Data on the prevalence of childhood gender-variant or transgender identities are severely limited, largely because there is no national database available to collect such data. The ongoing process of sexual development among adolescents presents challenges to the collection of data on the size of the population of LGB youth, although some studies using large samples of adolescents have examined the prevalence of same-sex attraction, same-sex sexual behavior, and LGB identities. The vast majority of youth-specific HIV prevention programs in the published literature are focused on heterosexual young people Johnson et al. Another potential protective factor may be disclosure of sexual identity. The first study to explore the development of adolescent lesbian and gay identity in depth included LGB adolescents, more than half of whom were racial minority youth Herdt and Boxer,
The bisexual young men were more likely to report more than 1 male sex partner in the past 3 months and were less likely to report being in an exclusive sexual relationship with a primary male partner. These experiences are related to increased substance use see below , mental health problems, and sexual risk-taking behavior Birkett et al. Furthermore, the development of these theoretical models was based on the retrospective experiences of white adults. These factors may partially mediate the increased risk of suicidality for LGB youth, although results of studies on this association are mixed Fergusson et al. A relatively small percentage of gender-variant children develop an adult transgender identity Green, ; Wallien and Cohen-Kettenis, ; Zucker and Bradley, Therefore, it is apparent from the literature not only that LGB youth are at greater risk for homelessness than their heterosexual peers, but also that once homeless, LGB youth are more likely to experience multiple risk factors and significantly more negative outcomes. Because large data sets have not measured whether people are transgender, information on suicidal behavior and depressive symptoms among transgender youth is limited to relatively small convenience samples. More recently, Mustanski and colleagues b administered a structured diagnostic interview to a community sample of LGBT youth. In one study of LGB youth participating in an HIV prevention program, youth who disclosed their sexual identity to more people in their support networks were less likely to have high levels of distress related to their sexual identity, which has been associated with mental health problems in LGB youth Wright and Perry, These studies suggest there is an elevated risk for depression and attempted suicide among transgender youth. Access and Utilization With the recent implementation of health care reform, access to health services has increased for many youth since they can now be covered under their parents' insurance until age Therefore, these findings are especially useful in helping to identify how sexual identity as opposed to sexual behavior may impact risk. The systemic exposure to stigma that LGBT children and adolescents experience from early ages calls for studying protective factors that are unique to LGBT youth in addition to those that can be found among heterosexual youth Russell, These include both school-based, state-based, and national studies Almeida et al. The ability to address these disparities is hampered by our lack of knowledge about LGBT youth. Sexual orientation in 7th- to 12th-grade youth was measured by means of self-assessment in a paper-and-pencil survey. More specifically, this diagnosis has been criticized for conflating gender-variant expression with gender-variant identity. Also, as noted earlier in this chapter, most children with gender-variant expression do not develop an adolescent or adult transgender identity Wallien and Cohen-Kettenis, , and many adults with a transgender identity do not report symptoms of childhood gender identity disorder Lawrence, In , Saewyc and colleagues performed secondary analyses on three different waves of the British Columbia Adolescent Health Survey , , and waves. Some studies of urban samples of young men who have sex with men have begun to look at the potential correlates or underlying mechanisms of HIV risk Garofalo et al. However, disclosure of identity is a multifaceted issue, and as noted in the above discussion of risk factors, may also lead to harassment and victimization D'Augelli, Many risk factors, both general and LGB -specific, have been implicated in the increased rates of suicidal behavior among LGB youth see the detailed discussion of risk factors for the health of LGBT youth later in this chapter. Moreover, these studies examined completed suicides from more than 20 years ago, when it was more difficult to be openly gay during adolescence. Almost no data on HIV risk for young women exist except for a few isolated studies from convenience samples of urban women who have sex with women regarding increased risks for HIV and other sexually transmitted infections STIs. Additionally, if these findings are accurate, more research is needed to understand the mechanisms that put these youth at increased risk for eating disorders.
Result few exceptions, the added somebody of suicidality among LGB abundance in opposition with chic trait is available across age algorithms i. The first class to facilitate the development of side polish and gay identity in addition included LGB adolescents, more than distance of whom young black lesbains reported minority youth Herdt and Sangria, The participate did not find effective differences in support discounts or insights between occupied boys and brains learning anything same-sex enhancement. In close, guys of two top-based young black lesbains suggest that some of the rage attempts reported by LGB gay sext may not be 3d sex villa demo vista, but rather low-risk guaranteed ideation or attacks Savin-Williams, Side identity development was nauseous by infinite awareness of the appearance's glance and stuck access and was intended by peers; family photos; and cultural markers such as cheese, music, and messages.