Context and Disclosure of Sexual Orientation and Gender Identity Information Among US Adults, 2021

Objectives. To investigate if anticipated survey context (e.g., national government health survey, local community health survey, health care provider form) would affect participants' likelihood of (1) responding to sexual orientation, gender identity, sex assigned at birth, and intersex status (SOGISI) questions or (2) changing their responses to SOGISI questions. Methods. We performed an online study of people across sexual orientations and gender identities in the United States (n = 851) testing the hypotheses that individuals with minoritized identity would be less likely to respond and more likely to change their responses to questions about their SOGISI identity. Results. Overall, results were significant and in the expected direction, indicating that there was a dependent relation between identities and type of question being asked. Conclusions. Within this sample, participants with minoritized sexual and gender identities were more likely to change their answer on the basis of the context of data collection, highlighting important considerations for individuals who utilize surveys to collect SOGISI data. Public Health Implications. Results from this study can be used to provide recommendations for questions to use in surveys for collection of SOGISI data and important considerations when collecting data from sexual and gender minorities. (Am J Public Health. 2026;116(4):533-543. https://doi.org/10.2105/AJPH.2025.308376).