Especially for Teens
TFAQ001, June 2019



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Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) Teens

What does it mean to be lesbian, gay, or bisexual?

Lesbian, gay, and bisexual are terms that describe a person’s sexual orientation. This is a person’s emotional, romantic, or sexual attraction to other people:

  • “Gay” means you are attracted to people of the same sex.
  • “Straight” means you are attracted to people of the opposite sex.
  • “Lesbian” means you are a female who is attracted to other females.
  • “Bisexual” means you are attracted to people of both sexes.

“LGBTQ” is an abbreviation for lesbian, gay, bisexual, transgender, and queer. The “Q” also can stand for questioning.

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

  • Women: About 6 in 100 identify as bisexual, and about 2 in 100 identify as lesbian.
  • Men: About 2 in 100 identify as bisexual or gay.

Many people feel that they are not 100% gay, straight, or bisexual. 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 your sense of being male, female, or somewhere in between. This identity may or may not correspond to the sex you were assigned at birth. Gender identity is not the same thing as sexual orientation.

What does transgender mean?

Most people are told they are a boy or a girl (male or female) based on the genitals they were born with. This is the sex you are assigned at birth. For some people, that male or female label may not feel right.

Someone born female may feel that they are really a male, and someone born male may feel that they are really a female. People who feel this way are called transgender. Others may feel that they belong to neither gender or to both genders. People who feel this way sometimes identify as “gender nonbinary,” “gender fluid,” or “genderqueer.” Some other terms may include androgynous, agender, gender neutral, and gender nonconforming.

What steps do people take to express gender?

The ways people express their gender can vary. Some people who are transgender decide to change how they dress. Some choose to change their name and preferred pronouns. Some choose to take hormones or have surgery 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 means that your gender identity matches the sex you were assigned at birth.

What does queer mean?

Queer is sometimes used to describe a fluid gender identity. In the past, this was a negative term for people who are gay. Now, queer is used by some people to describe themselves, their community, or both in a positive way.

What does questioning mean?

Questioning means you are exploring your sexual orientation, gender identity, or gender expression.

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

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. 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 their gender identity?

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. Many people have felt the same way about their gender identity since they were little or for as long as they can remember. If you are confused about your gender identity, find support by talking with someone you trust, such as your doctor or other health care professional.

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

Many communities accept LGBTQ people without bias. But some communities do not. For adults and teens, hate crimes, job discrimination, and housing discrimination can be serious problems. For teens, bullying in school also can be a problem. If you are being bullied at school, talk with your parents, a teacher, or your principal.

Teens who do not feel supported by adults are more likely to be depressed. Some LGBTQ 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.

If you need help, try to find support by talking with someone you trust, such as your doctor or other health care professional. There also are websites and hotlines where you can be anonymous (see “Resources”).

Should I tell my parents that I am LGBTQ?

Some parents are open and accepting. Others may not understand what it means to be lesbian, gay, bisexual, transgender, questioning, or queer. Some parents may believe stereotypes about LGBTQ people. Telling your parents can be big decision. Help and support are out there if you need it. See the “Resources” section for help educating parents, family members, and friends about the LGBTQ community.

What can I do if I want to talk with someone other than my parents?

If you don’t want to talk with your parents, you can talk with a teacher, counselor, doctor, or other health care professional. It’s a good idea to ask about what can be kept private before you talk to a professional. There also are websites and hotlines where you can be anonymous if you need information (see “Resources”).

Who is at risk of sexually transmitted infections?

All teens who are sexually active are at risk of getting a sexually transmitted infection (STI). Barrier methods (condoms, dental dams, and gloves) can be used to prevent STIs.

Girls who have sex with girls can get STIs. Many STIs can be passed from one partner to another through oral sex. These STIs include human immunodeficiency virus (HIV), human papillomavirus (HPV), genital herpes, syphilis, gonorrhea, and chlamydia.

Some STIs (HPV and genital herpes) can be transmitted through skin-to-skin contact. HPV also may be spread by genital-to-finger contact.

Who is at risk of pregnancy?

If you have female reproductive organs and have sex with someone with male reproductive organs, you can get pregnant. All teens who are sexually active and want to prevent pregnancy need to use birth control. See FAQ112 Birth Control for a list of birth control options.

Condoms give the best protection against STIs, but they are not the best protection against pregnancy. It is best to use condoms and another method of birth control, such as an intrauterine device (IUD), birth control pills, or a birth control implant, to protect against pregnancy and STIs.

Who should see an obstetrician–gynecologist?

All teen girls should have their first reproductive health care visit 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 feminizing hormones also need female reproductive health care.

What happens during the first visit with an obstetrician-gynecologist?

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 may get the following tests and immunizations:

  • HPV vaccine—HPV can be passed from person to person during sex. HPV infection increases the risk of cervical cancer and genital warts. Girls and boys should get the HPV vaccine. This is a series of shots to protect against the most common types of HPV that cause cancer, precancer, and genital warts. The best age for the HPV vaccine is age 11 years or 12 years, but you can get the vaccine starting at age 9 years.
  • STI screening tests—If you are sexually active, you may have tests for certain STIs. Most STI tests can be done with a urine sample or a swab of your genital area or mouth.
  • Pap test—All women should have their first Pap test at age 21 years. The Pap test is a screening test for cervical cancer and precancerous cell changes.

What is safe sex?

The only definite 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:

  • Talking about safe sex before having sexual contact with a partner.
  • Not mixing sex with the use of drugs or alcohol.
  • Using a barrier method (condoms, dental dams, or gloves) when touching another person’s genitals with your genitals, fingers, mouth, or a sex toy.
  • Avoiding getting menstrual blood or semen into cuts or sores.
  • Using 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

Centerlink
954-765-6024
www.lgbtcenters.org
Directory of community centers for LGBT people.

GLMA
415-255-4547
www.glma.org
Medical associations of LGBTQ health care professionals. Provides a directory of LGBTQ-friendly health care professionals.

Gay, Lesbian & Straight Education Network (GLSEN)
212-727-0135
www.glsen.org
Organization that supports safe and inclusive schools for LGBTQ students. Local chapters offer trainings, community outreach, and more.

Gender Spectrum
510-788-4412
www.genderspectrum.org
Organization that supports gender expansive children, teens, and their families.

It Gets Better Project
www.itgetsbetter.org
Videos of LGBTQ people and allies sharing their personal stories.

Iwannaknow.org
www.iwannaknow.org
Information on sexual health for teens and young adults.

PFLAG
202-467-8180
www.pflag.org
Network of communities for LGBTQ people, parents, and friends.

The Trevor Project
310-271-8845
www.thetrevorproject.org
Crisis intervention, suicide prevention, and resources related to sexual orientation and gender identity.

Hotlines

Trevor Lifeline
Toll-free: 866-4-U-TREVOR (866-488-7386)
Hours: 7 days a week, 24 hours a day
www.thetrevorproject.org
Confidential suicide and crisis counseling for LGBTQ teens and young adults. Text and instant messaging options are available on the website.

LGBT National Youth Talkline
800-246-PRIDE (800-246-7743)
Hours: Monday–Friday 1 pm–9 pm PST / 4 pm–12 am EST, Saturday 9 am–2 pm PST / 12 pm–5 pm EST
help@LGBThotline.org
Peer support and resources for LGBTQ teens and young adults.

Centers for Disease Control and Prevention National STD and AIDS Hotline
Toll-free: 800-232-4636
Hours: 7 days a week, 24 hours a day

Linea Nacional del SIDA y ETS
Toll-free: 800-344-7432
Hours: 7 days a week, 8 am–2 pm EST

National Runaway Safeline
Toll-free 800-RUNAWAY (800-786-2929)
Hours: 7 days a week, 24 hours a day
www.1800runaway.org
Hotline for runaway or homeless youth and their families. An instant messaging option is available on the website.

Trans Lifeline
Toll-free: 877-565-8860
Hours: 7 am–1 am PST / 9 am–3 am CST / 10 am–4 am EST.
Peer support hotline run by and for trans people.

Glossary

Barrier Method: Birth control that stops sperm from entering the uterus, such as condoms.

Birth Control: Devices or medications used to prevent pregnancy.

Bisexual: Being attracted to members of both sexes.

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

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

Cisgender: A term for someone who identifies as the sex that he or she was assigned at birth.

Gender Identity: A person’s sense of being male, female, or somewhere in between. This identity may or may not correspond to the sex assigned at birth.

Genital Herpes: A sexually transmitted infection (STI) caused by a virus. Herpes causes painful, highly infectious sores on or around the vulva and penis.

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. If left untreated, HIV can cause 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 cancer of the cervix, vulva, vagina, penis, anus, mouth, and throat.

Lesbian: A woman who is attracted to other women.

Menstrual Period: The monthly shedding of blood and tissue from the uterus.

Pap Test: A test in which cells are taken from the cervix (or vagina) to look for signs of cancer.

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

Puberty: The stage of life when the reproductive organs start to function and other sex features develop. For women, this is the time when menstrual periods start and the breasts develop.

Queer: A term sometimes used to describe a fluid gender identity. In the past, this was a negative term for people who are gay. But now, queer is used by some people to describe themselves, their community, or both in a positive way. Typically used when self-identifying or quoting someone who self-identifies as queer.

Questioning: A term used to describe people who are exploring their sexual orientation, gender identity, or gender expression.

Sexually Transmitted Infections (STIs): Infections that are spread by sexual contact.

Sexual Orientation: Emotional, romantic, or sexual attraction to other people. Examples include heterosexual, homosexual, and bisexual.

Syphilis: A sexually transmitted infection (STI) that is caused by an organism called Treponema pallidum. This infection 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:This information was designed as an educational aid to patients and sets forth current information and opinions related to women’s health. It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care. It is not a substitute for a treating clinician’s independent professional judgment. Please check for updates at www.acog.org to ensure accuracy.

Copyright May 2019 by the American College of Obstetricians and Gynecologists

American College of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188
Mailing Address: PO Box 96920, Washington, DC 20024-9998