Especially for Teens
TFAQ001, February 2016



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Lesbian, Gay, Bisexual, and Transgender (LGBT) Teens

What does “LGBT” stand for?

“LGBT” is an abbreviation for “lesbian, gay, bisexual, and transgender.” These terms describe a person’s sexual orientation—a person’s emotional or sexual attraction to other people:

  • “Gay” describes a person (either male or female) who is attracted to people of the same sex.
  • “Straight” describes a person (either male or female) who is attracted to people of the opposite sex.
  • A “lesbian” is a female who is attracted to other females.
  • “Bisexual” describes a person (either male or female) who is attracted to people of both sexes.

How many people in the United States are gay, lesbian, or bisexual?

In general, about 3.5% of people identify as gay or bisexual. But many people feel that they are not 100% gay, straight, or bisexual. Sexual orientation often is described as a “spectrum” or “continuum.” Some people may not identify with any of these labels, and that is OK too. It also is possible to not feel any sexual attraction. This sometimes is described as being asexual.

What is gender identity?

Gender identity is not the same thing as sexual orientation. Gender identity is your sense of being a man, a woman, or other gendered.

What does transgender mean?

Being transgender means having a gender identity that is different from the sex you were assigned at birth (your biological sex). Someone born female may feel that they are really a boy, and someone born male may feel that they are really a girl. Others may feel that they belong to neither gender or to both genders (sometimes called “genderqueer” or “gender fluid”).

Some transgender people decide to live, dress, and act as someone of the gender they feel they really are or as neither gender. Some choose to have surgery or take hormones so that their bodies more closely match their gender identity. Others do not. There is no “right” way to be a transgender person.

What does cisgender mean?

Cisgender is a term sometimes used to describe people whose gender identity is the same as the sex they were assigned at birth.

What makes a person straight, a lesbian, gay, or bisexual?

It’s not known for certain what determines a person’s sexual orientation. Who a person has sex with doesn’t determine their sexual orientation. Sometimes sexual orientation has more to do with feelings of love and care. Many adults and teens have never had sex with a person of the same sex but still identify as gay.

When does a person know for sure what their gender identity is?

Some teens may question their gender identity for the first time during puberty. But most people have a steady sense of their gender starting very early in life, by about age 4 years. If you have felt the same way about your gender identity since you were little or for as long as you can remember, you probably will not change your mind. If you are confused about your gender identity, find support by talking to someone you trust, such as your doctor or other health care professional.

What are some concerns that LGBT teens may face at home, at school, and in the community?

Society as a whole is changing. All states now allow same-sex couples to marry. Many schools support LGBT teens and create a safe environment for all students. Still, bullying in school can be a problem. If you are being bullied, talk to your parents, a teacher, or your principal.

Some communities still don’t accept LGBT people. Although some states have laws that address hate or bias crimes against LGBT people, others do not. Some states don’t have laws that protect LGBT people from job discrimination. As a result, LGBT people may hide their orientation or gender identity.

All of these factors can make an LGBT teen feel anxious and alone. LGBT teens who do not feel supported by adults in their homes and schools are more likely to be depressed. Some LGBT teens cope with these thoughts and feelings in harmful ways. They may try to hurt themselves. They may turn to drugs and alcohol. Some skip school or drop out. Some run away from home. Lesbian or bisexual girls may be more likely to smoke or have eating disorders.

Should I tell my parents that I am LGBT?

This is a question that many LGBT people of all ages struggle with. Some parents are open and accepting, while others may not understand what it means to be lesbian, gay, bisexual, or transgender. Some parents may believe stereotypes about LGBT people. Telling your parents is a big decision. Help is out there if you need it. Organizations and resources that can help educate parents, family members, and friends about the LGBT community are listed in the “Resources” section.

What can I do if I am depressed or just want to talk to someone?

If you don’t want to talk to your parents, you can talk to a teacher, counselor, or doctor. Doctors and counselors keep what you tell them private unless they feel that that you are a danger to yourself or others, or if you tell them that you are being physically or sexually abused. It’s a good idea to ask about what can be kept private before you talk to a professional. There also are web sites and hotlines where you can be anonymous if you need information (see “Resources”).

Are lesbian teens at risk of pregnancy and sexually transmitted infections (STIs)?

It’s very common for boys and girls who later identify as gay to have sex with opposite-sex partners. All teens who are sexually active with opposite-sex partners need to use birth control to prevent an unwanted pregnancy. It also is important to use a condom every time to protect against sexually transmitted infections (STIs).

Girls who have sex with girls can get STIs too. Many STIs, including human immunodeficiency virus (HIV), human papillomavirus (HPV), genital herpes, syphilis, gonorrhea, and chlamydia, can be transmitted (passed from one partner to another) through oral sex. Some STIs (HPV and genital herpes) can be transmitted through skin-to-skin contact. An infection called bacterial vaginosis can be common in lesbians. It can be transmitted by oral sex, sex toys, and genital–finger contact. HPV also may be spread by genital–finger contact.

Do lesbian teens need to see an obstetrician–gynecologist (ob-gyn)?

Yes. All teen girls should have their first reproductive health care visit sometime between ages 13 years and 15 years. After the first visit, a yearly check-up visit is recommended. Transgender teens who have female reproductive organs or who are taking female hormones also need female reproductive health care.

What happens during the first visit with an ob-gyn?

The first visit may be just a talk between you and your doctor. You can find out what to expect at future visits and get information about how to stay healthy. You also may have a general physical exam. You usually do not need to have a pelvic exam at the first visit unless you are having problems.

Your doctor may ask a lot of questions about you and your family. Some of them may seem personal, such as questions about your menstrual period or sexual activities (including vaginal, oral, or anal sex).

You also can get the following tests and immunizations:

  • HPV vaccine—HPV can be passed from one woman to another during sex. HPV infection increases the risk of cervical cancer. Three vaccines are available that protect against HPV. They are recommended for girls and women aged 9–26 years. They are given in three doses over a 6-month period.
  • STI screening tests—If you are sexually active, you may have tests for certain STIs. Most of the tests that teens need can be done by the doctor with a urine sample.
  • A Pap test—All women should have their first Pap test (a screening test for cervical cancer and precancerous cell changes) at age 21 years.

What is safe sex?

The surest way to prevent STIs is to not have oral, anal, or vaginal sex. If you are sexually active, you should practice safe sex to help protect yourself and your partner against STIs. You should practice safe sex whether your partner is male or female.

Safe sex means to

  • talk about safe sex before having sexual contact with a partner.
  • avoid mixing sex with the use of drugs or alcohol.
  • use a barrier method (such as condoms, dental dams, and gloves) when touching another person’s genitals with your fingers, your mouth, or a sex toy.
  • avoid getting menstrual blood or other body fluids into cuts or sores.
  • use a male condom to cover sex toys before use. Clean sex toys before and after use.

If you think you may have an STI or have had sexual contact that may have put you at risk, you should be tested for STIs. Even if you do not think you are at risk, your doctor or other health care professional may screen you for gonorrhea and chlamydia if you are sexually active.

Resources

The following organizations and web sites have information that may be of interest to our readers. The American College of Obstetricians and Gynecologists (ACOG) does not necessarily endorse the views expressed or the facts presented by these organizations or on these web sites. Further, ACOG does not endorse any commercial products that may be advertised or available from these organizations or on these web sites.

Advocates for Youth

Web: www.advocatesforyouth.org

American Academy of Pediatrics

Telephone: (847) 434-4000

Web: www.aap.org

American College of Obstetricians and Gynecologists

Telephone: (202) 638-5577 or (800) 673-8444

Web: www.acog.org

American Psychological Association

Telephone: (202) 336-5500 or (800) 374-2721

Web: www.apa.org

Center for Young Women’s Health

Web: www.youngwomenshealth.org

Centerlink: National Association of Lesbian, Gay, Bisexual and Transgender Community Centers

Telephone: (954) 765-6024

Web: www.lgbtcenters.org

Gay and Lesbian Medical Association

Telephone: (415) 255-4547

Web: www.glma.org

Gay, Lesbian & Straight Education Network (GLSEN)

Telephone: (212) 727-0135

Web: www.glsen.org

It Gets Better Project

Web: www.itgetsbetter.org

Iwannaknow.org

Web: www.iwannaknow.org

National Gay and Lesbian Task Force

Telephone: (202) 393-5177

Web: www.thetaskforce.org

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

Telephone: (202) 467-8180

Web: www.pflag.org

Sexuality Information and Education Council of the United States (SIECUS)

Telephone: (212) 819-9770

Web: www.siecus.org

The Trevor Project

Telephone: (310) 271-8845

Web: www.thetrevorproject.org

YouthResource.Org

Web: www.youthresource.org

Hotlines

Trevor Helpline

Toll-free: (866) 4-U-TREVOR (866-488-7386)

Hours: 7 days a week, 24 hours a day

National suicide and crisis counseling for lesbian and gay youth. Local resource referrals available.

GLBT National Youth Talkline

Telephone: (800) 246-PRIDE (800-246-7743)

Web: info@glbtnationalhelpcenter.org

Hours: Monday–Saturday, 9:30 pm–12:00 am EST

Peer support and resources for lesbian, gay, bisexual, transgender, queer, and questioning youth.

CDC National STD and AIDS Hotline

Toll-free: (800) 342-AIDS or (800) AIDS-TTY

Hours: 7 days a week, 24 hours a day

GLBT (Gay, Lesbian, Bisexual, and Transgender) National Hotline

Toll-free: (888) THE-GLNH (888-843-4564)

Hours: Monday–Friday, 4:00 pm–12:00 am; Saturday, 12:00 pm–5:00 pm EST

Linea Nacional del SIDA y ETS

Toll-free: (800) 344-7432

Hours: 7 days a week, 8:00 am–2:00 pm EST

National Runaway Switchboard

Toll-free (800) 621-4000

Hours: 7 days a week, 24 hours a day

Hotline for runaway or homeless youth and their families.

Glossary

Bacterial Vaginosis: A type of vaginal infection caused by the overgrowth of a number of organisms that are normally found in the vagina.

Barrier Method: Contraception that prevents sperm from entering the female reproductive system.

Birth Control: Prevention of pregnancy.

Bisexual: Being sexually attracted to members of both sexes.

Cervical Cancer: A type of cancer that affects the cervix, the opening to the uterus at the top of the vagina.

Chlamydia: A sexually transmitted infection caused by bacteria that can lead to pelvic inflammatory disease and infertility.

Cisgender: A person whose gender identity is the same as the sex they were assigned at birth.

Condom: A thin sheath used to cover the penis during sex to prevent sexually transmitted infections and pregnancy.

Gender Identity: A person’s sense of themselves as a man, a woman, or other gendered.

Genital Herpes: A sexually transmitted infection caused by a virus that produces painful, highly infectious sores on or around the sex organs.

Gonorrhea: A sexually transmitted infection that may lead to pelvic inflammatory disease, infertility, and arthritis.

Hormones: Substances made in the body that control the function of cells or organs.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS).

Human Papillomavirus (HPV): The name for a group of related viruses, some of which cause genital warts and some of which are linked to cervical changes and cancer of the cervix, vulva, vagina, penis, anus, and throat.

Lesbian: A woman who is sexually attracted to other women.

Menstrual Period: The monthly discharge of blood and tissue from the uterus that occurs in the absence of pregnancy.

Pap Test: A test in which cells are taken from the cervix and vagina and examined under a microscope.

Pelvic Exam: A physical examination of a woman’s reproductive organs.

Puberty: The stage of life when the reproductive organs become functional and secondary sex characteristics develop.

Sexually Transmitted Infections (STIs): Infections that are spread by sexual contact, including chlamydia, gonorrhea, human papillomavirus, herpes, syphilis, and human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Sexual Orientation: A person’s emotional or sexual attraction to men, women, or both.

Syphilis: A sexually transmitted infection that is caused by an organism called Treponema pallidum; it may cause major health problems or death in its later stages.

Transgender: A person whose gender identity differs from the sex they were assigned at birth.

If you have further questions, contact your obstetrician–gynecologist.

TFAQ001: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright February 2016 by the American College of Obstetricians and Gynecologists

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998