It is difficult to know how many adolescents identify themselves as predominately or exclusively gay. In the original Kinsey studies, twenty-eight percent of boys and seventeen percent of girls between puberty and age twenty had one or more homosexual experiences. In a more recent study of thirteen- to nineteen-year-olds, eleven percent of boys and six percent of girls reported a homosexual experience, and in a study published in 1992 by Remafedi, 10.7 percent of high school students between ages twelve and eighteen years were unsure of their sexual orientation.
There are several terms to define:
Gender identify: the person’s sense of being male or female—established by age three years
Sex roles: social and cultural expectations and beliefs about male and female behaviors; established by ages three to seven years
Sexual orientation: the pattern of physical behavior and emotional and erotic attraction to other individuals; homosexuality refers to same sex attraction, heterosexuality refers to opposite sex attraction and bisexuality refers to attraction to both sexes. This is discovered gradually during adolescence or even later in life.
Transsexual or transvestite: refers to individuals who feel trapped in the wrong body or who cross dress in opposite gender clothes.
Transgender: includes transsexuals and transvestites, male and female impersonators. Transgendered persons may have any sexual orientation and have a gender-nonconforming identity and behaviors.
Gay: refers to an individual, male or female, with a homosexual orientation. Gay females are termed lesbians.
In the closet: the condition of a gay individual who poses as a heterosexual and is unwilling to publicly disclose his or her sexual orientation
Coming out: the recognition by the individual that he or she is gay and additionally when the individual informs others that he or she is gay.
Homophobia: this is an irrational fear, hatred, prejudice or negative attitude toward gay and lesbian individuals by an individual or group.
Anti-gay violence: bias-related violence and crimes that are committed again gays and lesbians
Whatever the origins, there is strong evidence that gay males and lesbian females feel different about themselves as early as age four or five years. According to Richard R. Troiden, gay identity development occurs over a number of years in four different stages.
Sensitization: almost always occur before the individual is twelve years. These individuals feel different from their peers, but they do not perceive themselves to be sexually different
Identity Confusion: this usually occurs after puberty during early and middle adolescence when gay and lesbian adolescents become aware of same sex thoughts. Often closeted, these teens are confused and seek to develop coping skills. Due to social stigma and the perceived need for secrecy about their identity, many gay males and lesbian females do not discuss their emerging homosexual feelings with others.
Identity Assumption: a period during adolescence, usually between the ages of fifteen and twenty-one years when most young gay and lesbian adolescents recognize their homosexual identity and begin to share it with others. At this time there is increasing association with other gay individuals, sexual experimentation and explorations of the gay subculture.
Commitment: in this stage, which usually occurs in adulthood, the gay male or lesbian female incorporates his or her sexual identity into many or all aspects of life. He or she shares the identity with non-gay friends and family members.
Very few individuals chose consciously to be homosexual or heterosexual. In fact, recent research findings suggest that there may be a biological basis for gay sexual preference. Whatever the source of sexual preference, it develops well before puberty and cannot be changed by conscious efforts. Newer research indicates that an individual’s sexual preference falls somewhere along a continuum from exclusive heterosexuality to exclusive homosexuality. Most individuals probably fall at either end of the continuum. If someone falls in the middle, they would probably be attracted to both males and females and be called bisexuals.
Where a teen falls on this continuum is not always obvious to the adolescent. Many teens experiment with both heterosexual and homosexual behaviors before they learn and understand what is most natural for them. Some women discover they are lesbians later in life. Other adolescents may realize they have had homosexual feelings since childhood, but chose not to act on these feelings until later in adulthood.
Contrary to stereotypes commonly held, boys who prefer artistic pursuits appear effeminate or pay meticulous attention to their clothes or hair are not necessarily gay. And girls who dress in unisex clothing, have masculine haircuts or prefer contact sports ar not necessarily lesbian. In addition group masturbation, having several sexual experiences with a member of the same sex does not indicate that the teen is homosexual. Moreover, having sex with the opposite sex does not indicate that the adolescent is heterosexual.
A persistent and exclusive sexual and emotional attraction to members of the same sex that persists into adulthood is more indicative of homosexuality. Teens should know that most people are neither one hundred percent homosexual or heterosexual but lie somewhere in between in their range of sexual expression.
Many teens wait until later in life to express their homosexual feelings. Because of recent public acceptance of homosexuality, more homosexuals of both sexes are coming out during adolescence.
The incidence of transsexualism is unknown, although estimates of one in thirty thousand males and one in one hundred thousand females are mentioned in the literature. Most of the information about transsexuals is obtained from individuals who have sought services from gender identity clinics. Many transsexuals report substance abuse problems, attempted suicide and psychiatric problems. Some transsexuals utilize hormones to develop the desired female or male secondary sexual characteristics. Because they are often unwilling or unable to see clinicians to obtain prescriptions for these hormones, they seek the hormones on the street. As a result, they may use the hormones improperly and can suffer serious health complications including high blood pressure, cardiovascular disease, blood clots and bleeding disorders. Use of sex hormones during puberty may adversely affect the teen’s growth and development. Transsexual teens usually require ongoing counseling to deal with the distress of gender identity issues.
As adolescents begin to realize they are gay or lesbian, they begin to encounter and experience hostility toward the gay population and begin to deal with homophobia. There is tremendous pressure on younger gay youth to refrain from homosexual activities. Gay and lesbian teens may experiment with heterosexuality. Surveys show that up to eighty-seven percent of lesbians and sixty-eight percent of gay men reported heterosexual experiences. A consequence of this is unintended pregnancy.
Intolerance of gays and lesbians may result in rejection by family, friends, teachers and others who are important to adolescents. These psychological stressors place gay and lesbian teens at higher risk for mental health problems. Gay and lesbian adolescents are at higher risk to attempt suicide than their straight peers. Homosexuality is not related to a mental health origin, disease or a problem with the gay individual’s psychological adjustment. Rather, the results of rejection and abuse in the lives of gay and lesbian adolescents can lead to mental health problems. Gays may internalize societal homophobia and this may result in self-destructive behaviors. Homelessness, prostitution, substance abuse and running away from home are some of the more overt consequences of self-destructive behavior in gay adolescents. More subtle consequences include school failure, poor self-esteem and isolation. For the majority of gay males ages eighteen to twenty-five years, mental health concerns include coming out to parents and friends, relationships with family, sadness or depression, anxiety and concerns about AIDS.
The healthcare concerns of gay and lesbian adolescents are not necessarily different from their straight peers. However, the incidence of certain medical and mental health issues may be higher in gay youth. Gay males are susceptible to sexually transmitted infections as are straight teens but the incidence is highest among sexually active young gay males. In the recently published Youth Risk Behavior Survey, which was done by the Centers for Disease Control and Prevention, self-identified gay, lesbian and bisexual youth reported having engaged in a far higher percentage of risky healthy behaviors than their straight peers. Young gay males use sexual experiences to learn about being gay. Unprotected intercourse between gays may occur especially among young males. HIV, gonorrhea, hepatitis, herpes, public lice, syphilis, genital warts, chlamydia and certain gastrointestinal infections are some of the sexually transmitted infections that may occur in gay adolescent males. Sexually active gay males who have anal intercourse and oral contact may develop infections of the rectum that have symptoms of abdominal pain, bloody diarrhea and fever.
Gay and straight adolescents need safer sex counseling. Gay, straight and bisexual males should always use latex condoms to protect against sexually transmitted infections. Lesbians, straight and bisexual females should always use condoms or latex dental dams to protect against sexually transmitted infections or pregnancy. And gay, straight and lesbian teens should avoid using drugs and alcohol before sex since these substances may alter the teen’s judgment.
Lesbians who are exclusively homosexual and only have sex with other females have a substantially lower risk for sexually transmitted infections. Genital warts, bacterial vaginosis and trichomoniasis have occurred in lesbians and their female partners. Lesbians who have sex with men are of course, at risk for the whole range of sexually transmitted infections as well as pregnancy.
There are no convincing data demonstrating that gays use substances either more or less than their straight peers. Lesbians and gay males use alcohol and substances for the same reason as straight youth. They may wish to self-medicate for depression or anxiety, assert independence, relieve tension or seek ease in social situations. Because of societal attitudes and prejudices as well as their confusion about sexual orientation, gays may lack or have diminished self-esteem and may be tempted to use substances.
More than one third of all gay, lesbian and bisexual teenagers reported in an anonymous survey that they had attempted suicide within the previous year. These findings are consistent with earlier studies that indicated that as many as thirty percent of all teenage suicides are committed by lesbian and gay youth. In addition to higher suicide rates, homosexual adolescences have higher feelings of depression. Gay and lesbian teenagers who are depressed may withdraw from participation in clubs, sports and other enjoyable activities. They may also suffer from academic difficulties, poor self-esteem and problems with concentration.
Lesbians and gay males are at risk for anti-gay violence and this may include rape, physical attack, verbal and physical abuse as well as harassment. For those adolescents who are openly or stereotypically gay, victimization is a common problem. These attacks heighten the gay adolescent’s feelings of vulnerability, and may heighten his or her negative feelings regarding sexual orientation.
Gay males and lesbian females need sensitive, caring and knowledgeable clinicians in whom to confide as well as to provide primary care medical services. While the health issues of gay teens are similar to those of straight youth, mental health concerns are more frequent and the gay adolescent should seek out help if there are emotional concerns. The hepatitis A vaccine may be administered to gay males who engage in oral or anal intercourse. All gay and straight adolescents should receive the hepatitis B vaccine. And the gay teen should clarify his or her clinician’s policy on confidentiality of medical information. All females between ages nine and twenty-six should receive the HPV vaccine.
Related topics:
AIDS, anger, anxiety disorders, confidentiality, depression, peer pressure, runaways, self-esteem, sexually transmitted diseases, violence and aggression
