AAP Report on Adolescent Sexuality

The Committee on Adolescence of the American Academy of Pediatrics (AAP) has released a new clinical report on adolescent sexual orientation advising physicians to be attentive to the needs of patients who may be confused over their sexual orientation or believe they are homosexual or bisexual. “Sexual Orientation and Adolescents” appears in the June 2004 issue of Pediatrics and is available online athttp://pediatrics.aappublications.org/cgi/reprint/113/6/1827.

According to the report, adolescents frequently are asking physicians about sexual behavior and orientation. While physicians are not responsible for identifying homosexual or bisexual youth, physicians should create a clinical environment where adolescents feel safe to discuss sensitive personal issues, including sexuality and orientation.

The overall goal in caring for all youth is to promote normal adolescent development, social and emotional well-being, and physical health. One stark difference between homosexual and heterosexual youth is the suicide rate. According to the report, studies found homosexual youth were two to seven times more likely to attempt suicide than their heterosexual peers. They also are two to four times more likely to be threatened with a weapon at school, and are more likely to engage in the use of drugs and alcohol.

The report urges physicians to offer a safe and supportive environment to all youth. Among the recommendations are the following:

• Assure patients that their confidentiality is protected.

• Be aware of the special issues surrounding the development of sexual orientation.

• Use gender-neutral language in discussing sexuality (i.e., use of the word “partner” rather than “boyfriend” or “girlfriend,” talk about “protection” rather than just “birth control”).

• Encourage abstinence, discourage multiple partners, and discuss “safer sex” guidelines with all adolescents.

• Provide relevant information and resources about homosexual, bisexual, or heterosexual issues to patients who are concerned about these issues.

The authors of the report acknowledge that not all physicians may feel able to provide the type of care described in the report. Any physician who is unable to care for and counsel homosexual and bisexual youth should refer the patient to an appropriate colleague.