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Topics In Brief

All Topics In Brief

Gay, Lesbian, Bisexual, Transgender and Questioning Youth

This edition focuses on gay, lesbian, bisexual, transgender, and questioning (GLBTQ) youth and includes:

Understanding the needs of gay, lesbian, bisexual, transgender, and questioning (GLBTQ) youth is essential to our work with teens. All young people need to feel connected and safe, but to many GLBTQ youth, the stakes are raised because of the stigma they face in society as a whole.

While teens typically experience uncomfortable emotions as they develop their sexual identity, GLBTQ youth are more at risk for health problems due to feelings of isolation and a lack of support in their homes, school, and community. In fact, they are among the most targeted hate crime victims. As health educators, we can help create a safe learning environment, as well as promote the healthy sexual development of all youth, including GLBTQ youth. We devote this edition of ReCAPP to that objective.

What is Sexual Orientation?

Sexual orientation refers to a constellation of personal factors, such as sexual attraction, behavior, fantasies, emotional and social preferences. It is related to sexual identity, or how you think of yourself, which can change from one period of your life to another. One's sexual orientation is likely the result of a combination of biological and social factors. According to research, it is not just a matter of sexual "preference." People do not choose to be gay or lesbian. In fact, according to well-known sexual researcher, Alfred Kinsey, many of us have had thoughts, at some time during our life, about same sex interaction.

Definitions of GLBTQ

We offer the following definitions to understand the terms "Gay," "Lesbian," "Bisexual," "Transgender," and "Questioning" youth. However, we should note that these definitions are not standardized, and terms are used differently by different individuals and in different regions. The meanings of words also change over time. Concepts and attitudes toward gender identity and sexual identity are changing in society as a whole, as well as within the Lesbian, Bisexual, Gay and Transgender communities. Therefore, the meanings of these words will continue to change as well.

Gay usually refers to an individual who has significant sexual or romantic attractions primarily to members of the same gender or sex, or who identifies as a member of the gay community. A gay person may be of any gender identity. The term "gay" is sometimes used as a synonym for gay male; however, a male may identify as gay without identifying with the gay community. (From the Bisexual Resource Center at

Lesbian usually refers to a girl or woman who has significant sexual or romantic attractions primarily to members of the same gender or sex, or who identifies as a member of the lesbian community. (From the Bisexual Resource Center at

Bisexual refers to people who have the potential to feel sexually attracted to, and to engage in sensual or sexual relationships with, people of either sex. A bisexual person may not be equally attracted to both sexes, and the degree of attraction may vary over time. Self-perception is the key to a bisexual identity. Many people engage in sexual activity with people of both sexes, yet do not identify as bisexual. Likewise, other people engage in sexual relations with people of one sex, or do not engage in sexual activity at all, yet consider themselves bisexual. There is no behavioral "test" to determine whether or not one is bisexual. (From the Bisexual Resource Center at

Transgender refers to people who manifest characteristics, behaviors or self-expression, which in their own or someone else's perception, is typical, of or commonly associated with, persons of another gender. There is great diversity among transgender people. Various terms are used to describe segments of the transgender community. Some of these terms are transvestite, crossdresser, bi-gendered, androgyne, transsexual, drag queen and male/female impersonator. Each of these terms describes a distinct type of transgender person.

Research suggests there is a biological basis for transgender behavior, but to what degree is unknown. Transgender people manifest their characteristics, behaviors and self expression at different stages in their lives ranging from infancy to old age. This leads to the observation that biology creates a capacity while nurturing and individual choice may retard or accelerate the emergence or degree of transgender behavior. (From the PFLAG -Talk/TGS-PFLAG Virtual Library at

youth refers to teens who are going through a process of questioning or are unsure of their sexual orientation.

Overview of the Issues

Why is pregnancy prevention important for lesbian, gay, bisexual, transgender and questioning (GLBTQ) youth?

Actually, research tells us that the majority of adult lesbian and bisexual women have had heterosexual intercourse at some point in their lives, (Johnson, 1987). Moreover, at least 30% have been pregnant, (Ryan, 1988).

Lesbian and bisexual teens might have heterosexual experiences for a number of reasons, including curiosity, wanting to hide or "change" their sexual identity, or as a result of rape. Findings from a study published in Family Planning Perspectives ("Sexual Intercourse, Abuse and Pregnancy Among Adolescent Women: Does Sexual Orientation Make a Difference?," Saewyc et al., 1999) indicate that reproductive health care providers should not assume that pregnant teenagers are heterosexual, or that teens who identify as bisexual, or lesbian, or are unsure of their sexual orientation do not need family planning counseling.

The study also highlights a need for health interventions that target lesbian and bisexual young women to prevent sexual and physical violence, as well as reduce risky sexual behaviors. According to its authors, "Clinicians who work with [lesbian and bisexual] adolescents need to be aware of the multiple psychosocial abuse, early sexual debut, frequent sexual intercourse, participation in prostitution and ineffective contraceptive use." They urge further research to explore such issues, including the "interactions" between sexual identity development in teens and risky sexual behavior.

Other emotional and physical health concerns…

Apart from pregnancy prevention specifically, there are other related issues faced by GLBTQ youth. Safe schools are a top priority for parents and teachers. However, according to PFLAG (Parents, Families and Friends of Lesbians and Gays), students are not safe in schools. In fact, harassment from other students is a primary concern for GLBTQ youth.

  • The average high school student hears 25 anti-gay slurs daily.
    (Source: Carter, Kelley, "Gay Slurs Abound," in The Des Moines Register, March 7, 1997, p.1.)

  • As many as 97% of high school students regularly hear homophobic remarks.
    (Source: Making Schools Safe for Gay and Lesbian Youth: Report of the Massachusetts Governor’s Commission on Gay and Lesbian Youth, 1993.)

  • One study found 18.4% of the gay, lesbian, and bisexual students had been in a physical fight resulting in treatment by a doctor or nurse compared to 4% of their peers, and 22.2% skipped school in the past month because they felt unsafe on route to or at school, compared to 4.2% of their peers.
    (Source: Massachusetts Youth Risk Behavior Survey, Massachusetts Department of Education, 1997.)

  • According to the same study, of 4,159 Massachusetts high school students, 31.2% identifying as lesbian, gay, or bisexual, were threatened/injured with a weapon at school in the past year compared to 6.9% of their peers.
    (Source: Massachusetts Youth Risk Behavior Survey, Massachusetts Department of Education, 1997.)

  • In a national survey, youth described being called lesbian or gay as the most deeply upsetting form of sexual harassment they experienced.
    (Source: American Association of University Women, 1993. A total of 1,632 field surveys were completed by public school students, grades 8-11, in 79 schools across the U.S.)

  • The Gay, Lesbian and Straight Education Network (GLSEN) recently completed a National School Climate Survey of lesbian, gay, bisexual and transgender (LGBT) students affiliated with local youth service organizations around the country.

    GLSEN is the largest national organization working to end homophobia in K-12 schools. Their survey findings include reported data on homophobic remarks in school, harassment and overall comfort in school. For example, 91.4% of a total of 496 LGBT youth reported that they sometimes or frequently hear homophobic remarks in their school, with one-third reporting that no one ever intervened in these circumstances. More information is available from GLSEN's web site:

Because GLBTQ youth are more frequently harassed, they are also more likely to skip classes, drop out of school, and be forced to leave home or become runaways.

  • Service providers estimate that lesbian, gay and bisexual youth make up 20-40% of homeless youth in urban areas.
    (Source: "The National Network of Runaway and Youth Services. To Whom Do They Belong?: Runaway, Homeless and Other Youth in High-Risk Situations in the 1990’s." Washington, D.C. The National Network, 1991.)

Another critical health issue for GLBTQ youth is drug and alcohol abuse.

The P.E.R.S.O.N. Project's Appendix V: Research on Health Education Needs of LGBT Youth indicates that "lesbian, gay, bisexual, and transgender youth are at special risk for misuse of substances such as alcohol, tobacco, and drugs due to the stresses to which a hostile society and homophobic educational system subject them."

GLBTQ youth are also at increased risk to attempt and commit suicide.

  • Studies on youth suicide consistently find that lesbian and gay youth are 2-6 times more likely to attempt suicide than other youth and may account for 30% of all completed suicides among teens.
    (Source: Report of the Secretary’s Task Force on Youth Suicide, US Department of Health and Human Services, 1989.)

  • In a study of 4,159 Massachusetts high school students, 46% who identified as lesbian, gay or bisexual had attempted suicide in the past year compared to 8.8% of their peers, and 23.5% required medical attention as a result of a suicide attempt compared to 3.3% of their peers.
    (Source: Massachusetts Youth Risk Behavior Survey, Massachusetts Department of Education, 1997.)

What Educators Can Do

  • Be Sensitive to factors which may contribute to low self-esteem. The first step is simply becoming aware of the special needs and concerns faced by GLBTQ youth. Examine your own biases. Since most of us have come from a homophobic society, we are likely to be influenced by misinformation and fear-based attitudes. And whatever our health education setting, we can make sure to set and enforce clear boundaries (rules and norms) to ensure respectful behavior between individuals and to prevent harassment.

  • Be aware of heterosexism or assumptions that identifying as heterosexual and having sexual and romantic attractions only to members of the other gender is good and desirable, that other sexual identities and attractions are bad and unacceptable, and that anyone whose sexual identity is not known is heterosexual.

  • Use "inclusive" language. Unwittingly, many educators alienate gay and lesbian youth with the language they use. Creating a classroom climate that is safe for and inclusive of gay and lesbian youth is important if we want to include them in the learning process. (See the ReCAPP Learning Activity Six Simple Strategies for Including Gay and Lesbian Youth.)

  • PFLAG offers 12 informative "Tips for Professionals Who Work with Gay Youth." Find these at Other Resources for Safe Schools & Youth are available for ordering at

  • We recommend another resource which can be viewed online and downloaded. "Just the Facts About Sexual Orientation & Youth" was developed as a primer for educators and is endorsed by several organizations who share a concern for the health and education of all students. Organizations including the American Academy of Pediatrics, the American Association of School Administrators, the Interfaith Alliance Foundation, and the National Education Association developed this document to help guide school personnel dealing with controversies about homosexuality in their schools. This primer addresses sexual orientation development, reparative therapy, transformational ministries, relevant legal principles, and identifies other resources as well. You can view it online at

More Information/Resources

Check out other web sites including:

Parents, Families and Friends of Lesbians and Gays (PFLAG)

Advocates for Youth

Gender Identity Center

Children of Lesbians and Gays Everywhere

Gay, Lesbian & Straight Education Network

Lambda Legal Defense & Education Fund

National Youth Advocacy Coalition

The P.E.R.S.O.N. Project

Safe Schools Coalition of Washington

Sexual Information and Education Council of the United States

Sexual Minority Youth Assistance League

Youth Resource