Providing sensitive health care to gay and lesbian youth.

While the years of adolescence are usually very difficult, for gay and lesbian youth they are tremendously traumatic. Gay and lesbian youth face many problems because of the homophobia in our culture; such a young person often hides his or her gay or lesbian identity, and health care professionals often deny its existence. Increased anxiety and fear cause gay and lesbian youth to be particularly vulnerable to the major problems of adolescence, such as drug and alcohol abuse, sexual acting-out, pregnancy, AIDS, homelessness and suicide. The etiology of homosexuality is still not understood, and a number of theories are discussed in this article. Troiden's model of gay and lesbian identity development is presented, covering sensitization, identity confusion, assumption and commitment. A lack of appropriate role models has been a significant problem, although some change is occurring. Specific ways of helping these troubled adolescents are given, with a particular emphasis on education and providing methods of support.