A small percentage of the teenage population is homosexual. Aside from the normal stresses of adolescence, gay teens also have distinct health and psychosocial needs. Not all parents suspect or know that their son or daughter is gay, but those who do have a special responsibility for providing support and care. Parents, teachers, and doctors are all links in the chain that can provide support and encouragement for gay teenagers.
If medical care is not user-friendly, gay teens just may do without. "One of the biggest concerns about healthcare in the minds of gay or lesbian teens is how they are going to be treated," says Bret Rudy, MD, a director of an adolescent HIV program.
While many gay or lesbian teens struggle with their sexual identities, they still have the same healthcare concerns as other teenagers. For gay young men, the risk of getting HIV is higher than that for most other teens. The risk adds significantly to the health "worry" burden that teenagers normally face.
Lack of empathy or harsh bedside manner potentially turns teens off not just to the doctor, but away from healthcare altogether. Gay teens need to feel relaxed because sexual information must be very specific so the doctor can learn if the teenager is at risk. Moreover, the physician must also be very specific in telling young men or women about the skills needed to protect themselves.
"Healthcare providers should have some understanding of sexual behavior to approach gay and lesbian teens and treat them appropriately," Dr. Rudy says. For example, young lesbian women may deny need for birth control despite occasional sexual encounters with men. Only frank discussion between a teen and a doctor can identify important concerns and risks like this.
"A physician needs to take a very sensitive and complete medical and sexual history to be able to treat those kids appropriately," Dr. Rudy says.
Often, gay-and-lesbian friendly posters and brochures in a waiting room can be enough to put a teen at ease. Because many youths are still questioning and exploring their sexual identities, they may be ill at ease with the term "lesbian" or "gay." However, still other teens are farther along in their quest for sexual identity and may be comfortable using those terms to describe themselves. Most doctors avoid labeling and simply ask, "During your life, with whom have you had sexual contact?" The teen can answer none, males, females, or both.
Sexually transmitted infections are an important risk for all teens, gay or straight. Gay teens are particularly at risk for HIV because this infection is still common among older gay men. Condoms can help prevent transmission of HIV, but inexperienced teens may not know how to ensure that they are used. When a teen gets HIV, symptoms may not appear for many years. Counseling and testing can protect teens and help them to get proper treatment.
"Healthcare concerns for gay and lesbian teens are very hard to separate from psychosocial concerns," says Dr. Rudy. "Usually, teens go through stages where they just feel different from other kids. Then they go through stages of confusion about their emotional and physical attractions to people of the same sex where they're not at all sure what their actual orientation is."
Gay teens are also very concerned about bashing and emotional abuse at home and school in the years after coming out.
"One of the best ways to help gay teens is to support them," Dr. Rudy says. "Have resources so they can talk about sexuality and offer an environment where physical or psychological abuse based on any kind of differences, whether it be gender, religious, or sexual, is not tolerated."
As the parent of a gay teen, you can help most by remaining open-minded and supportive. Love and warmth from supportive parents can work wonders as children face the challenge of growing up gay or lesbian in a straight world. Work with your son or daughter to find groups and associations where they can interact positively with people who understand their orientation.
One of the more important connections for gay and lesbian teens are gay-straight alliances. Gay kids need to know that not only other gay people care for them. They also need to know that straight people care for them and want to see them healthy.
Gay, Lesbian, and Straight Education Network
Sexuality and U
Frankowski BL, American Academy of Pediatrics Committee on Adolescence. Sexual orientation and adolescents. Pediatrics 2004; 113:1827-1832.
HIV and young men who have sex with men. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthyyouth/sexualbehaviors/pdf/hiv_factsheet_ymsm.pdf. Published June 2012. Accessed April 3, 2013.
Kitts RL. Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients. J Homosex. 2010;57(6):730-747.
Lesbian, gay, bisexual, and transgender health-youth. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/lgbthealth/youth.htm. Updated May 19, 2011. Accessed April 3, 2013.
Rutherford K, McIntyre J, Daley A, et al. Development of expertise in mental health service provision for lesbian, gay, bisexual and transgender communities. Med Educ. 2012 46(9):903-913.
Society for Adolescent Health and Medicine. Recommendations for promoting the health and well-being of lesbian, gay, bisexual, and transgender adolescents: a position paper of the society for adolescent health and medicine. J Adolesc Health. 2013;52(4):506-510.
Last reviewed April 2013 by Brian P. Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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