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American Association of Pediatricians Releases New Statement on Sexual Orientation
(07/13/2004) by Blaise Parker
Sexual Orientation and Adolescents
Barbara L. Frankowski and the Committee on Adolescence
PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1827-1832
http://pediatrics.aappublications.org/cgi/content/full/113/6/1827#R16
In June of 2004, the American Academy of Pediatrics released a new clinical report dealing with the topic of sexual orientation and adolescents. This report is an update to previous statements for pediatricians concerning homosexuality. The first of these reports was issued in 1983, and it was updated in 1993. The most recent report, prepared by the Committee on Adolescence, offers pediatricians an overview of the current status of scientific research about homosexuality and non-heterosexual adolescents. Its goal is to help pediatricians make sensible and appropriate decisions and referrals for adolescents who may be questioning their sexual orientation. This is particularly important since adolescents are recognizing and stating their sexual orientations at younger ages than previous generations have done.
The report defines sexual orientation as “an individual’s pattern of physical and emotional arousal toward other persons” (p. 1872). They distinguish this from gender identity, which they refer to as “the knowledge of oneself as being male or female” (p. 1872) and gender role, which they define as “the outward expression of maleness or femaleness” (p. 1872). These are important distinctions, as they allow pediatricians to understand the differences between and overlaps among those who identify themselves as gay, lesbian, bisexual, or transgendered. The report also stresses that sexual orientation does not necessarily predict sexual activity or behavior, and therefore it is a mistake to make assumptions about the sorts of activities in which adolescents engage.
For physicians who have questions about the causes and prevalence of homosexuality, the report provides the few conclusions scientists and experts in the field have made. First, they stress that current literature in the study of sexual orientation states “that one’s sexual orientation is not a choice” (p. 1828), and that it is “probably not determined by any one factor but by a combination of genetic, hormonal, and environmental influences” (p. 1828). It also dispels the notion that non-heterosexuality is caused by childhood life events, bad parenting, or sexual abuse. Because it is difficult, even in carefully controlled research, to determine the percentage of people who identify as gay, lesbian, bisexual, or transgendered, the report simply cites a number of surveys without drawing any conclusions. The numbers range from Kinsey’s (1948) high finding of 37% (the number of adult males who have a sexual experience to orgasm with another male) to low ratings of 1-2% from studies by Garofalo et al. (1999) and Seidman and Reider (1994).
The remaining portion of the report is perhaps the most important, as it offers physicians clear advice about special needs of GLBT youth, tips for making one’s practice safe and supportive, and information about comprehensive sexual health care for adolescents. Among the best advice are tips for reducing heterosexism (e.g., asking about “partners” instead of “boyfriends” and “girlfriends,”; displaying materials for GLBT adolescents), building trust with patients (e.g., assuring confidentiality; making referrals when appropriate), and treating sexual health in a comprehensive way (e.g., discussing emerging sexuality with all patients; providing additional STD and pregnancy screenings based on the situation). The remaining information provides suggestions for helping adolescents come out to friends and family, as well as data about special risks (e.g., depression) that GLBT adolescents face.
Overall, the report is a remarkably positive perspective on sexual orientation and adolescents. The American Academy of Pediatrics also recognizes that some physicians will not feel comfortable discussing sexual orientation or will have negative responses to GLBT youth. Commendably, they encourage those physicians to refer their patients to someone better equipped to deal with the situation. This report and the advice within mark an important and constructive step in treatment for GLBT youth and their families.
References:
Garofalo R, Wolf RC, Wissow LS, Woods ER, Goodman E. Sexual orientation and risk of suicide attempts among a representative sample of youth. Arch Pediatr Adolesc Med.1999; 153 :487 –493
Kinsey AC, Pomeroy WB, Martin CE. Sexual Behavior in the Human Male. Philadelphia, PA: WB Saunders Co; 1948
Seidman SN, Reider RO. A review of sexual behavior in the United States. Am J Psychiatry.1994; 151 :330 –341 This article appears in the following topics:
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