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Collecting Sexual Orientation in Counseling Research: Implications for Counselor Education

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Title: Collecting Sexual Orientation in Counseling Research: Implications for Counselor Education
Language: English
Authors: Westcott, Jordan B., Epstein, Dryden, Wiley, Benjamin, Westcott, Jess M., Welfare, Laura E. (ORCID 0000-0002-9342-2469), Catalano, Chase
Source: Counselor Education and Supervision. 2023 62(4):384-397.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 14
Publication Date: 2023
Document Type: Journal Articles
Reports - Research
Descriptors: Counseling, Counselor Training, Sexual Orientation, Research, Data Collection, LGBTQ People, Researchers, Research Methodology, Risk, Affordances, Informed Consent
DOI: 10.1002/ceas.12285
ISSN: 0011-0035
1556-6978
Abstract: Sexual orientation is often invisible in counseling research despite increasing LGBQ+ identity in the United States. We used consensual qualitative research to explore considerations from LGBQ+ counseling researchers for collecting sexual orientation. Three domains emerged: risks, benefits, and methodological considerations. Our findings highlight inclusive research practice strategies for LGBQ+ research participants.
Abstractor: As Provided
Entry Date: 2023
Accession Number: EJ1402817
Database: ERIC
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  Value: <anid>AN0173988803;cev01dec.23;2023Dec06.04:02;v2.2.500</anid> <title id="AN0173988803-1">Collecting sexual orientation in counseling research: Implications for counselor education </title> <p>Sexual orientation is often invisible in counseling research despite increasing LGBQ+ identity in the United States. We used consensual qualitative research to explore considerations from LGBQ+ counseling researchers for collecting sexual orientation. Three domains emerged: risks, benefits, and methodological considerations. Our findings highlight inclusive research practice strategies for LGBQ+ research participants.</p> <p>Keywords: cultural competence; demographic; LGBTQ+; methodology; research</p> <hd id="AN0173988803-2">INTRODUCTION</hd> <p>A primary role of counselor education programs is supporting the development of multicultural competence in their trainees (Hill, [<reflink idref="bib19" id="ref1">19</reflink>]). However, evidence of inadequacy in skills related to counseling lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) clients (e.g., Farmer, [<reflink idref="bib9" id="ref2">9</reflink>]) prompted many programs to improve student preparation. One challenge counselor educators face in preparing students to work effectively with sexual minority (e.g., lesbian, gay, bisexual, queer, etc. [LGBQ+]) clients is lack of representation in research. In part due to failure to collect sexual orientation as a demographic variable, researchers often exclude or render invisible LGBQ+ people (Griffith et al., [<reflink idref="bib13" id="ref3">13</reflink>]; HRC, [<reflink idref="bib20" id="ref4">20</reflink>]). Limited demographic data may mask the presence of LGBQ+ participants in research studies, making confounds or moderation effects undetectable.</p> <p>In the context of counseling research, when researchers do not explicitly name participant sexual orientation, implications for LGBQ+ people remain unknown. For example, a study of developmental theories that excludes sexual orientation as a demographic variable masks unique developmental considerations for LGBQ+ participants. Notably, this is also the case for gender minority (e.g., transgender, nonbinary, genderqueer, etc.) people; however, sexual orientation and gender identity are distinct constructs that are often erroneously conflated. Therefore, the focus of this paper is sexual orientation. Accordingly, understanding considerations for including sexual orientation as a demographic variable may advance inclusive counseling research and enhance counselor training.</p> <hd id="AN0173988803-3">Demographic information in counseling research</hd> <p>Collecting demographic information is standard practice in human subjects research (HHS, [<reflink idref="bib8" id="ref5">8</reflink>]). Collecting participants' demographic information enables researchers to understand the characteristics of their study sample (Giordano et al., [<reflink idref="bib11" id="ref6">11</reflink>]), thereby establishing the context and generalizability of the findings. This is especially important in counselor education, wherein counselor educators train future counselors to evaluate evidence‐based practices to determine their applicability to specific clients or client groups (Hill, [<reflink idref="bib19" id="ref7">19</reflink>]). Within counseling literature, some demographic variables appear to be ubiquitous, including sex assigned at birth or gender, race and/or ethnicity, age, educational attainment, and income (Giordano et al., [<reflink idref="bib11" id="ref8">11</reflink>]). Researchers may collect other demographic variables if they perceive them as relevant to the study. All people have a sexual orientation, thus these demographic data are relevant to all research. HRC ([<reflink idref="bib21" id="ref9">21</reflink>]) estimated between 3% and 9% of the U.S. population is not heterosexual. However, implications for counseling interventions, counselor education, and supervision practices among LGBQ+ people remain unclear and understudied (Goodrich, [<reflink idref="bib14" id="ref10">14</reflink>]), which may be in part due to the absence of sexual orientation as a demographic variable in many studies. Indeed, when the LGBQ+ participants present in counseling research are made invisible, counselors may unintentionally overlook their unique needs and strengths.</p> <p>Excluding sexual orientation from counseling research may obfuscate unique impacts of counseling, counselor training, and supervision methods on LGBQ+ clients and students. Bryan ([<reflink idref="bib4" id="ref11">4</reflink>]) found that LGBTQ+ students in counselor education programs experience numerous microaggressions, such as invalidation, heteronormative assumptions, and environmental challenges. These experiences may be disruptive to skill and identity development. When counselor preparation research does not include sexual orientation, researchers cannot account for the influence of LGBQ+ microaggressions that might complicate their findings. Therefore, counseling researchers should consider collecting and reporting sexual orientation in their research.</p> <hd id="AN0173988803-4">Counselor educators' responsibilities</hd> <p>Research and scholarship are integral components of counselor educators' roles (Hatchett et al., [<reflink idref="bib16" id="ref12">16</reflink>]; Ramsey et al., [<reflink idref="bib27" id="ref13">27</reflink>]). Therefore, as scholars, counselor educators may help resolve the problem posed by exclusion of sexual orientation in counseling research. The demographic information that researchers decide to collect, as well as how they decide to collect it, has implications for who may be present in a given sample (HHS, [<reflink idref="bib8" id="ref14">8</reflink>]). Ethical guidelines and standards of research (i.e., ACA, [<reflink idref="bib2" id="ref15">2</reflink>]; Griffith et al., [<reflink idref="bib13" id="ref16">13</reflink>]), as well as federal regulations and guidelines (HHS, [<reflink idref="bib8" id="ref17">8</reflink>]; Policy for Protection of Human Subjects, 45 C.F.R. §46), emphasized researchers' responsibility to include and accurately describe marginalized populations, such as LGBQ+ people, in their research (Sharma et al., [<reflink idref="bib29" id="ref18">29</reflink>]). Counseling researchers aim to honor LGBQ+ participants' complex social identities by collecting sexual orientation with intentionality (Griffith et al., [<reflink idref="bib13" id="ref19">13</reflink>]) and resources for how to do so are available (e.g., Wolff et al., [<reflink idref="bib31" id="ref20">31</reflink>]).</p> <p>At the same time, varying legal protections for marginalized sexualities (Conron & Goldberg, [<reflink idref="bib6" id="ref21">6</reflink>]; Goodrich, [<reflink idref="bib14" id="ref22">14</reflink>]) require intentional researcher protections to minimize potential risks and maximize potential benefits for their participants (ACA, [<reflink idref="bib2" id="ref23">2</reflink>]; Policy for Protection of Human Subjects, 45 C.F.R. §46). Accordingly, researchers must take significant care to protect data when collecting sexual orientation of participants, such as avoiding unnecessary risk and, when necessary, balancing potential risk against potential benefits for participants (Policy for Protection of Human Subjects, 45 C.F.R. §46). This risk–benefit analysis is challenging because, at present, scant empirical research exists to address risks unique to LGBQ+ people participating in research. Therefore, we sought to understand how counseling researchers can address the need for LGBQ+ inclusion while minimizing risks using the following research question: What are LGBQ+ researchers' perspectives on the risks, benefits, and methodological considerations related to collecting sexual orientation as a demographic variable?</p> <hd id="AN0173988803-5">METHODS</hd> <p>Given the dearth of literature related to risks, benefits, and methodological considerations associated with collecting sexual orientation as a demographic variable, we utilized consensual qualitative research (CQR) to explore LGBQ+ researchers' perspectives. CQR is an inductive, exploratory qualitative tradition unique in its ability to measure internal experiences and perspectives (Hill, [<reflink idref="bib17" id="ref24">17</reflink>]). CQR is a rigorous qualitative methodology due to its use of multiple perspectives, emphasis on consensus among a qualified research team, and ongoing accuracy checks throughout the research process (Hill, [<reflink idref="bib17" id="ref25">17</reflink>]; Hill et al., [<reflink idref="bib18" id="ref26">18</reflink>]).</p> <hd id="AN0173988803-6">Participants</hd> <p>Participants who (a) identified as LGBQ+ and (b) conducted human subjects research in counseling or related fields were eligible for the study. Given their own experiences conducting research as individuals with a marginalized identity, LGBQ+ researchers were the voices we sought to provide any unique perspectives on potential risks and benefits. Our sample (<emph>n</emph> = 20) exceeded the recommended minimum eight to 15 participants for CQR (Hill et al., [<reflink idref="bib18" id="ref27">18</reflink>]). Sixty percent (<emph>n</emph> = 12) identified as women, 35% (<emph>n</emph> = 7) identified as men, and one participant identified as nonbinary. There was diversity regarding sexual/affectional orientation (see Table 1). Our sample was largely racially homogeneous with 75% (<emph>n</emph> = 15) identifying as White. Participants ranged in age from 22 to 77 years (<emph>M</emph> = 36.8). Eleven of the 20 participants had completed doctoral degrees and were faculty, researchers, or practitioners, seven were pursuing doctoral degrees, and two were master's‐level practitioners.</p> <p>1 TABLE Participant demographics.</p> <p> <ephtml> <table><thead><tr><th>Pseudonym</th><th>Sexual/affectional orientation</th><th>Gender</th><th>Race or ethnicity</th></tr></thead><tbody><tr><td>Participant A</td><td>Lesbian</td><td>Cisgender woman</td><td>White</td></tr><tr><td>Participant B</td><td>Lesbian</td><td>Cis female</td><td>White</td></tr><tr><td>Participant C</td><td>Gay</td><td>Man</td><td>White</td></tr><tr><td>Participant D</td><td>Queer</td><td>Gender nonconforming woman</td><td>Black</td></tr><tr><td>Participant E</td><td>Bisexual</td><td>Cisgender female</td><td>White</td></tr><tr><td>Participant F</td><td>Gay</td><td>Cisgender male</td><td>White</td></tr><tr><td>Participant G</td><td>Gay</td><td>Cisgender man</td><td>Black</td></tr><tr><td>Participant H</td><td>Gay man</td><td>Male</td><td>White</td></tr><tr><td>Participant J</td><td>Gay</td><td>Male</td><td>Latino</td></tr><tr><td>Participant K</td><td>Bisexual</td><td>Female</td><td>White</td></tr><tr><td>Participant L</td><td>Queer/lesbian</td><td>Cisgender woman</td><td>White</td></tr><tr><td>Participant M</td><td>Bisexual</td><td>Woman</td><td>White</td></tr><tr><td>Participant N</td><td>Pansexual/queer</td><td>Cis woman</td><td>White</td></tr><tr><td>Participant O</td><td>Aromantic asexual</td><td>Cisgender woman</td><td>White</td></tr><tr><td>Participant P</td><td>Pansexual</td><td>Woman</td><td>White</td></tr><tr><td>Participant Q</td><td>Queer</td><td>Woman (cisgender)</td><td>White</td></tr><tr><td>Participant R</td><td>Bisexual</td><td>Cisgender (pronouns: she/her)</td><td>Latina</td></tr><tr><td>Participant S</td><td>Queer</td><td>Cisgender male</td><td>Black</td></tr><tr><td>Participant T</td><td>Pansexual</td><td>Nonbinary/gender fluid/trans</td><td>White</td></tr><tr><td>Participant U</td><td>Gay man</td><td>Male</td><td>White</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note</emph>: Participant demographics retain the language participants used to describe their identities. People who identified themselves using the term female or woman were counted as women, and people who identified themselves as men or using the term male were counted as men in the narrative summary presented in text.</p> <hd id="AN0173988803-7">Research team</hd> <p>Our interdisciplinary research team included a doctoral student and faculty member in Counselor Education, two recent graduates from a master's‐level counseling program accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), a counseling psychologist, and a faculty member in Higher Education with expertise in qualitative methods and whose research agenda includes queer and trans identities. We participated in group discussions prior to data collection related to our salient personal identities, personal experiences related to the topic of research, and our biases and expectations of the data (Hill, [<reflink idref="bib17" id="ref28">17</reflink>]; Hill et al., [<reflink idref="bib18" id="ref29">18</reflink>]). We additionally engaged in individual (i.e., journaling) and group reflexivity processes, such as discussions (Hill et al., [<reflink idref="bib18" id="ref30">18</reflink>]). The team represented a range of marginalized and privileged sexualities and gender identities. All research team members had experience conducting and/or participating in human subjects research.</p> <hd id="AN0173988803-8">Procedure</hd> <p>After receiving institutional review board approval, we sought participants through professional listservs and snowball recruiting to complete a structured interview via an anonymous, online survey. After providing informed consent, we invited participants to respond to open‐ended questions (see example questions described in the data analysis section below).</p> <hd id="AN0173988803-9">Data analysis</hd> <p>CQR data analysis is a team endeavor, involving three primary steps: developing domains; creating core ideas within each domain that abstract the data; and cross‐analysis to construct themes or categories from the data (Hill, [<reflink idref="bib17" id="ref31">17</reflink>]; Hill et al., [<reflink idref="bib18" id="ref32">18</reflink>]). To enhance the rigor and trustworthiness of our analyses, we utilized a three‐member primary coding team, with two internal auditors and one external auditor. The primary coding team developed initial domains from a "start list" (Miles & Huberman, [<reflink idref="bib26" id="ref33">26</reflink>]), which led to six initial domains derived from the interview questions (e.g., "Risks," derived from "What risks do you perceive to be associated with disclosing sexual and/or affectional orientation in research questionnaires?"). Participant responses to the question associated with each domain were the data in the six initial domains.</p> <p>The primary coding team then independently reviewed all the cases within a given domain and held a consensus meeting to construct core ideas within that domain, repeating this process until core ideas were constructed for all six initial domains. Next, the team revised domain coding to identify superordinate themes, leading to four domains. All coding was conducted during the consensus meetings. This method of coding is preferable to independent coding in CQR because it enhances the consensus process by allowing the team to discuss the case in greater depth during the coding process, resulting in more valid data (Hill et al., [<reflink idref="bib18" id="ref34">18</reflink>]).</p> <p>Next, the primary coding team generated categories and subcategories as a group, then characterized the frequency of the categories (i.e., general, typical, or variant; see the notes on Table 2 for definitions; Hill et al., [<reflink idref="bib18" id="ref35">18</reflink>]). At this stage, the primary coding team provided the raw, de‐identified data and associated core ideas, organized by domain and category, to the internal auditors for review. Internal auditors provided written feedback, and then the primary coding team and internal auditors met to arrive at consensus on any changes to the domains, categories, or organization of data. Once the coding team reached consensus, they shared the results and data with the external auditor for feedback. Once again, the external auditor provided written feedback, then met with two members of the research team to arrive at consensus. The rest of the research team reviewed the changes to reach consensus. The audit and revision process led to three final domains, confirmed using cross‐analysis. Finally, we conducted a stability check, which confirmed our categorization of the data.</p> <p>2 TABLE Results: Domains, categories, subcategories, and frequency.</p> <p> <ephtml> <table><thead><tr><th align="left">Domain</th><th>Category</th><th>Frequency</th></tr></thead><tbody><tr><td align="left">Risks</td><td>No or minimal risk</td><td>Typical</td></tr><tr><td>Individual risk</td><td>Typical</td></tr><tr><td>Outing</td><td>Typical</td></tr><tr><td>Community risk</td><td>Variant</td></tr><tr><td align="left">Benefits</td><td>Individual benefits</td><td>Typical</td></tr><tr><td>Community benefits</td><td>Typical</td></tr><tr><td>Positive cultural and political change</td><td>Variant</td></tr><tr><td>Need for research</td><td>General</td></tr><tr><td>No benefits</td><td>Variant</td></tr><tr><td align="left">Methodological considerations</td><td>Qualitative methodology</td><td>Typical</td></tr><tr><td>Quantitative methodology</td><td>Typical</td></tr><tr><td>Simplification of identities/experiences</td><td>Typical</td></tr><tr><td>Study focus</td><td>General</td></tr><tr><td>No impact</td><td>Variant</td></tr><tr><td>Demographic collection</td><td>General</td></tr><tr><td>Communication</td><td>General</td></tr><tr><td>Confidentiality</td><td>Typical</td></tr><tr><td>Researcher positionality</td><td>Variant</td></tr><tr><td>Researcher advocacy</td><td>Variant</td></tr></tbody></table> </ephtml> </p> <p>2 <emph>Note</emph>: To illustrate how representative a category or subcategory is of the data, we indicated the frequency of occurrence using the labels suggested by Hill et al. ([<reflink idref="bib18" id="ref36">18</reflink>]): general (applicable to almost every case), typical (applicable to more than half of the cases), and variant (applicable to half or fewer of the cases).</p> <hd id="AN0173988803-10">FINDINGS</hd> <p>Our analysis yielded three domains: (a) Risks, (b) Benefits, and (c) Methodological Considerations. A summary of these domains, and their associated categories and subcategories, is in Table 2 and explored in greater depth below.</p> <hd id="AN0173988803-11">Risks</hd> <p>The Risks domain reflected risks associated with collecting sexual orientation as a demographic variable. Categories include <emph>no or minimal risk</emph> (typical), <emph>individual risks</emph> (typical), <emph>outing</emph> (variant subcategory), and <emph>community risks</emph> (variant). The <emph>no or minimal risks</emph> category revealed that many participants believed that collecting sexual orientation as demographic information involved "little to no risk" (Participant K) beyond what is typical for research participation. Participant B shared that "the risk of disclosure is very low." That being said, as a researcher, she is "acutely aware of the sensitivity of the information I am asking for and attempt to convey that to potential participants." Overall, responses in this category suggested that, so long as researchers are attending to standard ethical research practices and aware of the sensitivity of some kinds of information, collecting sexual orientation as a demographic variable poses little risk to participants.</p> <p>However, a divergent perspective emerged in the typical <emph>individual risk</emph> category, where participants described unique risks to LGBQ+ participants that exceed minimal acceptable risks. Individual risk increased based on the participant disclosure process including when in the research process. This included concerns about how disclosure in the research process might activate participant discomfort with their sexual orientation or newfound awareness of their sexual orientation. Participant H suggested that participants may experience "coming out, perhaps for the first time," "experiencing the extent to which one is uncomfortable with one's sexual identity," psychological risks associated with "selecting the most accurate term... and what that means to you," or "cognitive dissonance between behavior and private self‐identity." These risks reflect discomfort that might emerge for some participants when asked to label their sexual orientation during research participation.</p> <p>Psychological distress may also emerge for participants if researchers collect sexual orientation in an exclusive way. Participants described ways that participants' identities may be misrepresented in demographic surveys (i.e., no option to select their identity) or in subsequent aggregation by the researcher. Participant O shared "sometimes well‐intentioned researchers can unintentionally harm LGBTQIA+ participants with how their questions are written." This may also occur in aggregation strategies during data analysis, erasing distinctions between queer and heterosexual participants as well as across different queer identities. Participant M suggested such aggregation strategies "[remove] the individuality of the groups and individuals within the group."</p> <p>Within individual risk were aspects of researchers' responsibilities to avoid <emph>outing</emph>, and associated consequences. Participant U shared that collecting sexual orientation could result in "indirect outing." This could occur for several reasons, such as conducting research in "settings in which data collection is not entirely confidential" (Participant N), "parental consent being required for a kiddo to participate in a study" (Participant U) that might out underage participants to their parents, or triangulation with other salient identities. For example, Participant S shared that "the greatest risk is when I am identified in a population in which I am of a small minority of the greater population," such as when participants occupy a multiply marginalized social position (e.g., Black, woman, and gay; Latino, man, bisexual, and disabled). Participants with multiple marginalized identities may be more identifiable via triangulation, particularly if they are the only person in a given context with that unique social position. Although this may not out a research participant's sexual orientation, it may associate a participant with their specific response, which may carry personal or professional risks depending on the sensitivity of the information disclosed. Being outed may lead to a variety of other harmful consequences, including creating "a safety issue," "losing relationships/family" (Participant U), and "threat of losing the tenure of one's professional career due to sexual orientation" (Participant R).</p> <p>A final area of risk emerged in the variant <emph>community risk</emph> category, which highlighted potential risks to LGBQ+ communities based on the way data are used when researchers collect sexual orientation as demographic information. Participant O suggested that "the risk begins with who's asking about sexual/affectional orientations," specifically noting that researchers with biases against LGBQ+ people may interpret their results "in bad faith to harm the LGBTQIA+ community." Participant Q similarly stated that there was risk of some researchers using data generated in research to "try to 'prove' something harmful about people who identify as LGBTQ+." These harmful conclusions have the potential to contribute to biases against and negative social attitudes toward people who are already marginalized due to sexual orientation.</p> <hd id="AN0173988803-12">Benefits</hd> <p>Participants also described potential benefits related to collecting sexual orientation as a demographic variable, many of which were related to participants' decisions to disclose their identities. There were four categories: <emph>individual benefits</emph> (typical), <emph>community benefits</emph> (typical), <emph>need for research</emph> (general), and <emph>no benefits</emph> (variant). <emph>Community benefits</emph> included a variant subcategory, <emph>positive cultural and political change</emph>.</p> <p>The <emph>individual benefits</emph> category referred to positive emotional experiences related to participants' decisions to disclose their sexual orientation in research studies. Participant E suggested that participants "can feel more understood and seen more holistically as a result of this disclosure." For some participants, research may be one of the only avenues for sharing their identity. Therefore, identity disclosure "could also be a freeing feeling" (Participant F) and may lead to "self‐affirmation of one's identity" (Participant H). Although <emph>individual benefits</emph> tended to focus on emotional experiences related to identity disclosure, the <emph>community benefits</emph> category revealed both emotional validation and broader cultural change as benefits to LGBQ+ communities. Participant A shared that identity disclosure "makes us visible in a heterosexist and transphobic world." The act of "sharing experiences" (Participant P) may lead to community benefits as the result of documenting and connecting broader LGBQ+ experiences.</p> <p>Participant responses in the variant subcategory <emph>positive cultural and political change</emph> highlighted positive cultural and policy shifts that may result from collecting sexual orientation in counseling research. Participant U suggested that collecting sexual orientation may lead to "better understanding of social determinants of health for queer people," especially because "being out is [a] process that is stressful and factors into all facets of everyday life." Participant O argued that "increased knowledge about minority sexual/affectional identities" may lead to "more acceptance of minority LGBTQIA+ identities." Participant Q speculated how results from research could also improve the "quality of care" provided to LGBQ+ people.</p> <p>The most cited benefit was addressing the <emph>need for research</emph> with LGBQ+ populations, both through studies related to sexual orientation and including these participants in studies that are not specifically related to sexual orientation. Participants argued for advancing knowledge about sexual minority populations specifically, citing benefits such as "increasing representation" (Participant T) and "expansion of the body of literature about licensed professionals by focusing on sexual affectional orientation" (Participant R). Participant S summarized the risk–benefit analysis of including sexual orientation as demographic variable:</p> <p>Research becomes much more specific in its findings for a particular population when the benefits of the outcome outweigh the risks of possible exposure through demographic exposure. There are challenges when an individual may be working within an environment that may not affirm their sexual/affectional orientation. In those cases, anonymity and confidentiality are incredibly important.</p> <p>Several participants also called for the inclusion of sexual orientation as a standard demographic variable. Participant D argued that it was "imperative" to collect "this important demographic information," regardless of the topic under study. Including sexual orientation as a universal demographic variable emerged as a strategy to improve counseling research. For example, Participant F noted that including sexual or affectional orientation in demographic surveys "allows researchers to be more intersectional in their research questions, running analyses by different identities to make sure we are not assuming a relationship holds for all people." Participant C also shared that including sexual orientation may allow researchers "to detect if there is a systematic difference between groups if the sample is large enough, but even just reporting LGBT identities in demographics helps to add to visibility in areas where LGBT topics may not be common." Collecting sexual orientation may therefore have benefits to LGBQ+ people even when that information is not included in data analyses.</p> <p>Although most participants suggested that there were several potential benefits associated with collecting sexual orientation as a demographic variable, a variant category emerged that suggested there are <emph>no benefits</emph> to collecting this information. Specifically, when asked about the benefits associated with collecting sexual orientation as a demographic variable, Participant G shared, "none." We were unable to further explore this response because we collected data via an anonymous online survey. This negative case illustrates the diversity of views, even among LGBQ+ researchers, related to collecting sexual orientation as demographic information.</p> <hd id="AN0173988803-13">Methodological Considerations</hd> <p>The final domain, Methodological Considerations, described how researchers' decisions influence the collection of sexual orientation as a demographic variable, as well as how to communicate results. Five categories emerged: <emph>qualitative methodology</emph> (typical), <emph>quantitative methodology</emph> (typical), <emph>study focus</emph> (general), <emph>demographic collection</emph> (general), and <emph>communication</emph> (general). Subcategories included <emph>simplification of identities/experiences</emph> (typical) in the <emph>quantitative methodology</emph> category and <emph>no impact</emph> (variant) in the <emph>study focus</emph> category.</p> <p>Regarding <emph>qualitative methodology</emph>, participants described unique considerations for collecting sexual orientation as a demographic variable using qualitative research traditions, as well as differences in risks and benefits associated with collecting sexual orientation that might emerge using such methods. Many participants preferred qualitative methods for conducting research with LGBQ+ participants. The ability to explore experiences with greater depth and nuance was highlighted as a specific strength to qualitative methods, as was the "personal" nature of qualitative findings and associated "reflexive work" of the researcher (Participant S). LGBQ+ research participants can typically self‐identify in qualitative research, allowing researchers to accurately describe their samples. Unique risks also emerged in qualitative approaches. Collecting research participants' sexual or affectional orientation may feel "more intimate" (Participant F) to participants in qualitative research, which may create a greater sense of personal risk for participants. Participant M shared that "qualitative research is typically more in‐depth and intimate to the person's unique experience, so people may feel vulnerable disclosing their sexual orientation in this context vs an anonymous quantitative study." Indeed, the very processes that allow more nuanced findings may cause greater distress for participants.</p> <p>Participants also described unique considerations for collecting sexual orientation in <emph>quantitative methodology</emph> and associated benefits and risks. In general, participants perceived quantitative research as involving "less stress" (Participant H) when collecting sexual orientation demographic information. Participant F suggested that this is because "quantitative is likely more impersonal and comfortable, because it is often survey‐based and feels more private." Participant R agreed, highlighting "privacy" as a specific strength to quantitative approaches. Participants also suggested that quantitative research provides less nuanced responses, as it explores "less direct experience" to focus on "more general" information (Participant P). This leads to less nuanced findings, which decreases participant risk exposure while flattening out their experiences reflected in the <emph>simplification of identities/experiences</emph> subcategory. Participant K noted that the categorization typical to quantitative research may lead researchers to treat sexual orientation as "just a label without much context." Participant N acknowledged challenges for researchers, as it "can be difficult to reduce complex sexualities into discrete questions/categories on quantitative studies." Participant Q provided a personal example: "I identify as queer. Quantitative does not give me the chance to explain what that means to me, as this term means something different for others." These limitations are important to consider in designing research studies and demographic questionnaires, as well as the findings they produce; potential solutions described by respondents, such as open‐ended demographic items, are described in the <emph>demographic collection</emph> category below.</p> <p>Another notable element of research design is the <emph>study focus</emph>. Participants described differences in risks, benefits, and respondents' potential reactions in research studies related and unrelated to sexual orientation. Generally, participants believed that LGBQ+ respondents may experience a greater sense of safety disclosing their identities in studies related to sexual orientation. Participant J suggested that participants are aware that LGBQ+‐specific studies will "mostly be run by people who are more sensitive to the populations," whereas researchers who include the question in unrelated studies "may not be as aware of [sexual orientation] still being a sensitive piece of information." Participant E agreed that LGBQ+ participants may "distrust" the inclusion of questions related to sexual orientation in unrelated studies. However, other participants noted the benefits of collecting sexual orientation as demographic information in studies unrelated to sexual or affectional orientation. Participant C suggested that collecting this information may allow researchers "to detect if there is a systematic difference between groups if the sample is large enough." Even if researchers do not use this information to conduct sophisticated analyses, he suggested that reporting demographics related to sexual or affectional orientation may "add visibility."</p> <p>Although most participants agreed that the study focus was relevant to risks and benefits associated with collecting sexual orientation, some suggested that it had <emph>no impact</emph>. Participant D stated that "asking the question should not matter and does not put the participant in harm's way as long as the researchers do not engage in biased or problematic data reporting." Similarly, Participant L denied that there were differences in risks and benefits based on study focus because "this gathering of data is beneficial for all types of studies."</p> <p>Another category of methodological decision‐making for researchers is the method of <emph>demographic collection</emph>. Notably, some participants only collected sexual orientation "if it is pertinent to the research topic" (Participant B), whereas others argued that "asking about sexual orientation should be like asking about any other demographic variable" (Participant J). Participant S suggested that researchers should "be intentional" regarding the "purpose behind acquiring" this information, stating, "it's important to help further our understanding of these communities but [this information] should not be collected without forethought." Intentional demographic collection must also consider language use in collecting sexual orientation and methods for collecting it. Language was a particular concern in designing research surveys because "identity labels often change with generational cohorts and across cultures" (Participant J). Researchers who use out‐of‐date language may cause participants to reconsider their participation.</p> <p>Regarding collection methods, participants emphasized the need for "the option to skip" or invitations to "leave [the question] blank if they do not want to report it." By emphasizing participant autonomy in the decision to disclose sexual orientation, researchers can reduce risks to participants. Participant H also noted that it is "important to stress accurate reporting," particularly when sexual orientation is an inclusion criterion or a variable in the study. Participant K recommended "having options for multiple ways to identify," the use of "broader terms like queer or fluid as options," and to focus on how participants "individually identify" rather than using their partner to approximate sexual orientation. Participant U noted that he utilizes the term "nonheterosexual to avoid excluding any identities."</p> <p>Participants also described <emph>communication</emph> strategies that informed their methodological decisions related to collecting sexual orientation and sharing associated findings. Participants made recommendations for strengthening the informed consent process for LGBQ+ research respondents, such as describing potential distress, data management procedures, and "providing resources specific to LGBQ+ participants" (Participant L). Some researchers in this study described sharing their own positionality in the informed consent to build trust with research participants. Some of the topics included in researcher positionality statements included "what [researchers] intend to do with the data" (Participant G), personal engagement with the LGBTQ+ community, and salient personal identities. Including positionality information in research outputs can help communicate researchers' perspectives, biases, and relationship to the data. Similarly, reducing how much information to share in outputs prevents identification via triangulation is also important, therefore sharing results requires careful consideration. Participant T asked researchers to "consider the impact of sharing data on these communities and not making sweeping generalizations." Even well‐intentioned researchers may frame their results in ways that can be "used to discriminate or discredit the community" (Participant T).</p> <hd id="AN0173988803-14">DISCUSSION</hd> <p>Through this qualitative inquiry, we sought to understand LGBQ+ researchers' perspectives on the risks, benefits, and associated considerations for collecting sexual orientation in counseling research. Three emergent domains—risks, benefits, and methodological considerations—aligned with researchers' responsibilities to communicate about risks and benefits (ACA, [<reflink idref="bib2" id="ref37">2</reflink>]; Policy for Protection of Human Subjects, 45 C.F.R. §46), employ research methods that reduce unnecessary risk (ACA, [<reflink idref="bib2" id="ref38">2</reflink>]; HHS, [<reflink idref="bib8" id="ref39">8</reflink>]), and use inclusive, affirming strategies to collect potentially sensitive demographic information (Griffith et al., [<reflink idref="bib13" id="ref40">13</reflink>]).</p> <p>Notably, respondents called for greater inclusion of sexual orientation as a demographic variable in all counseling studies, even as they acknowledged specific risks associated with LGBQ+ identity disclosure. Although there are no specific data available about the proportion of articles published in counseling journals that reported sexual orientation as part of their participant demographics, there is evidence that journals related to LGBTQ+ topics continue to be the primary publication outlet for LGBTQ+ research (Goodrich, [<reflink idref="bib14" id="ref41">14</reflink>]). This may limit the reach of such work. Additionally, research focused on LGBTQ+ topics remains sparse in counseling and psychology literature (e.g., Abreu et al., [<reflink idref="bib1" id="ref42">1</reflink>]; Greenspan et al., [<reflink idref="bib12" id="ref43">12</reflink>]; Singh & Shelton, [<reflink idref="bib30" id="ref44">30</reflink>]), contributing to documented invisibility of LGBQ+ participants in research (Griffith et al., [<reflink idref="bib13" id="ref45">13</reflink>]; HRC, [<reflink idref="bib20" id="ref46">20</reflink>]). In counseling research, this is especially problematic, as not knowing participants' sexualities limits researchers' ability to identify potential confounds or otherwise explore the impact of sexual orientation on outcome variables (Limberg et al., [<reflink idref="bib23" id="ref47">23</reflink>]; Sharma et al., [<reflink idref="bib29" id="ref48">29</reflink>]).</p> <p>Although our respondents identified unique strengths in qualitative approaches for LGBQ+ populations, sexual orientation is underrepresented in counseling research that uses qualitative and mixed methods approaches (Singh & Shelton, [<reflink idref="bib30" id="ref49">30</reflink>]; Abreu et al., [<reflink idref="bib1" id="ref50">1</reflink>]). Existing qualitative research on LGBQ+ topics provides important context for topics in counselor education. For example, Bryan's ([<reflink idref="bib4" id="ref51">4</reflink>]) qualitative exploration of microaggressions revealed unique microaggression experiences of LGBQ+ and transgender/nonbinary students in counselor education programs. This study had important implications for LGBTQ+ inclusion in counselor education. Similarly, Luke et al. ([<reflink idref="bib24" id="ref52">24</reflink>]) identified themes related to LGBTQ+ integration in school counseling curricula, with implications for school counseling practice and counselor education strategies. These studies demonstrate that there is an audience for qualitative work related to sexual orientation and gender identity in our discipline. Greater inclusion of sexual orientation as a demographic variable in qualitative research also benefits the reader in understanding the contextual lived experience of respondents (Hays & Singh, [<reflink idref="bib15" id="ref53">15</reflink>]), particularly given that LGBQ+ identity has frequently been excluded.</p> <p>One challenge related to broader inclusion of sexual orientation as a demographic variable in counseling research is elevated risk for LGBQ+ people. For example, if data are compromised, respondents may be outed as LGBQ+, leading to harmful consequences such as employment discrimination (Federman & Rishel Elias, [<reflink idref="bib10" id="ref54">10</reflink>]), family (Ryan et al., [<reflink idref="bib28" id="ref55">28</reflink>]) or social (Cheek et al., [<reflink idref="bib5" id="ref56">5</reflink>]) rejection, and exposure to sexual orientation change efforts (Ryan et al., [<reflink idref="bib28" id="ref57">28</reflink>]). Physical and mental health disparities among LGBQ+ people (e.g., Conron et al., [<reflink idref="bib7" id="ref58">7</reflink>]) have been attributed to experiences of discrimination (Meyer, [<reflink idref="bib25" id="ref59">25</reflink>]), such as those listed above. Therefore, as researchers seek to expand the inclusion of LGBQ+ people's visibility in counseling research, it is equally important to employ additional protections for sensitive information, such as sexual orientation.</p> <p>This is particularly true in the context of the current legal landscape for LGBQ+ people in the United States, as legislative and judicial policies introduce new legal difficulties for this population (Goodrich, [<reflink idref="bib14" id="ref60">14</reflink>]). Including LGBQ+ people in research is an important element of destigmatizing LGBQ+ identity (e.g., minority stress theory as an explanation for health inequities; Meyer, [<reflink idref="bib25" id="ref61">25</reflink>]) and improving societal attitudes toward LGBQ+ people. For example, evidence‐based trainings improve healthcare providers' attitudes toward sexual minority clients and patients (Farmer, [<reflink idref="bib9" id="ref62">9</reflink>]; Bristol et al., [<reflink idref="bib3" id="ref63">3</reflink>]). However, these benefits must be balanced against the potential risks experienced by LGBQ+ research participants.</p> <hd id="AN0173988803-15">Implications for counselor education</hd> <p>Limited collection and reporting of sexual orientation in counseling research represents a significant challenge in preparing counselors to work effectively with LGBQ+ clients. There is evidence that even counselors who have positive attitudes toward LGBQ+ clients may lack skills and knowledge related to effective clinical work with this population (Farmer et al., [<reflink idref="bib9" id="ref64">9</reflink>]; Jennings, [<reflink idref="bib22" id="ref65">22</reflink>]), which may be exacerbated by research findings that do not account for the unique influence of sexual orientation in their outcomes. Counselor educators would benefit from resources that identify evidence‐based practices that apply to LGBQ+ populations specifically.</p> <hd id="AN0173988803-16">Implications for counseling research</hd> <p>Our findings yield new implications for risk–benefit analysis, transparent communication, and research design related to collecting sexual orientation as a demographic variable. For research related to LGBQ+ identities, collecting sexual orientation is a necessity; for other studies, researchers should consider the potential benefits of collecting participants' sexual orientation and design demographic questions with intentionality, attending particularly to language and question construction (see Griffith et al. [[<reflink idref="bib13" id="ref66">13</reflink>]] and Wolff et al. [[<reflink idref="bib31" id="ref67">31</reflink>]] for specific recommendations).</p> <p>Counseling researchers can mitigate many of the potential risks described by our respondents through a priori decisions related to research design and reporting their results. Certain kinds of risks may be more likely to occur in qualitative traditions than quantitative or vice versa, requiring researchers to employ specific strategies to reduce risk. For example, potential identification via triangulation is more likely in qualitative methods; researchers may mitigate this risk by summarizing some demographic variables to describe the sample and reporting others in a table to reduce the likelihood that a participant can be identified. Similarly, quantitative methods may require categorization of participants that does not align with their self‐identification (e.g., grouping all nonheterosexual people in one category for analysis purposes, thus erasing subgroup differences); researchers may address this by describing potential aggregation strategies in communication with participants. This approach may allow researchers to retain participants for analyses requiring appropriate cell sizes or equivalent study populations (e.g., mean differences comparisons) while providing informed consent to the participants regarding how they will be described in the manuscript. Researchers may also describe limitations of such approaches in their manuscripts to highlight how this erases important individual differences.</p> <p>Researchers should also consider their specific research context and the associated unique risks that might arise. For example, research conducted with adolescents may have greater risks associated with outing, so additional measures should be in place to address confidentiality. Researchers conducting studies specific to sexual orientation should consider potential bias in their samples due to self‐selection, as well as strategies related to communication (e.g., inclusion of personal positionality statements in informed consent) that might influence the study's outcomes. In studies unrelated to sexual orientation, researchers should consider how they plan to utilize sexual orientation (e.g., in a demographic report, to analyze differences between subgroups in their samples, etc.) and communicate this to participants.</p> <hd id="AN0173988803-17">Limitations and future directions</hd> <p>This study was the first to examine LGBQ+ researchers' perspectives on risks associated with collecting sexual orientation, but it was not without limitations. We collected data anonymously via an online questionnaire. Because we could not clarify responses or ensure accuracy of understanding, we relied on team members' interpretations of the data, which may introduce bias. Although CQR is a robust methodology that addresses some of these limitations, our expectations still influence our understanding of the data. The research team was mostly White, which also influenced interpretations of these findings. We collected data during early 2021, thus we cannot speak to how negative legislative changes influenced risk perception of sexual orientation identity disclosure. These findings suggest several future directions. More information is needed regarding the prevalence of collecting sexual orientation in counseling research to determine the degree to which it is ubiquitous and what barriers might prevent researchers from collecting it. Future research should also examine ways in which specific research contexts (e.g., research conducted in academic vs. other settings) might influence considerations related to collecting sexual orientation.</p> <hd id="AN0173988803-18">CONCLUSION</hd> <p>Counseling research strives to honor participants' complex identities while protecting their anonymity (ACA, [<reflink idref="bib2" id="ref68">2</reflink>]), with important implications for effectively training future counselors. As LGBQ+ people comprise a growing proportion of the U.S. population (HRC, [<reflink idref="bib21" id="ref69">21</reflink>]), they are likely present in most research study samples, yet remain invisible if researchers do not collect or report sexual orientation. This has negative implications for the application of counseling interventions with LGBQ+ clients. Despite recommendations for how to collect sexual orientation (e.g., Griffith et al., [<reflink idref="bib13" id="ref70">13</reflink>]), specific strategies for mitigating participant risk require examination. The present study highlighted individual risks and benefits, as well as researchers' responsibilities for designing studies that allow collection of sexual orientation as a ubiquitous demographic variable. Our findings provide initial evidence of potential risks and much‐needed considerations for reducing risk and improving counseling research for LGBQ+ populations.</p> <hd id="AN0173988803-19">CONFLICT OF INTEREST STATEMENT</hd> <p>The authors declare no conflicts of interest.</p> <ref id="AN0173988803-20"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref42" type="bt">1</bibl> <bibtext> Funding information: We received funding from the Diversity Scholar program through the Graduate School at the Virginia Polytechnic Institute and State University.</bibtext> </blist> </ref> <ref id="AN0173988803-21"> <title> REFERENCES </title> <blist> <bibtext> Abreu, R. L., Townsend, D., Mitchell, Y., Ward, J., Audette, L., & Gonzalez, K. A. (2022). LGBTQ qualitative and mixed methods research in counseling psychology: A content analysis. 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  Data: <searchLink fieldCode="SO" term="%22Counselor+Education+and+Supervision%22"><i>Counselor Education and Supervision</i></searchLink>. 2023 62(4):384-397.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 14
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2023
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Counseling%22">Counseling</searchLink><br /><searchLink fieldCode="DE" term="%22Counselor+Training%22">Counselor Training</searchLink><br /><searchLink fieldCode="DE" term="%22Sexual+Orientation%22">Sexual Orientation</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Data+Collection%22">Data Collection</searchLink><br /><searchLink fieldCode="DE" term="%22LGBTQ+People%22">LGBTQ People</searchLink><br /><searchLink fieldCode="DE" term="%22Researchers%22">Researchers</searchLink><br /><searchLink fieldCode="DE" term="%22Research+Methodology%22">Research Methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Risk%22">Risk</searchLink><br /><searchLink fieldCode="DE" term="%22Affordances%22">Affordances</searchLink><br /><searchLink fieldCode="DE" term="%22Informed+Consent%22">Informed Consent</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1002/ceas.12285
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0011-0035<br />1556-6978
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Sexual orientation is often invisible in counseling research despite increasing LGBQ+ identity in the United States. We used consensual qualitative research to explore considerations from LGBQ+ counseling researchers for collecting sexual orientation. Three domains emerged: risks, benefits, and methodological considerations. Our findings highlight inclusive research practice strategies for LGBQ+ research participants.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2023
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1402817
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1402817
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/ceas.12285
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 384
    Subjects:
      – SubjectFull: Counseling
        Type: general
      – SubjectFull: Counselor Training
        Type: general
      – SubjectFull: Sexual Orientation
        Type: general
      – SubjectFull: Research
        Type: general
      – SubjectFull: Data Collection
        Type: general
      – SubjectFull: LGBTQ People
        Type: general
      – SubjectFull: Researchers
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      – SubjectFull: Research Methodology
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      – SubjectFull: Risk
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      – SubjectFull: Affordances
        Type: general
      – SubjectFull: Informed Consent
        Type: general
    Titles:
      – TitleFull: Collecting Sexual Orientation in Counseling Research: Implications for Counselor Education
        Type: main
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    HasContributorRelationships:
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            NameFull: Westcott, Jordan B.
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            NameFull: Epstein, Dryden
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            NameFull: Welfare, Laura E.
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            NameFull: Catalano, Chase
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              Type: published
              Y: 2023
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            – Type: issn-print
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              Value: 1556-6978
          Numbering:
            – Type: volume
              Value: 62
            – Type: issue
              Value: 4
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            – TitleFull: Counselor Education and Supervision
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