Health and development of gay and lesbian youths: implications for HIV/AIDS.

Health and behavioral issues of gay and lesbian adolescents have recently become a focus of research and interest. A well conceived framework within which to consider thoughtfully the uniqueness of problems faced by homosexual youths and the role of health-care providers is needed. The prevalence, sociocultural history, and theories of origin of the homosexual orientation (biologic, psychoanalytic, and social processes) as well as general issues in adolescent development (biologic, cognitive, and emotional) all contribute to the development of a comprehensive perspective through which better health care and education can be provided. Responsible sexual behavior, depression, and suicide are health-care issues that physicians must be sensitive to and address openly. Up to 50% of gay youths have "seriously contemplated," suicide and 25% are estimated to have attempted suicide, according to the literature. In one study, up to 38% of pediatricians were uncomfortable in caring for homosexual adolescents within their practice. Practical suggestions include reviewing the language in office information forms and brochures providing appropriate literature that demonstrates acceptance of homosexual and bisexual orientations, and avoiding heterosexist bias in questions inquiring about sexuality. Physicians have an opportunity to modify the health and psychosocial risks faced by gay and lesbian youths by restructuring professional settings and accepting broader responsibilities for raising community awareness.