Sexual Orientation Information Questionnaire

Located in the Sample Adult Core, the NHIS sexual orientation question(s) are asked of all sample adults aged 18 and older. The question(s) are embedded in the Adult Selected Items (ASI) section, which also includes questions about computer use, satisfaction with health care, neighborhood tenure, neighborhood attachment, financial worries, sleep, HIV testing, and psychological distress. The sexual orientation question battery in the 2013 and 2014 NHIS consisted of four cascading questions: the main question and three follow-up questions. Beginning in 2015, only the main question has been asked. Consistent with the administration of other potentially sensitive NHIS questions, flashcards listing the response options are employed to administer the sexual orientation questions in the face-to-face interview. The field representative reads the question to the respondent, and the respondent is then asked to report the number corresponding to his/her answer. If the interview is conducted by telephone, the interviewer reads the question and the response options. As with other questions on the NHIS, respondents are free to refuse to answer any of these questions.

The main question reads, “Which of the following best represents how you think of yourself?” The first two response options differ depending on the respondent’s sex, whereas the third through fifth response options are identical for men and women. For men, the first two options are “gay” and “straight, that is, not gay.” For women they include “lesbian or gay” and “straight, that is, not lesbian or gay.” For both men and women, the third through fifth options are “bisexual,” “something else,” and “I don’t know the answer.”

During the question development process,  there were concerns that some respondents might not understand the key terms in the response options, and/or  might not identify with these prescribed answer choices. Therefore, during the first two years of data collection, respondents who answered “something else” or “I don’t know the answer” were asked follow-up questions to determine: (1) the extent to which adults use terms other than gay, lesbian, bisexual, and straight, and (2)  if any misclassification of responses may be occurring with the main sexual orientation question. Specifically, respondents who answered “something else” to the main question were asked the follow-up question, “What do you mean by something else?” Six response options were offered, one of which was “you mean something else.” Respondents who answered “I don’t know the answer” to the main question were asked the follow-up question, “What do you mean by don’t know?” Three response options were offered, one of which was “you mean something else.” Respondents who selected the response option “you mean something else” to either of the follow-up questions could then provide a verbatim response.

The following are the sexual orientation questions asked of sample adult men in the 2013 and 2014 NHIS. Variable names are shown in (BOLD) after each question. An [R] indicates that data from that question are not included in the NHIS public use file, but are available through the National Center for Health Statistics (NCHS) Research Data Center. From 2015 onward, only the main question was asked.

The following are the sexual orientation questions asked of sample adult men in the 2013 and 2014 NHIS. In 2015 and onward, only the main question (ASISIM) was asked.

Which of the following best represents how you think of yourself? (ASISIM)

• Gay
• Straight, that is, not gay
• Bisexual
• Something else
• I don’t know the answer

What do you mean by something else? (ASISMELS)[R]

• You are not straight, but identify with another label such as queer, trisexual, omnisexual, or pansexual
• You are transgender, transsexual, or gender variant
• You have not figured out or are in the process of figuring out your sexuality
• You do not think of yourself as having sexuality
• You do not use labels to identify yourself
• You mean something else

What do you mean by don’t know? (ASISIMDK)[R]

• You don’t understand the words
• You understand the words, but you have not figured out or are in the process of figuring out your sexuality
• You mean something else

What do you mean by something else? (ASIMSESP)[R]

(Sample adult provides verbatim response)

The following are the sexual orientation questions asked of sample adult women in the 2013 and 2014 NHIS. In 2015 and onward, only the main question (ASISIF) was asked.

Which of the following best represents how you think of yourself? (ASISIF)

• Lesbian or gay
• Straight, that is, not lesbian or gay
• Bisexual
• Something else
• I don’t know the answer

What do you mean by something else? (ASISFELS)[R]

• You are not straight, but identify with another label such as queer, trisexual, omnisexual, or pansexual
• You are transgender, transsexual, or gender variant
• You have not figured out or are in the process of figuring out your sexuality
• You do not think of yourself as having sexuality
• You do not use labels to identify yourself
• You mean something else

What do you mean by don’t know? (ASISIFDK)[R]

• You don’t understand the words
• You understand the words, but you have not figured out or are in the process of figuring out your sexuality
• You mean something else
• You mean something else

What do you mean by something else? (ASIFSESP)[R]

(Sample adult provides verbatim response)

Data

The data for the main question are available in the Sample Adult public use file from 2013 onward. The data for the follow-up questions for 2013 and 2014 are available through the NCHS Research Data Center.

Documentation

Survey Documentation

All NHIS survey information for the years 2004 and onwards can be accessed from the portion of the NHIS website titled Questionnaires, Datasets, and Related Documentation, 1997 to the Present. Links to questionnaires and other survey-related documents are found by scrolling down to the year of interest. For data and documentation (other than the questionnaires and the survey description), click on “Data Release” for the year of interest.