No access
SIG 14 Cultural and Linguistic Diversity
Viewpoint
17 December 2020

Toward More Inclusive Gender Identity Measurement in Speech, Language, and Hearing Practice and Research

Publication: Perspectives of the ASHA Special Interest Groups
Volume 5, Number 6
Pages 1710-1715

Abstract

Purpose

This article discusses current trends in clinical and research settings for collecting gender identity demographic information and argues for clinicians and researchers in communication disorders and sciences to adopt a two-question method for measuring the gender identity of clients and research participants. Traditional collection of gender demographic information has been constrained to a single question format with a binary response option. Increasing numbers of individuals across the life span identify with gender minorities such as transgender, nonbinary, and gender nonconforming, among others, and the traditional format for obtaining gender-identity related information is insufficient to capture and document this increasing diversity. An example of a two-question method for measuring gender identity demographic information is provided. The benefits and challenges of adopting such a measure in clinical and laboratory settings are discussed.

Conclusions

Gender minorities constitute a growing proportion of clinical caseloads and research participants within speech-language pathology and audiology. The adoption of demographic measurement tools that are inclusive of varying gender identities is necessary to acknowledge and quantify this growth and is a first step in normalizing transgender visibility in clinical and research settings. Such a move advances cultural responsiveness within the professions and promotes competent care and optimal health outcomes for individuals who are gender diverse.

Get full access to this article

View all available purchase options and get full access to this article.

References

American Psychological Association. (2009). Report of the task force on gender identity and gender variance. Author. https://www.apa.org/pi/lgbt/resources/policy/gender-identity-report.pdf
Boskey, E. R. (2014). Understanding transgender identity development in childhood and adolescence. American Journal of Sexuality Education, 9(4), 445–463.
Broussard, K. A., Warner, R. H., & Pope, A. R. D. (2018). Too many boxes, or not enough? Preferences for how we ask about gender in cisgender, LGB, and gender-diverse samples. Sex Roles, 78(9–10), 606–624.
Bussey, K., & Bandura, A. (1999). Social cognitive theory of gender development and differentiation. Psychological Review, 106(4), 676–713.
Cahill, S., Singal, R., Grasso, C., King, D., Mayer, K., Baker, K., & Makadon, H. (2014). Do ask, do tell: High levels of acceptability by patients of routine collection of sexual orientation and gender identity data in four diverse American community health centers. PLOS ONE, 9(9), e107104.
Chang, S. C., Singh, A. A., & Dickey, L. M. (2018). A clinician's guide to gender-affirming care: Working with transgender and gender nonconforming clients. New Harbinger Publications.
Clemens, B., Derntl, B., Smith, E., Junger, J., Neulen, J., Mingoia, G., Schneider, F., Abel, T., Bzdok, D., & Habel, U. (2020). Predictive pattern classification can distinguish gender identity subtypes from behavior and brain imaging. Cerebral Cortex, 30(5), 2755–2765.
Collin, L., Reisner, S. L., Tangpricha, V., & Goodman, M. (2016). Prevalence of transgender depends on the “case” definition: A systematic review. The Journal of Sexual Medicine, 13(4), 613–626.
Conron, K. J., Landers, S. J., Reisner, S. L., & Sell, R. L. (2014). Sex and gender in the US health surveillance system: A call to action. American Journal of Public Health, 104(6), 970–976.
Davies, S., Papp, V. G., & Antoni, C. (2015). Voice and communication change for gender nonconforming individuals: Giving voice to the person inside. International Journal of Transgenderism, 16(3), 117–159.
Department of Health and Human Services. (2015). Electronic health record incentive program–Stage 3 and modifications to meaningful use in 2015 through 2017. https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-25595.pdf
Deutsch, M. B., Green, J., Keatley, J. A., Mayer, G., Hastings, J., & Hall, A. M. (2013). Electronic medical records and the transgender patient: Recommendations from the world professional association for Transgender Health EMR working group. Journal of the American Medical Informatics Association, 20(4), 700–703.
Diamond, L. M., Pardo, S. T., & Butterworth, M. R. (2011). Transgender experience and identity. In S. J. Schwartz, K. Luyckx, & V. L. Vignoles (Eds.), Handbook of identity theory and research (pp. 629–647). Springer.
Fontanella, L., Maretti, M., & Sarra, A. (2014). Gender fluidity across the world: A multilevel item response theory approach. Quality and Quantity, 48(5), 2553–2568.
Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., & Kiesling, M. (2011). Injustice at every turn: A report on the national transgender discrimination survey. National Center for Transgender Equality & National Gay and Lesbian Task Force.
Hancock, A., & Haskin, G. (2015). Speech-language pathologists' knowledge and attitudes regarding lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations. American Journal of Speech-Language Pathology, 24(2), 206–221.
Haupert, M. L. (2019). Considerations for the development and implementation of transgender-inclusive gender demographic questions [Unpublished doctoral dissertation] . Indiana University.
Herek, G. M., Gillis, J. R., & Cogan, J. C. (2015). Internalized stigma among sexual minority adults: Insights from a social psychological perspective. Stigma and Health, 1(S), 18–34.
Ho, F., & Mussap, A. J. (2019). The gender identity scale: Adapting the gender unicorn to measure gender identity. Psychology of Sexual Orientation and Gender Diversity, 6(2), 217–231.
Hyde, J. S., Bigler, R. S., Joel, D., Tate, C. C., & van Anders, S. M. (2019). The future of sex and gender in psychology: Five challenges to the gender binary. American Psychologist, 74(2), 171–193.
Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. The National Academies Press. http://www.iom.edu/Reports/2011/The-Health-of- Lesbian-Gay-Bisexual-and-Transgender-People.aspx
Institute of Medicine. (2013). Collecting sexual orientation and gender identity data in electronic health records: Workshop summary. The National Academies Press.
Kelly, R. J., & Robinson, G. C. (2011). Disclosure of membership in the lesbian, gay, bisexual, and transgender community by individuals with communication impairments: A preliminary web-based survey. American Journal of Speech-Language Pathology, 20(2), 86–94.
McLemore, K. A. (2015). Experiences with misgendering: Identity misclassification of transgender spectrum individuals. Self and Identity, 14(1), 51–74.
Mizock, L., & Lewis, T. K. (2008). Trauma in transgender populations: Risk, resilience, and clinical care. Journal of Emotional Abuse, 8(3), 335–354.
Sawyer, J., Perry, J. L., & Dobbins-Scaramelli, A. (2014). A survey of the awareness of speech services among transgender and transsexual individuals and speech-language pathologists. International Journal of Transgenderism, 15(3–4), 146–163.
Steensma, T. D., Kreukels, B. P. C., de Vries, A. L. C., & Cohen-Kettenis, P. T. (2013). Gender identity development in adolescence. Hormones and Behavior, 64(2), 288–297.
Stets, J. E., & Harrod, M. M. (2004). Verification across multiple identities: The role of status. Social Psychology Quarterly, 67(2), 155–171.
Tate, C. C., Ledbetter, J. N., & Youssef, C. P. (2013). A two-question method for assessing gender categories in the social and medical sciences. Journal of Sex Research, 50(8), 767–776.
The Joint Commission. (2011). Advancing effective communication, cultural competence, and patient-and family-centered care for thelesbian, gay, bisexual, and transgender community: A field guide. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/health-equity/lgbtfieldguide_web_linked_verpdf.pdf?db=web&hash=FD725DC02CFE6E4F21A35EBD839BBE97
Thompson, H. M. (2016). Patient perspectives on gender identity data collection in electronic health records: An analysis of disclosure, privacy, and access to care. Transgender Health, 1(1), 205–215.
Voyzey, G. A. (2015). Meeting the cultural, therapeutic, and individual needs of the lesbian, gay, bisexual, or transgendered patient. SIG 15 Perspectives on Gerontology, 20(3), 85–103.
Zucker, K. J. (2017). Epidemiology of gender dysphoria and transgender identity. Sexual Health, 14(5), 404–411.

Information & Authors

Information

Published In

Perspectives of the ASHA Special Interest Groups
Volume 5Number 6December 2020
Pages: 1710-1715

History

  • Received: Jun 17, 2020
  • Revised: Sep 26, 2020
  • Accepted: Oct 1, 2020
  • Published online: Dec 14, 2020
  • Published in issue: Dec 17, 2020

Permissions

Request permissions for this article.

Authors

Affiliations

Department of Speech, Language and Hearing Sciences, Indiana University Bloomington

Notes

Disclosures
Financial: Brooke Merritt has no relevant financial interests to disclose.
Nonfinancial: Brooke Merritt has no relevant nonfinancial interests to disclose.
Correspondence to Brooke Merritt: [email protected]
Editor-in-Chief: Patrick Finn
Editor: Connie L. Summers

Metrics & Citations

Metrics

Article Metrics
View all metrics



Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Citing Literature

  • A year in stuttering research: A systematic review of global representation and sociodemographic reporting practices in English-language journals in 2020, Journal of Communication Disorders, 10.1016/j.jcomdis.2025.106500, 114, (106500), (2025).
  • Diversity of Research Participant Gender, Race, and Ethnicity in Communication Sciences and Disorders: A Systematic Review and Quantitative Synthesis of American Speech-Language-Hearing Association Publications in 2020, Perspectives of the ASHA Special Interest Groups, 10.1044/2024_PERSP-23-00204, 9, 3, (836-852), (2024).
  • Clinical Focus: The Development and Description of a Palette of Transmasculine Voices, American Journal of Speech-Language Pathology, 10.1044/2024_AJSLP-23-00398, 33, 3, (1113-1126), (2024).
  • Student Perceptions of Learning Clinical Masking in Audiology: An Exploratory Survey Study, American Journal of Audiology, 10.1044/2023_AJA-22-00149, 32, 2, (453-463), (2023).
  • Emerging professional practices focusing on reducing inequity in speech-language therapy and audiology: a scoping review, International Journal for Equity in Health, 10.1186/s12939-022-01815-0, 22, 1, (2023).
  • Revising the Canon: The Need for Expansive Perspectives on Gender and Sexuality in Speech Science Research and Pedagogy, Perspectives of the ASHA Special Interest Groups, 10.1044/2025_PERSP-24-00253, 0, 0, (1-19), (undefined).

Figures

Tables

Media

Share

Share

Copy the content Link

Share