Gay and lesbian adults often describe their adolescence as a time when they felt isolated, ashamed and afraid of being discovered that they were different – all of which can have an impact on self-esteem and identity formation ( 7, 8). They can be heterosexual, homosexual or bisexual. Transvestites get pleasure from dressing in the clothing of the opposite sex. Young people who are transvestites are sometimes, but not always, gay. The medical and psychological needs of transgendered youth are many and beyond the scope of the present paper. Those who are transgendered can be heterosexual, homosexual or bisexual. People whose gender identity does not match their anatomy are often referred to as transgendered, and need specialized consultation for a possible gender identity disorder. The majority of both heterosexuals and homosexuals have an identity of being male or female that matches their anatomy. It is important to distinguish between the youth who is gay and the youth with a possible gender identity disorder. The challenge for gay and lesbian youth is to develop a healthy and integrated identity in the context of negative stereotypes and prejudice, often without family or societal support. The teen may not acknowledge their orientation, avoid thinking about it or come up with an alternate explanation for their feelings ( 6). Further confusion may result if the youth also experiences some opposite-sex attractions. This confusion is influenced by the stigma attached to homosexuality, inaccurate knowledge, lack of role models and minimal opportunity to socialize with other youth who are having similar feelings.
The teen may experience identity confusion at this point, being aware of same-sex attractions but in turmoil about it. It can start with homosexual fantasies or dreams, with the realization that one is attracted to people of the same gender, with a feeling that one is different from one’s peers or even with a sexual experience.
The process of declaring a homosexual identity is often referred to as ‘coming out’. A Massachusetts (USA) study ( 5) found that 2.5% of youth self-identified as gay, lesbian or bisexual. American data are similar Remafedi et al ( 4) reported that 1.1% of teens identified as gay or bisexual, but 4.5% stated that their main sexual attraction was to individuals of the same sex. Three per cent of girls identified as bisexual, mostly homosexual or 100% homosexual, while 6.4% of sexually active girls reported having had sex with someone of the same gender in the past year ( 3). While only 1.5% of all boys identified themselves as bisexual, mostly homosexual or 100% homosexual, 3.5% of sexually active boys said that they have had sex with someone of the same gender in the past year. The best available Canadian statistics are from the 2003 British Columbia Adolescent Health Survey ( 3), a cluster-stratified, weighted survey that represented 289,767 students from British Columbia who were enrolled in public schools. Having had sex with someone of the same gender does not always mean the teen is gay, and many gay teens have never had sex with someone of the same gender. Teens who will eventually identify as gay, lesbian or bisexual do not always do so during adolescence. Studies that try to define the percentage of teens who are not heterosexual are often limited by the questions that they ask. Those who are attracted primarily to the opposite sex are heterosexual, those attracted primarily to the same sex are homosexual (gay or lesbian) and those who are attracted to both sexes are bisexual. Sexual and affectational preferences are not always congruent. One does not have to be sexually active to have a sexual orientation. Sexual orientation refers to whether a person’s physical and emotional arousal is to people of the same or opposite sex.