In Reply Sexual orientation is defined by sexual attraction, sexual identity, and sex of sexual contacts. The national YRBS currently measures sexual identity and sex of sexual contacts and, consistent with National Academy of Medicine (formerly the Institute of Medicine) recommendations,1 each construct is measured separately. Sexual orientation typically develops during adolescence and may progress in such a way that sexual identity and sex of sexual contacts may not be concordant. This dissonance between sexual identity and sex of sexual contacts is well documented1-3 and, as national YRBS data demonstrate,4 is not uncommon among youth. Consequently, we defined sexual minority students as those whose sexual identity was gay, lesbian, or bisexual or those who had sexual contact with only the same sex or with both sexes.
Kann L, Barrios LC. Estimating the Prevalence of Sexual Minority Adolescents—Reply. JAMA. 2017;317(16):1692–1693. doi:10.1001/jama.2017.2922
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