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Inclusion of LGBTQ persons in research related to pregnancy risk: a cognitive interview study
  1. Natalie Ingraham1,
  2. Erin Wingo2,
  3. Sarah C M Roberts2
  1. 1 California State University, East Bay, Hayward, California, USA
  2. 2 UCSF Advancing New Standards in Reproductive Health (ANSIRH), Oakland, California, USA
  1. Correspondence to Dr Natalie Ingraham, California State University, East Bay, Hayward CA 94542, USA; natalie.ingraham{at}


Introduction Recently, researchers have begun considering whether and how to include lesbian, gay, bisexual, transgender and queer (LGBTQ) people in research about abortion and contraception care. Including LGBTQ people in research about abortion and contraception care, as well as the risk for unintended pregnancy more broadly, requires accurate assessment of risk for unintended pregnancy, which involves different considerations for LGBTQ people.

Methods We created a survey with existing sexual orientation and gender identity measures, new reproductive anatomy questions to guide skip patterns, gender neutral terminology in sexual and behavioural risk questions, and existing contraception and pregnancy intentions questions that were modified to be gender neutral. We then assessed the appropriateness of these measures through cognitive interviews with 39 individuals aged 18–44 years who were assigned female at birth and identified as LGBTQ. Participants were recruited in the San Francisco Bay Area of California, Baltimore, Maryland and other cities.

Results Existing demographic questions on sexual orientation and gender identity were well received by participants and validating of participant reported identities. Participants responded positively to new reproductive anatomy questions and to gender neutral terminology in sexual behaviour and pregnancy risk questions. They felt skip patterns appropriately removed them out of inappropriate items (eg, use of contraception to avoid unintended pregnancy); there was some question about whether pregnancy intention measures were widely appropriate or should be further restricted.

Conclusions This study provides guidance on ways to appropriately evaluate inclusion of LGBTQ people in abortion and contraception research.

  • research techniques
  • qualitative research
  • lgbtq
  • pregnancy risk

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the UCSF Committee on Human Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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