Doctors must be attuned to sexual diversity among youth

Canadian health care providers should be prepared to discuss issues related to sexual orientation with their adolescent patients, according to a new statement from the Canadian Paediatric Society.
"It's important that doctors keep in mind that not everyone is heterosexual," says Dr. Miriam Kaufman, author of the CPS statement and an adolescent medicine specialist at The Hospital for Sick Children. "Health care providers need to be aware of the diversity of experience and feelings in adolescents and be able to address issues of sexual orientation."
Gay, lesbian and bisexual youth come from all ethnic groups, social classes and racial backgrounds. They have the same array of health care needs as heterosexual adolescents, including chronic illness, disabilities, sports injuries and even contraception.
But they can also face additional risk factors, many of which are due to the stigma that continues to surround homosexuality. Studies indicate that about half of gay men and a fifth of lesbians were verbally or physically assaulted in high school because of their sexual orientation. Gay and lesbian youth are more likely to drop out of school or be thrown out of their homes, sometimes ending up on the street. They are also at risk of using drugs and alcohol at an earlier age, sometimes to cope with depression or low self-esteem.
Talking with a health care professional can make a difference. Young people who disclose sexual orientation issues to their doctor are "automatically in a lower risk category," says Dr. Kaufman. "Paediatricians and family doctors can really help."
But many teens avoid discussing sexual orientation with their doctor, fearing their personal information will be shared. The statement recommends that doctors promote openness by using gender-neutral language when discussing sexuality and relationship history, rather than making assumptions about the youth's sexual identity. They should also be willing to provide support if a teen is "coming out."
Many physicians receive little training in talking to teens about sex and sexual orientation. Doctors who are uncomfortable talking about these issues should consider referring these patients to another physician.

Source: Canadian Paediatric Society