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To determine sexual orientation, adult respondents were asked, Which of the following best represents how you think of yourself? with a response options of: gay (lesbian or gay for female respondents), heterosexual, that is, not gay (not lesbian or gay for female respondents), bisexual, something else, and I dont know the answer. The six-question Kessler (K6) scale was developed to identify persons with a high likelihood of having a diagnosable mental illness and associated functional limitations