With increasing awareness of the importance of gender inclusivity, the user research community should take time to reflect on current practices for recruitment. This blog discusses how our community can move towards a more inclusive environment for all genders. Not only should we welcome all genders, we should actively seek to design for and gather feedback from all genders.
Asking Gender-Related Questions
Let’s start with the gender questions, which are asked in patient forms, health apps and, most notably, recruitment screeners for user research. These questions are shape patients’, users’, and participants’ first impressions of a health system, product or a research team. Typically, these questions focus on sex at birth. They are asked to ensure that the appropriate user group is targeted and/or to ensure that there is a mix of genders in research activities.
However, we are starting to see a shift in how gender questions are asked, and note three common approaches:
add more gender options;
ask two questions (sex at birth and gender identity); and
add a section to self-identify.
Below is an example from a recent Mass General Brigham Patient Survey that includes many more gender-related questions than surveys did in the past:
The two-question approach seems most appropriate for the healthcare industry because knowing sex at birth and gender identity is important since some medical procedures are meant for specific anatomy. At the same time, it is crucial to consider the patients’ needs and treat them with dignity. For example, a pap smear is an important exam that screens for cervical cancer in people who have a cervix. In this example, the gender questions are needed but there are other scenarios in the healthcare industry where these questions may not be needed, think of a sleep diagnostic device or a COVID testing kit. The two-question approach also ensures that the correct information is being collected. With one gender question, there can be different interpretations of what is being asked. One person might think it the legal sex that they have on their driver’s license and someone else might think it is their gender identity.
The other two solutions of adding more gender options and adding a section to self-identify can be combined into one approach. While adding more gender options might be helpful, it may not consider all the options. Allowing space for people to self-identify or decline to answer is more inclusive. In addition, all the options should be shown together, including the option to self-identify, because that emphasizes that all the options are welcomed and respected. Ultimately, an array of options is always better than binary questions or questions that include the “other” option which can be alienating.
Of course, another option is removing the gender questions all together if there is no clear purpose for them. If the healthcare service or product is not based on specific anatomy, then the gender questions may not be required. Sex at birth and gender identity are not as important as psychographics if you are looking for a diversity of participants and valuable feedback during user research activities. Psychographics provide insights into users’ behaviors, preferences, attitudes, and values. Example psychographic questions in healthcare include when do users choose to visit their general physician, when and why do patients with diabetes choose to change their glucose meter, and what are users’ exercise habits. These might be more relevant to your research goals.
An example provided by Cara Brasgears in an enlightening UX Collective article emphasizes why demographic questions should be avoided if they not needed. The example describes a person suffering from generalized anxiety disorder who is filling out an online form for a new physician. Brasgears wrote, “her entire body stiffened when she got to the marital status question” and she said, “I don’t understand why they need to know that.” The marital status question, like the gender-related questions, can take some people into a state of anxiety because they are uncertain how the information will be used and how they will be treated based on their responses.
Perspectives from Recruitment Specialists
I spoke with recruitment specialists from Schlesinger Group and Fieldwork Boston about gender inclusivity in research participant recruitment, their current practices, and their hopes for the future. While both organizations are finding new ways to improve inclusivity, they said that they are only at the beginning and they are open to exploring more ways to be inclusive to all genders and ethnicities.
At Schlesinger they have started a group called SWAG (Strengthening Women Across Generations). This employee resource group celebrates diversity and inclusivity of genders. One initiative the group took on was to change the gender question asked in their sign-up form. They changed it from one question to two questions that ask for both sex at birth and gender identity. The step away from binary questions allows an individual to self-identify and provide the information that they choose. One project manager expressed that “wording the question correctly speaks volumes; it shows that you are willing to listen to their perspective.” The work that SWAG has done emphasizes the importance of listening to the needs and perspectives of all individuals.
Regarding recruitment screeners, both Schlesinger and Fieldwork mentioned using the screeners that their clients provide. At times, the recruiters have helped clients with the wording of questions on the screener. The recruiters said that depending on the study, some clients just focus on job titles and do not ask about gender while others, such as those working on consumer studies, focus on reaching specific quotas for genders. They emphasized that 90% of screeners still use only female and male. Both firms are finding ways to improve gender inclusivity in recruitment by starting a dialogue with their clients and raising awareness on how to approach gender questions.
Overall, the recruiters emphasized that recruiters and the user research community could work on raising awareness and starting the conversation with clients. Ultimately, everyone is working on finding the best approach to create safe, inclusive, and welcoming environment for all genders. During this time where companies are exploring different approaches, it is helpful to share resources that raise awareness and guide conversations around gender.
Schlesinger’s sign-up form is shown below:
Fieldwork’s sign-up form is shown below:
Steps for Addressing Gender Questions with Clients
Take time to discuss the goals of the research in detail with your stakeholders.
Determine if gender-related questions are needed. What is the purpose of including them? Can they be optional?
If gender questions are needed, think about how to ask the questions in the most inclusive way. Could two questions be asked instead of one? Could you provide a multitude of options and/or allow participants to write in how they self-identify?
Discuss other ways to learn relevant information about participants. This could be with psychographic questions or questions more specific to the research goals.
How We Can Do Better
Whether you are working in industry or at a consultancy, evaluate questions related to gender before recruitment for a research study begins. Although screeners with binary gender questions have been standard practice in the past, promote diversity and gather more meaningful insights by actively promoting gender inclusivity. When working with stakeholders, raise awareness about the issue and follow through with sensitivity. The time has come.