The decade between and saw rapid increases in research on adolescent sexual orientation development and related health issues, Sexual orientation psychology research articles in quantity and in quality of studies. While much of the research originated in North America, studies from other countries Sexual orientation psychology research articles contributed to emerging understanding of developmental trajectories and social influences on the health of sexual minority adolescents.
This paper reviews the body of research from the past decade on adolescent sexual orientation, focused on issues of measurement, developmental trajectories, evidence related to health disparities, and the risks and protective factors that help explain the health and developmental challenges some lesbian, gay, and bisexual adolescents experience. Although many sexual minority adolescents face stigma and rejection within their families, their schools, or communities, it should be noted that most successfully navigate the developmental tasks of adolescence, and attain similar levels of health and well-being as their heterosexual peers, often despite the stigma and discrimination they encounter.
Further research is needed to understand population trends as well as individual patterns of development; cultural variations in both development
Sexual orientation psychology research articles health disparities; the
Sexual orientation psychology research articles of general and unique risk factors that contribute to various health disparities and protective factors that buffer those risks; and interventions to promote the healthy development of sexual minority adolescents.
The study of sexual orientation, especially the development of homosexual or bisexual attractions and behaviors, is not new. Yet, beginning inthe past decade or so has seen a huge increase in research on sexual orientation in adolescence, across a variety of disciplines, including education, family studies, genetics, medicine, nursing, nutrition, psychology, public health, social work, and sociology.
Thus, this decade has offered considerable progress toward understanding sexual orientation development and related health issues among adolescents, and has provided key studies that have altered both professional and popular understandings. While much of the research prior to was from the United Sexual orientation psychology research articles, the rapid growth of research after that point has included a growing diversity in geographic coverage, with studies of adolescents in countries on nearly every continent, as well as varied ethnic and cultural groups Sexual orientation psychology research articles countries.
The decade has also seen an expansion in design and methods used in studies of adolescent sexual orientation, including a growing number of multivariate modeling studies, large-scale, population-based surveys, as well as longitudinal studies in various countries.
These design approaches have strengthened the body of evidence in understanding developmental milestones, health disparities, and potential risk and protective factors affecting the health and well-being of sexual minority adolescents.
Because of this rapid growth in research, there have finally enough studies for meta-analysis, and repeated population studies in the same regions to allow for studies of population trends. A great deal of the research has focused on areas of health or social disparities, or increased risk for problems. Documenting health inequities for a particular population is often a first step to focus attention, to facilitate a shift of priorities in practice and policy, and to develop effective interventions to support healthy youth development.
Thus, much of the research in this decade has focused on disparities in health and risk behaviors, but has included more sophisticated approaches to exploring contributing factors to explain these disparities. As with most fields of study relevant to a wide
Sexual orientation psychology research articles of disciplines and areas of practice, there is an equally wide range in quality of research in this topic area.
Some studies lacked any theoretical grounding, and some used weaker designs and methods; however, the decade saw a growing number of soundly conceptualized studies, rigorous and sophisticated methodology, and critical discussion of results. In general, there is more to laud than
Sexual orientation psychology research articles dismiss.
Therefore, this review will emphasize studies that have greater scientific rigor, or wider generalizability, or are the sole studies about an issue, or whose theory development or findings subsequently exerted a stronger influence on the field than have other studies.
In terms of timing, the decade is loosely defined as to ; a few key studies that occurred just
Sexual orientation psychology research articles to will also be included, as will a number of studies available in on-line editions during but published in print inwhich offer important perspectives or touch on relatively understudied issues.
Although much of the research is U. The focus of this review is on adolescence, Sexual orientation psychology research articles the studies included are primarily limited to adolescents of high school age or younger, i. The paper is organized into several sections. First is a discussion of measurement, followed by research on sexual orientation development.
Next, the health disparities that have documented for sexual minority youth are covered, as well as evidence for the theoretical explanations and factors to these health disparities.
Moving beyond health disparities and problems, the next section explores emerging studies on protective factors and resilience among sexual minority youth. Finally, the limited research on interventions to promote healthy development and reduce health disparities for sexual minority adolescents will be examined. Despite impressive progress in the past decade, there remain an array of areas that need further evidence or additional directions of inquiry.
Each section of this paper will include suggestions for future research, and a final section will offer recommendations for the next decade of research on sexual orientation and adolescent well-being.
The definition and measurement of sexual orientation generally, and among adolescents specifically, Sexual orientation psychology research articles been consistently difficult. Some researchers consider internal recognition of these attractions and self-labels—as gay, bisexual, or heterosexual—to be an important element of sexual orientation.
Others feel identity labels are unduly influenced by cultural and social factors, especially if the identity carries serious social stigma. There has been growing consensus on measurement, as interdisciplinary expert panels have been convened to develop recommendations about measurement, drawing on experiences of a wide range of researchers and empirical validation of measures LGB Youth Sexual Orientation Measurement Work
Sexual orientation psychology research articles, ; Saewyc et al.
Such recommendations take time to filter to the wider field, however; although these panels have Sexual orientation psychology research articles including least two dimensions of orientation in studies where possible, most adolescent research studies that incorporate sexual orientation measures include only identity, attraction, or behavior.
Even within a specific dimension, measures are not consistently worded, or have the same number of response options. Terms change in popularity and usage over time, and researchers may include new terms, or ethnic-specific labels. Studies that include multiple measures of orientation reveal another important issue: Such studies face complex choices for defining groups: Do they combine measures into an aggregate Sexual orientation psychology research articles or score?
Defining and measuring sexual orientation in adolescent research must also take into account development. Cognitive development associated with sexual maturation, i. The majority of younger adolescents have not had sexual relationships; in the U.
Measurement of any developmental aspect across the intense physical, cognitive, and behavioral transformations of adolescence is fraught with such difficulties and limitations. In this decade an important set of longitudinal studies have examined the stability of sexual orientation across adolescence and Sexual orientation psychology research articles adulthood Austin et al.
There are significant risks when research findings from a topic that generates social controversy are misapplied Saewyc, How big a problem are these measurement Sexual orientation psychology research articles for the field? Certainly they create difficulties in comparing across studies, across regions, or across time Austin et al.
Whatever nuances in definition or measurement of orientation, a greater proportion of adolescents who indicate some form of non-heterosexual orientation report unsupportive environments, less nurturing parental relationships, increased risk of developmental stressors and health disparities compared to heterosexual peers. The robustness of these findings, especially in population-based or large-scale longitudinal studies, provide some Sexual orientation psychology research articles that studies are capturing the same groups.
There is also reason for encouragement. In this decade a few measurement studies, thoughtful critiques of theory development, and expert panels have worked to resolve these challenges. Sell and Diamond b provided constructive reviews, while my colleagues and I evaluated measures of sexual orientation within several large-scale school-based surveys across North America Saewyc, et al.
According to these studies, adolescents consider attractions sexual and romantic to be the principal element of sexual orientation, and questions about attractions the easiest to Sexual orientation psychology research articles and answer.
Youth rejected behavior questions as a measure of sexual orientation, and expressed some discomfort with identity labels, in part because of the potential permanence implied by labels, in part because of stigma as a result of negative peer responses to sexual minority labels.
Finally, a recent study among more than 2, California high school students Russell, et al. Although all of these studies are important beginning steps in validating definitions and measures among young people, they only include older adolescents from the U.
In sum, the past decade has seen a developing consensus about the definition and measurement of sexual orientation for adolescent research, supported by a growing body of validation studies. Given the developmental stage of adolescence, the expert panels recommend studies should measure more than one dimension of orientation, whether attraction, identity labels, or behavior, and where at all possible, disaggregate orientation categories in analyses.
We still need to pilot existing measures in studies, especially with diverse cultural groups or younger teens, to ensure that the measures remain understood and relevant. There have been a growing number of informative studies about sexual orientation development during adolescence in the past decade.
These studies have explored the timing and patterns of sexual identity development milestones, the stability of sexual orientation elements over the course of adolescence and young adulthood, and differences Sexual orientation psychology research articles gender and ethnicity. There have even been a few studies exploring changing trends in Sexual orientation psychology research articles orientation milestones, as well as studies examining factors that could influence development Sexual orientation psychology research articles non-heterosexual orientations.
A few studies have Sexual orientation psychology research articles begun to explore genetic and evolutionary perspectives on sexual orientation, although to date, there are distinct weaknesses in the methodologies that have been used. These will be summarized briefly below.
Earlier conceptualizations of sexual orientation development e. These linear models did not differentiate paths for
Sexual orientation psychology research articles and females, and laid out a set of milestones that were supposed to occur in mostly the same order, although with variable lengths of time between each stage. Research became more sophisticated, including prospective longitudinal research rather than solely retrospective recall, and cluster analyses for patterns of coming out, rather than averaged group responses.
One of the few studies examining sexual orientation among ethnic groups found that African-American and Latino groups showed no differences in most milestones compared to White teens, but delays in public disclosure and less involvement in gay-related social networks Rosario, et al.
The study of cohort trends over time among adolescent populations found a decrease in heterosexual identification, and increase in the prevalence of bisexual and mostly heterosexual identification, but only among girls Saewyc, Poon et al. One of the primary critiques of a milestones approach to orientation development is that it taps experiences and behaviors without necessarily considering the contexts in which those Sexual orientation psychology research articles occur, the meanings for individual adolescents, or the changing societal contexts for teens in the most recent decade, compared to previous generations Hammack, et al.
Hammack and colleagues suggest that the master narratives,
Sexual orientation psychology research articles. Bisexuality remains under-theorized and under-investigated, despite some increase in research. Another problem with the milestones approach is it suggests orientation is a fundamental trait unfolding during adolescence, but once adulthood is reached, labels and behaviors are stable and consistent.
However, longitudinal studies published during the past decade have raised awareness about the fluidity of orientation among some teens during Sexual orientation psychology research articles and into adulthood.
Studies by Lisa Diamondabdocumented this fluidity among older adolescent and young adult women Sexual orientation psychology research articles a longer Sexual orientation psychology research articles, charting attractions, labels and behavior. They found adolescents with a non-heterosexual orientation in any dimension were less likely than exclusively heterosexual teens to remain consistent in their attractions and behavior over time.
However, Savin-Williams and Ream also noted that as some gay, lesbian and bisexual adolescents shifted to opposite-gender attractions, behavior, or heterosexual self-labels, a larger absolute number of heterosexual teens shifted to same- or both-gender attractions and behaviors, keeping the overall prevalence relatively
Sexual orientation psychology research articles across time.
Studies have explored the more question of what might cause the continuum of sexual orientation, or at least what contributes to or influences Sexual orientation psychology research articles pathways. It should be noted that the overwhelming majority of the biological research has been conducted with adults, not adolescents, and disproportionately among males
Sexual orientation psychology research articles than both males and females.
Mustanski and colleagues identified significant limitations in methods, sample sizes, lack of replicability of findings, and inconsistent results among studies. Perhaps the most troubling challenge in biological approaches are inherent assumptions by most researchers that orientation is a dichotomous, stable trait; many of the studies used measures of orientation that have long been considered problematic in the health and social sciences, and presume that sexual orientation development in males and females result from similar but opposite processes.
It seems likely that there are genetic and environmental influences on propensity for non-heterosexuality, but the actual mechanisms are still unknown. Beyond biological mechanisms of sexual orientation development, one environmental influence that has been taken up in the wider social discourse has Sexual orientation psychology research articles childhood
Sexual orientation psychology research articles adolescent sexual abuse.
Studies have noted disproportionately higher rates of sexual abuse and assault among sexual Sexual orientation psychology research articles populations see for example, Saewyc, Skay, et al. The logic does not hold, however: Similarly, if sexual abuse was a causal factor in gay, lesbian or bisexual orientation, the majority of sexual minority
Sexual orientation psychology research articles should report a history of sexual abuse, and the majority of sexually-abused adolescents should identify as gay, lesbian, or bisexual.
Neither is true; in 7 different population-based surveys across North America, fewer than half of LGB-identified adolescents reported sexual Saewyc, Skay, Sexual orientation psychology research articles al. Since teens vastly outnumber lesbian, gay, bisexual, queer and questioning youth, the smaller percent of them who have been abused still outnumber abused LGBQ teens; based on estimates from the BC Adolescent Health Survey, for example Saewyc, Skay, et al.
Thus, the increase in studies over the decade on sexual
Sexual orientation psychology research articles development have provided further nuanced understanding of how orientation unfolds during adolescence, and have challenged more simplistic views of previous work, documenting potential changes in narratives of development, identifying variability in patterns of development, and potential fluidity in sexual orientation over adolescence and young adulthood, especially for young women.
Future areas of research that could improve our understanding should include longitudinal studies preferably birth-cohort Sexual orientation psychology research articles to more carefully sequence potential influences or confounding factors.
Similarly, international and studies of sexual orientation development in diverse ethnic groups will deepen understanding of how culture and social environment influence orientation identity.
Finally, we need more rigorously designed studies of the genetic and biological contributions to sexual orientation, that take into account the complex interrelationship of biology with culture and context.
Although studies have explored differences in health risks among sexual minority adolescents for
Sexual orientation psychology research articles, the past decade saw an important shift to studies with population-based sampling designs, which significantly strengthened the evidence about health disparities experienced by LGBQ teens in a number of countries around the world. This shift resulted from the inclusion of sexual orientation measures in large-scale, school-based cross-sectional Sexual orientation psychology research articles in some regions of the United States and Canada, followed by similar surveys in other countries, such as Australia, New Zealand, Guam, Belgium, Switzerland, Norway, and Turkey.
Some of these school-based cohort surveys have been repeated at regular intervals in the same regions since the early s, offering opportunities to explore population trends. At the same time, the field was Sexual orientation psychology research articles strengthened when researchers added sexual orientation Sexual orientation psychology research articles to waves of national longitudinal studies, such as the New Zealand Christchurch birth cohort study, the U.
Most of these surveys monitor a wide array of risk exposures, protective factors, health-compromising behaviors, psychological adjustment, and psychosocial outcomes, allowing a variety of health and developmental issues to be compared between LGBQ youth and their heterosexual peers.
Sexual orientation psychology research articles received far more attention than others; Coker, Austin and Schuster recently reviewed the level of evidence in U. By far the
Sexual orientation psychology research articles commonly studied health disparities have been those related to mental health, especially suicidal ideation and suicide attempts.