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Home » Child and Adolescent Psychiatry

Psychiatric Times. Vol. 28 No. 12
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CHILD AND ADOLESCENT PSYCHIATRY 

Sexual Minority Identity Development

A Review of the Process and Effects

By Cynthia J. Telingator, MD and Kelly T. Woyewodzic, MD | December 16, 2011
Dr Telingator is assistant professor of psychiatry at the Harvard Medical School and director of child and adolescent psychiatry residency training, Cambridge Health Alliance. Dr Woyewodzic is a clinical fellow in psychiatry at the Harvard Medical School and a fellow in child and adolescent psychiatry at the Cambridge Health Alliance. The authors report no conflicts of interest concerning the contents of this article.

Definitions

Although definitions may vary in the literature and in clinical discussion, some core concepts are defined here.

Gender identity refers to one’s internally perceived gender, regardless of chromosomal constitution, gonadal/hormonal secretions, or genitalia. Most children develop a stable gender identity that is concordant with their biology at about the age of 3 years. This process is probably driven by biological determinants, but environmental or psychosocial factors may also play a role.

Gender role refers to culturally underwritten masculine and feminine behaviors, attitudes, and personality traits that are partly biologically driven and partly shaped by the environment. This is often noticeable as early as age 2 or 3 years, although in some children there can be flexibility until age 5 or later.

Transgender youth identify with or express a gender identity that differs from the one that corresponds to the person’s sex at birth. This definition does not capture the complexity of an individual’s experience. Transgender youth may share issues and experiences addressed in this article; however, this group is not discussed here because of the need to understand them as a distinct population. References to literature that specifically addresses this population and the topic of gender dysphoria in children and adolescents appear at the end of this article.

Sexual orientation is the predominance of erotic feelings, thoughts, and fantasies one has for members of one’s sex, or both sexes. Savin-Williams and Diamond2 posit that sexual orientation exists along a continuum; a multitude of expressions are possible over a person’s life span. Sexual orientation may not be within conscious control. It may shift along a bisexual continuum for some and for others remain fixed.

Sexual identity describes one’s broader feelings towards one’s gender and sexual attractions. It describes how one consciously labels one’s sexuality.

(MORE: Continuation Treatment and Relapse Prevention in Pediatric Depression)

Resources for Parents and Adolescents

Parents, Families and Friends of Lesbians and Gays (PFLAG) is a support, education, and advocacy organization that promotes the health and well-being of sexual minorities in more than 400 communities: www.pflag.org.

Gay-Straight Alliances (GSA) are student organizations that are intended to provide a safe and supportive environment for sexual minorities. The goal of most, if not all, GSAs is to make schools welcoming to all students regardless of sexual orientation and gender identity: www.gsanetwork.org.

Gay, Lesbian, and Straight Education Network (GLSEN) strives to ensure that each member of every school community is valued and respected regardless of sexual orientation or gender identity/expression: www.glsen.org.

ThinkB4YouSpeak.com is a Web site created by GLSEN that promotes education on the potentially negative impacts of language and bullying on sexual minorities: www.ThinkB4YouSpeak.com

Gender Spectrum Education and Training provides education, resources, and training to create a more gender-sensitive and supportive environment for all people, including gender-variant and transgender youth: www.genderspectrum.org.

The Family Acceptance Project is a community research, intervention, and education initiative to study the impact of family acceptance and rejection on the health, mental health, and well-being of sexual minority youth: www.familyproject.sfsu.edu.

 

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Also in this Special Report

Eating Disorders in Children and Adolescents

Anxiety Disorders in Children and Adolescents

Continuation Treatment and Relapse Prevention in Pediatric Depression

Sexual Minority Identity Development





References

1. Omoto AM, Kurtzman HS, eds. Sexual Orientation and Mental Health: Examining Identity and Development in Lesbian, Gay, and Bisexual People. Washington, DC: American Psychological Association; 2006.
2. Savin-Williams RC, Diamond LM. Sexual identity trajectories among sexual-minority youths: gender comparisons. Arch Sex Behav. 2000;29:607-627.
3. Diamond LM. A new view of lesbian subtypes: stable vs fluid identity trajectories over an 8-year period. Psychol Women Q. 2005;29:119-128.
4. Glover JA, Galliher RV, Lamere TG. Identity development and exploration among sexual minority adolescents: examination of a multidimensional model. J Homosex. 2009;56:77-101.
5. Rosario M, Schrimshaw EW, Hunter J, Gwadz M. Gay-related stress and emotional distress among gay, lesbian, and bisexual youths: a longitudinal examination. J Consult Clin Psychol. 2002;70:967-975.
6. Russell ST, Joyner K. Adolescent sexual orientation and suicide risk: evidence from a national study. Am J Public Health. 2001;91:1276-1281.
7. Gibson P. Gay and lesbian youth suicide. In: Feinlieb MR, ed. Prevention and Intervention in Youth Suicide. Report of the Secretary’s Task Force on Youth Suicide. Vol 3. Washington, DC: US Dept of Health and Human Services; 1989.
8. Garofalo R, Wolf RC, Kessel S, et al. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998;101:895-902.
9. Eisenberg ME, Resnick MD. Suicidality among gay and lesbian and bisexual youth: the role of protective factors. J Adolesc Health. 2006;39:662-668.
10. Jamil OB, Harper GW, Fernandez MI; Adolescent Trials Network for HIV/AIDS Interventions. Sexual and ethnic identity development among gay-bisexual-questioning (GBQ) male ethnic minority adolescents. Cult Divers Ethnic Minor Psychol. 2009;15:203-214.
11. Diaz EM, Kosciw JG. Shared Differences: The Experiences of Lesbian, Gay, Bisexual and Transgender Students of Color in Our Nation’s Schools. A report released by GLSEN, the Gay, Lesbian and Straight Education Network; 2009.
12. D’Augelli AR, Hershberger SL. Lesbian, gay, and bisexual youth in community settings: personal challenges and mental health problems. Am J Community Psychol. 1993;21:421-448.
13. Remafedi G. Death by Denial: Studies of Suicide in Gay and Lesbian Teenagers. Boston: Alyson Publications; 1994:205.
14. Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics. 2009;123;346-352.
15. Kruks G. Gay and lesbian homeless/street youth: special issues and concerns. J Adolesc Health. 1991;12:515-518.
16. Ueno K. Sexual orientation and psychological distress in adolescence: examining interpersonal stressors and social support process. Soc Psychol Q. 2005;68:258-277.
17. Savin-Williams RC. Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: associations with school problems, running away, substance abuse, prostitution, and suicide. J Consult Clin Psychol. 1994;62:261-269.


 
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