Estimating Population Size and Demographic Characteristics of Lesbian, Gay, Bisexual, and Transgender Youth in Middle School

Abstract

Purpose:
To estimate the size and demographic characteristics of the lesbian, gay, bisexual, and transgender youth populations using data from the 2011 Youth Risk Behavior Survey (YRBS) administered in San Francisco Unified School District middle schools.

Methods:
The YRBS was administered to a stratified random sample of 2,730 youth (grades 6-8) across all 22 public middle schools in San Francisco. Cross-tabulations using complex samples analyses were used to derive population estimates and confidence intervals.

Results and conclusions:
Results show that 3.8% of middle school students identify as lesbian, gay, or bisexual, and 1.3% of middle school students identify as transgender. To improve our understanding of the size of these populations across the nation, researchers conclude it is imperative that all YRBS administration sites include items on sexual orientation and gender identity as they would any other demographic item, such as race/ethnicity, sex, or age. The current lack of reliable data on the size and characteristics of the lesbian, gay, bisexual, and transgender youth population limits the capacity of policy makers, administrators, and practitioners to address their needs.

Full text

Adolescent health brief
Estimating Population Size and Demographic Characteristics of Lesbian, Gay,
Bisexual, and Transgender Youth in Middle School
John P. Shields, Ph.D., M.S.W.
a,
*, Rebekah Cohen, M.A.
a
, Jill R. Glassman, Ph.D., M.S.W.
a
,
Kelly Whitaker, M.P.A.
a
, Heather Franks, M.A.
a
, and Ilsa Bertolini, M.A.
b
a
Education, Training and Research Associates, Research Department, San Francisco, California
b
Student, Family, and Community Support Department (School Health Programs), San Francisco Unified School District, San Francisco, California
Article history: Received March 19, 2012; Accepted June 17, 2012
Keywords: Lesbian, gay, bisexual, and transgender youth (LGBT); Youth Risk Behavior Survey (YRBS); Middle school; Early
adolescence
ABSTRACT
Purpose: To estimate the size and demographic characteristics of the lesbian, gay, bisexual, and
transgender youth populations using data from the 2011 Youth Risk Behavior Survey (YRBS)
administered in San Francisco Unified School District middle schools.
Methods: The YRBS was administered to a stratified random sample of 2,730 youth (grades 6–8)
across all 22 public middle schools in San Francisco. Cross-tabulations using complex samples
analyses were used to derive population estimates and confidence intervals.
Results and conclusions: Results show that 3.8% of middle school students identify as lesbian, gay,
or bisexual, and 1.3% of middle school students identify as transgender. To improve our understand-
ing of the size of these populations across the nation, researchers conclude it is imperative that all
YRBS administration sites include items on sexual orientation and gender identity as they would
any other demographic item, such as race/ethnicity, sex, or age. The current lack of reliable data on
the size and characteristics of the lesbian, gay, bisexual, and transgender youth population limits
the capacity of policy makers, administrators, and practitioners to address their needs.
䉷2013 Society for Adolescent Health and Medicine. All rights reserved.
IMPLICATIONS AND
CONTRIBUTION
It is imperative that all YRBS
administration sites include
items on sexual orientation
and gender identity as they
would any other demo-
graphic item. Lack of reli-
able data on the size and
characteristics of the LGBT
youth population limits the
capacity of policy makers,
administrators, and practi-
tioners to address their
needs.
Estimating the size of the lesbian, gay, bisexual, and transgen-
der (LGBT) youth population is a challenging endeavor [1]. Chil-
dren’s transitions into adolescence include an ongoing process of
developing sexuality, sexual orientation, and gender identity
[1,2]. The constantly changing social and political contexts that
frame children’s development of sexuality, sexual orientation,
and gender identity present challenges to measuring the size of
the population of LGBT youth in general and early adolescents in
particular [3]. Cognitive, social, and cultural factors also affect
students’ interpretation of and responses to survey questions
about sexual orientation and gender identity [4]. Students may
also be hesitant to identify themselves as LGBT to protect their
privacy and/or avoid stigma and discrimination, even on anony-
mous surveys [5].
These challenges have resulted in a dearth of studies that
estimate the size of the lesbian, gay, or bisexual (LGB) youth
population in the United States and a near complete lack of data
on the size of the population of transgender youth. To date, only
a small number of studies using probability samples provide
national population estimates for LGB youth in high school, and
fewer include youth in middle school [1]. The most rigorous
studies (i.e., those based on large probability-based samples)
have not included respondents younger than 18 years (e.g., Na-
tional Health and Social Life Survey [2010], General Social Sur-
veys [2008]; National Survey of Family Growth [2002]). Just two
published studies used data from probability samples, included
item(s) related to sexual orientation, and included middle
school-aged respondents. In the first study, published in 1992, 1%
of approximately 35,000 respondents aged 12–17 years identi-
* Address correspondence to: John P. Shields, PhD, MSW, Senior Research
Associate II, Education, Training and Research Associates (ETR), 251 Rhode Island
Street, Suite 204, San Francisco, CA 94103.
E-mail address: johns@etr.org (J.P. Shields).
Journal of Adolescent Health 52 (2013) 248–250
www.jahonline.org
1054-139X/$ - see front matter 䉷2013 Society for Adolescent Health and Medicine. All rights reserved.
http://dx.doi.org/10.1016/j.jadohealth.2012.06.016

fied as “homosexual or bisexual,” whereas another 5% reported
they were “mostly heterosexual,” and 2% were “unsure” [6]. The
second study, which analyzed Add Health data from more than
12,000 7th–12th grade students, found that 5% of female subjects
and 7.3% of male subjects reported “same-sex romantic attrac-
tion” [7]. To our knowledge, no study has been published that
estimates the size of the transgender population at the middle
school level.
This study provides estimates of the size of the LGBT popula-
tions at the middle school level using data from the San Francisco
Unified School District (SFUSD), which in 2011 became the first
district in the country to include items on both sexual orientation
and gender identity on their middle school Youth Risk Behavior
Survey (YRBS).
Methods
Using a stratified random sampling design, the 2011 YRBS
was administered to 2,730 youth (grades 6–8) across all 22
public middle schools in San Francisco in compliance with the
CDC’s administration guidelines and state regulations on parent
consent/notification. The process yielded a 74% survey comple-
tion rate, surpassing the CDC’s 60% criteria for the generation of
weighted data. CDC statisticians calculated sampling weights,
strata, and primary sampling unit statistics. Cross-tabs using
complex samples methods, which incorporate sampling param-
eters (i.e., strata, weight, and primary sampling unit) into the
analyses, were used to derive population estimates and their
confidence intervals. The YRBS results are representative of all
SFUSD students in grades 6–8.
Measures
Following the CDC guidelines, standard YRBS demographic
items (e.g., sex, race/ethnicity, age, and grade) were included in
the analyses if no fewer than 100 respondents were represented
[8]. Sexual orientation was measured using the item, “Which of
the following best describes you?” and the response set “hetero-
sexual (straight); gay or lesbian; bisexual; and not sure.” Trans-
gender-inclusive gender was measured with the item, “What is
your gender?” and the response set “female; male; and transgen-
der.”
Results
Population estimates show 3.8% of students in SFUSD middle
schools identify as LGB (Table 1). Within the 3.8% of LGB students,
1.7% identify as gay or lesbian and 2.1% as bisexual. Another
12.1% of students responded they were “not sure” about their
sexual orientation. Results also show 1.3% of students identify as
transgender, resulting in a weighted population estimate of 137
transgender youth. Across available demographic variables, the
proportion of LGB and transgender youth appeared to increase
with age and varied by race/ethnicity (Table 2). Although LGB
students were represented in each race/ethnicity group, Chinese
students, who comprised 38.3% of the YRBS sample, reported a
significantly smaller LGB population (p⬍.05) than African Amer-
ican, Hispanic/Latino, white, and multiple race students. No sig-
nificant differences were found across racial groups of transgen-
der students.
Discussion and Conclusions
The population estimates derived in this study clearly dem-
onstrate the presence of LGBT students at the middle school
level. The large proportion of students (12.1%) who report being
“unsure” of their sexual orientation is likely owing to a combina-
tion of factors, including the variability of developmental trajec-
tories across youth; their social, cultural, and familial contexts;
and differences in youths’ understanding and interpretation of
the survey item. Additional research is needed on the reliability
and validity of the items used to measure sexual orientation and
gender identity. Research is also needed on the social, political,
and economic contexts that may affect the size of LGBT youth
populations in specific communities.
Although the CDC permits the inclusion of items on sexual
orientation and/or gender identity on the YRBS, to date, only 17
of the 76 high school sites have chosen to do so. Data from the
Table 1
Sexual orientation and gender identity of middle school students: population statistics
Sexual orientation/
gender identity
Unweighted count Population estimate Standard error 95% Confidence interval
Lower Upper
Sexual orientation
Heterosexual 2,254 8,721.410 316.362 8,094.191 9,348.628
Gay or lesbian 48 172.724 26.727 119.734 225.713
Bisexual 59 217.362 37.171 143.667 291.057
Not sure 276 1,250.964 131.543 990.167 1511. 761
Total 2,637 10,362.459 374.772 9,619.437 11,105.482
Heterosexual 2,254 84.2% 1.1% 81.9% 86.2%
Gay or lesbian 48 1.7% 0.3% 1.2% 2.3%
Bisexual 59 2.1% 0.3% 1.5% 2.9%
Not sure 276 12.1% 1.1% 10.0% 14.5%
Total 2,637 100.0% 0.0% 100.0% 100.0%
Gender identity
Female 1,331 5,148.062 224.796 4,702.382 5,593.742
Male 1,337 5,381.086 231.687 4,921.744 5,840.429
Transgender 33 137.053 48.423 41.050 233.057
Total 2,701 10,666.201 398.453 9,876.230 11,456.173
Female 1,331 48.3% 1.2% 46.0% 50.5%
Male 1,337 50.4% 1.1% 48.2% 52.7%
Transgender 33 1.3% 0.4% 0.6% 2.5%
Total 2,701 100.0% 0.0% 100.0% 100.0%
J.P. Shields et al. / Journal of Adolescent Health 52 (2013) 248–250 249

high school administration sites have provided a range of LGB
population estimates from 3.9% to 7.8% [9]. To our knowledge,
just 4 of the 15 sites that administer the YRBS at the middle
school level included at least one item related to sexual orienta-
tion in 2011, and other sites’ results have not yet been published.
A growing body of data shows LGBT youth are subjected to
disproportionally high rates of harassment, bullying, and other
violence at school and engage in higher rates of health risk
behavior compared with students who are not LGBT [9,10].Itis
critical to explore the YRBS for evidence of similar disparities at
the middle school level. To better understand and support LGBT
youth, it is imperative that all middle school and high school
YRBS administration sites include items on sexual orientation
and gender identity as they would any other demographic item,
such as race/ethnicity, sex, or age.
Acknowledgments
The authors gratefully acknowledge the San Francisco Unified
School District’s School Health Programs staff; its director Kim
Coates; and program managers Kevin Gogin and Kim Levine for
their invaluable contributions to and support of this study. Points
of view or opinions expressed in this document are those of the
authors and do not necessarily represent the official position or
policies of the San Francisco Unified School District.
References
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GA: Center for Disease Control and Prevention, 2004.
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Table 2
Population estimates of lesbian, gay, and bisexual (LGB) and transgender
middle school students by demographic characteristics
Demographic
characteristics
Percentage of overall
population
(95% confidence interval)
Overall
population
total
LGB students 3.8 (2.9–4.8) 2,637
Sex
Male 3.2 (2.3–4.3) 1,331
Female 3.8 (2.8–5.3) 1,293
Age (years)
11 or younger 1.2 (.6–2.5) 435
12 2.7 (1.9–4.0) 1,014
13 5.9 (4.4–7.9) 970
Grade
6th 1.9 (.9–3.7) 476
7th 2.9 (2.1–4.1) 1,110
8th 5.5 (4.5–6.8) 1,013
Race/ethnicity
African American
a
6.8 (3.7–12.2) 161
Chinese 1.6 (1.0–2.5) 921
Filipino 4.5 (2.0–10.0) 138
Hispanic/Latino/a 4.4 (2.7–6.9) 615
White
a
5.7 (3.2–10.1) 227
All other races 3.5 (1.6–7.5) 203
Transgender students 1.3 (.6–2.5) 2,701
Sex
Male 1.1 (.6–2.1) 1,355
Female 1.0 (.5–2.0) 1,334
Age (years)
11 or younger .6 (.3–1.8) 242
12 .8 (.3–2.1) 543
13 1.7 (.8–3.7) 456
Grade
6th .8 (.2–2.9) 259
7
th
.9 (.4–2.1) 568
8th 1.1 (.6–2.0) 490
Race/ethnicity
African American
a
2.6 (.9–7.8) 84
Chinese .5 (.2–1.2) 475
Filipino
b
70
Hispanic/Latino/a 1.9 (.7–5.1) 297
White
a
.7 (.2–2.9) 109
All other races 2.0 0.6
Multiple races 2.1 0.8
a
Non-Hispanic/Latino/a.
b
Fewer than 100 students in the subgroup.
J.P. Shields et al. / Journal of Adolescent Health 52 (2013) 248–250250