Friday, October 25, 2013

Challenging Gender Demographics in Research

Collecting information on demographic details is standard practice in data collection in all manner of areas – census data, academic surveys, mortgage and credit card applications to name just a few. These questions usually elicit gender, marital status, level of education, ethnicity, religion and so on. For most of these categories, detailed subset answers are provided as standard procedure. Census data are some of the most widely collected and standardized forms of research on the planet. Their results allow governments to analyse population growth and diversity, and can be crucial in aligning public policy with future predictions.

In the 2011 Census results for England and Wales there were eight options provided to describe one’s religion, ranging from Christianity (representing 59.3% of the population) to Muslim (4.8%) and Buddhism (0.4%). The 2011 Irish Census contained 8 possible answers for ethnicity including Irish Traveller (0.5%) and Chinese (0.4%). Both these questions, and many others in the census, included an option to record “other” followed by a space for the respondent to write additional detail. However, in the UK, Irish, and Australian Censuses, as well as those recorded in other countries, there are only two choices for the gender variable: “male” or “female”.

 Given that a national census is only conducted once every few years and is an expensive and time-consuming procedure, it is generally desirable to try and capture as much nuance in the population as can be reasonably elicited without making the process too cumbersome. This kind of fine-grained analysis can tell you if, for example, one minority religious group has different characteristics than another, or one ethnic group tends to live clustered together in a certain area, or any number of questions which might inform policy and research. This kind of nuance, captured so well by most of the Census questions, is missed entirely in the options for gender: here there is only a binary choice of “male” or “female”, with no “other” category. Is this approach the most effective way of capturing our data or are we missing out on some nuance in the population? Prevalence rates for transgender populations in the U.K. have been found to vary between 0.1-0.5%, although the true rate is difficult to ascertain due to the varying definitions of ‘transgender’, the differing inclusion criteria used by different researchers and individuals not openly identifying as transgender due to the stigma and prejudice which surrounds it.

The Transgender Equality Network Ireland defines transgender as “a person whose gender identity and/or gender expression differs from the sex assigned to them at birth. This term can include diverse gender identities such as: transsexual, transgender, crossdresser, drag performer, androgynous, genderqueer, gender variant or differently gendered people”. In 2004, the Gender Recognition Act was passed in the UK, which allows for individuals who identify as a gender different to what they were assigned at birth to be legally recognised by the UK government. Similar legislation has been passed in Australia, parts of Canada and a number of Asian countries. Despite these legal changes, the UK and Australia have yet to amend their Census forms to reflect the legal status of transgender individuals.

“Transgender”, or any other derivative, is essentially non-existent in the research demographics of Behavioural Science, Economics or Psychology (apart from when target variables are gender identity or sexual orientation). Although not included in the majority of research, many studies on mental health and suicide show staggering findings with regard to individuals who identify as transgender. This group consistently records higher levels of depression, anxiety and substance abuse compared to the general population (Haas et al. 2011). A 2006 study found that 32% of transgender subjects had attempted suicide (Clements-Nolle 2006) and in 2010 Mustanski et al. found this rate to be as high as 45%, with major depression being diagnosed in 20% of transgender subjects. The 2012 UK Trans Mental Health Study found 84% of transgender participants considered taking their own life at some point and 25% had attempted suicide more than once, with 4% considering it as an option on a daily basis. One participant noted, “I do wish that society was more understanding and accepting of trans people. I wish that the physical outcomes were better and that I had not lost so much (relationship, job, physical and mental health, home).” 

Consider then the implications for researchers who only include “male” and “female” in their gender variable, particularly for well-being research. If, for example, a study on well-being only provides the traditional gender options, it will potentially neglect a major source of variance from transgender individuals who may report high levels of depression or suicidality. This, of course, is most useful in larger data sets, as the population estimates for the transgender community continue to lack real reliability, the inclusion of the variable could increase reliability of the estimates, as well as record variance between target groups. By folding this group into “male” or “female”, a researcher would fail to identify the group potentially most in need of further attention. As an analogy, imagine if research on how sugar consumption affects people’s health failed to record whether the subjects were diabetic.

Furthermore, this exclusion from research may further exacerbate the stigma associated with deviations from binary gender identification. Clements-Nolle’s (2006) research examined gender-based discrimination and gender-based victimization experienced by transgender individuals and found them to be independently associated with suicide attempts.

Starting a conversation 
In line with legal gender recognition, recognition of a more nuanced gender status within a research context would be a small step towards transgender inclusion, as well improving data quality. This is particularly important for the area of mental health and well-being research, given the shocking mental health statistics of the transgender population. Even the My World Survey National Study of Youth Mental Health in Ireland, Australia’s Health Survey 2010 and The Scottish Health Survey: Equality Groups (2012), three large-scale national data sets and otherwise state-of-the-art health surveys, only elicit the traditional binary gender variable.

As a starting point for future surveys, the Human Rights Campaign contains examples of how gender questions can be asked to better elicit the true population rate. While it is perhaps unrealistic to expect a future Census to have 5 or 6 answer options for a gender question, at a minimum an “Other” option would be a valuable step forward in transgender equality. In the meantime, behavioural science and other social science research should consider using a gender variable that allows for more accuracy.

1. Clements-Nolle (2006), Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization, Journal of homosexuality
2. Haas et al. (2011), Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations, Journal of homosexuality
3. Mustanksi et al. (2010), Mental Health Disorders, Psychological Distress, and Suicidality in a Diverse Sample of Lesbian, Gay, Bisexual, and Transgender Youths, American Journal of Public Health ________________________________________

[1] In this blog post we use the term transgender to describe individuals who identify as a sex other than which they were assigned at birth. However, in other writings the term trans* is sometimes used, whose asterisk highlights the lack of discretion in the term i.e. transgender, transsexual and transvestite. [2] Sexual orientation is recorded in the My World survey and Scottish Health Survey, however, it is important to emphasise the distinction between gender identity and sexual orientation.

1 comment:

Anonymous said...

In the news - Germany to allow 'third' gender - Michael