Obtaining data on gender identity and sex in diverse settings: findings from a WHO/HRP consultative process

release date:2021-09-10 18:13
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Obtaining data on gender identity and sex in diverse settings: findings from a WHO/HRP consultative process

by Takhona G. Hlatshwako

Population-based studies have historically collected limited data on gender identity and sex. Until recently, most surveys focused their data collection on binaries, narrowing the options for gender to woman/man and the options for biological sex to male/female. Recognizing the need to better reflect the lived experiences and identities of all people, many countries have started capturing broader information on gender identity and sex. This move towards a more inclusive approach is important because obtaining more complete data on gender identity and sex can help inform the development and provision of relevant health services.

A new study used crowdsourcing to identify a sexual and reproductive health survey instrument. A multidisciplinary group of researchers, (including SESH team members Dan Wu, Megan Srinivas, Eneyi Kpokiri and Joe Tucker), developed sexual and reproductive health survey items for use in low-, middle- and high-income countries.1 The group worked in partnership with the World Health Organization’s Department of Sexual and Reproductive Health and Research and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (WHO/HRP). They identified two items to capture data on gender identity and sex.

Two brief items to assess gender identity and sex in sexual and reproductive health surveys for use in diverse settings:
1.At birth, were you described as
a)Male
b)Female
c)Intersex, undetermined, or another sex
2.Today, do you think of yourself as…?
a)Man/boy
b)Woman/girl
c)In another way (specify)



These two items were developed through a consultative process that aimed to move surveys beyond the commonly used gender and sex binaries. As noted by the group, there is a need for survey items that are applicable in diverse settings, as most survey instruments have been tailored for high-income countries. To close this gap, the group employed a “crowdsourcing open call, a participatory hackathon, and an adapted Delphi method.”2 These participatory methods allowed the study team to tap into a diverse pool of perspectives and ideas, especially from researchers who are familiar with local norms and gender research in their local contexts. These new survey items may help to spearhead more inclusive population-based sexual and reproduction health studies across a variety of settings.

Read more about the study here: https://journals.lww.com/stdjournal/Abstract/9000/Assessing_Gender_Identity_and_Sex_in_Diverse_Low,.97607.aspx


1.Kpokiri EE, Wu D, Srinivas ML, et al. Development of an international sexual and reproductive health survey instrument: results from a pilot WHO/HRP consultative Delphi process. Sex Transm Infect. April 2021. doi:10.1136/sextrans-2020-054822
2.Tucker JD, Bajos N, Mercer CH, Gitau E, Ahmad NA, Gonsalves L. Assessing Gender Identity and Sex in Diverse Low, Middle, and High-Income Settings: Findings from a WHO/HRP Consultative Process. Sex Transm Dis. July 2021. doi:10.1097/OLQ.0000000000001525

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