Change Request Memo

Non-substantive Change Request

OMB Control Number 0920-0740; Expiration Date 05/31/2027

Medical Monitoring Project

Date Submitted: 03/18/2025

Summary of request: CDC/NCHHSTP is requesting a change request to revise questions to align with EO 14168 Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.

Description of Changes Requested: This request includes updates to questions used in the Medical Monitoring Project to be in accordance with EO 14168. Specifically, we are requesting to delete questions and response options that ask about gender, and to edit questions to only ask about male or female sex.

Please check the boxes below if your request includes:

☒ Revision of an existing question(s)

☒ Deletion of an existing question(s)

There is no change in Burden Hours associated with the modifications made in compliance with EO 14168. Changes are detailed in Table A below and red-lined and clean data collection forms are provided in Appendices 1a, 1b, 1c, 1d, 2a, and 2b.

Other Considerations (optional): The interview data collection forms contain red-lined changes to programming logic made necessary due to the EO-compliant modifications, but these are not read to the participant. The questionnaire is administered by an interviewer and is not shown to the respondent. The interviewer does not read the response options of “Don’t Know” and “Refuse to Answer” to respondents. These response options are included for the sole purpose of enabling the interviewer to move forward with the interview in the event the respondent is unwilling or unable to provide a clear response. These hidden options are included for all questions in the instrument and have been retained in the edited sex question.

Table A: Description of Changes (optional, helpful if multiple changes to multiple forms):	Type of Change	Question/Item	Requested Change
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Question Revision	What was your sex at birth? [READ RESPONSES EXCEPT “Intersex/ambiguous.” SELECT ONLY ONE.] 1 Male 2 Female 3 Intersex/ambiguous	What is your sex: male or female? [Don't read responses. SELECT ONLY ONE.] 1 Male 2 Female (Att. 1a, pg. 27)
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Question Deletion	Do you consider yourself to be male, female, or transgender?	Delete (Att. 1a, pg. 27)
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Question Deletion	Do you use a term other than [INSERT GENDER] to describe yourself?	Delete (Att. 1a, pg. 27)
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Question Deletion	What term do you use to describe yourself?	Delete (Att. 1a, pg. 27)
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Say box deletion	"Next I'm going to ask you about sex. When I say sex, I mean vaginal or anal sex. Vaginal sex means penis in the vagina, neovagina, or front hole. Anal sex means penis in the anus, butt, or back hole. When answering, don't include people you only had oral sex with. The number of people could range anywhere from 0 to over a hundred. Remember that your answers will be private."	Delete (Att. 1a, pg. 59)
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Question Deletion	During the past 12 months, how many transgender persons have you had sex with? Number of transgender partners 0-999	Delete (Att. 1a, pg. 59)
Interview (English redlined version: att. 1a, English clean version: att. 1b, Spanish redlined version: att. 1c, Spanish clean version: att. 1d)	Question revision	Is [INSERT SX_NM1N4_21] male, female, or transgender? [READ RESPONSES. SELECT ONLY ONE.] 1 Male 2 Female 3 Transgender (question asked for each of the person’s last 5 sexual partners, if applicable)	Is [INSERT SX_NM1N4_21] male or female? [READ RESPONSES. SELECT ONLY ONE.] 1 Male 2 Female (question asked for each of the person’s last 5 sexual partners, if applicable, Att. 1a, pgs. 63, 67, 71, 75, 79)
Medical record abstraction data structure (Redlined version: attachment 2a, clean version: attachment 2b)	Question revision	Gender	Sex (Att. 2a, pg. 1)