Scotland. However sometimes these categories have been derived in different ways and for some research topics these are not the most appropriate categories to use.

It may be more appropriate for a male sexual health study, for example, to recruit (and describe its sample population as) 'men who have sex with men'. Where this is the case, reporting should state how the category was derived (e.g. 'sex with another man in the past 12 months') so that users of the data know what the classification means and can identify what other studies have used a comparable definition.

Definitions need to be selected to be appropriate to the topic being researched; there needs to be clear descriptions in research reports regarding what particular categories were used with respondents and how the categories being reported were derived; and definitions need to be regularly reviewed to ensure that they are currently relevant and meaningful to the population being studied or consulted, as well as to other users of the data. It is recommended that where appropriate and relevant, the terminology and meanings used in the Scotland Act should be employed to increase comparability and consistency across studies.

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