Inappropriate question: “I have difficulty talking to an attractive person of the opposite sex”

Despite welcomed changes in societal attitudes and practices towards sexual minorities, instances of heteronormativity can still be found within healthcare and research. The Social Interaction Anxiety Scale (SIAS) is a valid and reliable self-rating scale of social anxiety, which includes one item (number 14) with an explicit heteronormative assumption about the respondent s sexual orientation. This heteronormative phrasing may confuse, insult or alienate sexual minority respondents. A clinically validated version of the SIAS featuring a non-heteronormative phrasing of item 14 is thus needed.


ITEM 14: “I have difficulty talking to an attractive person of the opposite sex”


In a new paper published today in the BMC journal About Health and Quality of Life Outcomes (impact factor 2.27) we published a study. In that a total of 129 participants with diagnosed social anxiety disorder, enrolled in an Internet-based intervention trial, were randomly assigned to responding to the SIAS featuring either the original or a novel non-heteronormative phrasing of item 14, and then answered the other item version. Within-subject, correlation between item versions was calculated and the two scores were statistically compared. The two items’ correlations with the other SIAS items and other psychiatric rating scales were also statistically compared.


This study concludes that the Social Interaction Anxiety Scale (SIAS) can be revised with the non-heteronormative formulation of item 14 herein described without affecting the psychometric properties. This non-heteronormative revision of SIAS is recommended for use in both clinical and research settings to avoid potentially alienating, confusing or insulting sexual minority respondents. The scale can be used freely and both more in depth information about the study and the new wording is available in the original paper which is available as open access. 

Lindner, P., Martell, P., Bergström, J., Andersson, G., & Carlbring, P. (2013). Clinical validation of a nonheteronormative version of the Social Interaction Anxiety Scale (SIAS). Health and Quality of Life Outcomes, 2013, 11:209. [DOI: 10.1186/1477-7525-11-209]

2 thoughts on “Inappropriate question: “I have difficulty talking to an attractive person of the opposite sex””

    • I agree! Asking about difficulties talking or approaching potential partners is a relevant questions in social phobia. Hopefully our suggested rewording will be used instead of the heteronormative original.

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