Trans and gender diverse identities in adolescent health research: making the most of imperfect data.

Advancing adolescent health research necessitates deliberate design and analysis that accurately captures the rapidly evolving world in which adolescents live and the ways in which they understand and express themselves and their experiences. In this Perspective, we reflect on how researchers might approach existing, imperfect data in a way that is accurate and inclusive of trans and gender diverse (TGD) adolescents. Drawing on our experience of running a large school-based survey of health and well-being (the OxWell Student Survey) and extensive coproduction with three TGD adolescents ('youth advisors'), we present considerations for critically appraising, processing and analysing quantitative gender data to better reflect adolescents' lived experiences. Specific topics discussed include how to assess the strengths and limitations of existing gender data; how to generate meaningful research data from free-text gender descriptions (and the implications of not doing so); and how to analyse data from TGD adolescents, including for those who choose not to disclose their gender. We conclude with a set of 10 recommendations, coproduced with the three youth advisors, for those working with 'imperfect' gender data.