Homosexuality and bisexuality


Homosexuality is the consistent sexual and emotional attraction, including fantasy, interest, and arousal to a person of the same sex. Bisexuality is the sexual and emotional attraction to members of both sexes.


References to homosexuality and bisexuality can be found in recorded history and literature dating back thousands of years. They are part of a trio of classifications referred to collectively as sexual orientation. The third is heterosexuality, the sexual and emotional attraction to members of the opposite sex. Both male and female homosexuals are commonly referred to as gay while homosexual females are called lesbians.

The earliest documentation of homosexuality in Western civilization occurs in ancient Greece, where same-sex relationships were considered normal by society. Although there were some homosexual relationships between adult males, most were between men and boys. Although there is some disagreement among historians, a number of historical figures were believed to be gay, including Alexander the Great (356 B.C.–323 B.C.), Plato (20 B.C.–45 A.D.) Virgil (Vergil) (70 B.C.–19 B.C.), Leonardo da Vinci (1452–1519), and Michelangelo (1475–1564). Homosexuality in Asian, especially Japanese and Chinese, cultures has been documented since at least 600 B.C.

Social attitudes towards homosexuality and bisexuality have varied over the centuries, from complete rejection, or homophobia, through covert acceptance, to complete normalization, with many degrees in between. The religious response to homosexuality varies, though in the three major Western religions (Judaism, Christianity, and Islam) homosexuality and bisexuality are considered sins.

In some cultures, especially those influenced by homophobic religions, homosexuality is considered a perversion and has been outlawed; in some jurisdictions homosexual behavior is a crime punishable by death. Persecution of homosexuals in such cultures is common. In Nazi Germany, homosexuals and bisexuals were sent to concentration camps and were murdered in gas chambers along with other minority and religious groups.

The modern gay rights movement began in the late 1960s and included the development of the often activist academic treatment of sexuality in colleges and universities. This focus led to changes in social acceptance and in the media portrayal of homosexuality and bisexuality. In 1973, the American Psychiatric Association (APA) removed homosexuality from its list of mental disorders. The legalization of same-sex marriage and non-gender-specific civil unions is one of the major goals of gay rights activism. Toward the end of the 1990s and into the early 2000s, a number of jurisdictions relaxed or eliminated laws curbing homosexual behavior, including sodomy laws and laws preventing homosexuals from serving in armed forces. This trend culminated on June 26, 2003, with the landmark U.S. Supreme Court decision Lawrence v. Texas which overturned all sodomy laws in the United States.

In 2003, Canada legalized same-sex marriages, according the same rights to gay married couples as to heterosexual married couples. Gay marriage is also legal in The Netherlands and Belgium. In 2004, due to several local and state actions, gay marriages were legalized in San Francisco; Massachusetts; Portland, Oregon; and several other areas. They were as of 2004 all under legal challenge, and the California Supreme Court nullified the San Francisco gay marriages in mid-2004. The Defense of Marriage Act, signed by President Bill Clinton in 1996, prevents federal recognition of same-sex marriage and allows states to ignore same-sex licenses from outside their borders.

The correct term or terms to use when referring to homosexuals varies widely by location and culture. In the United States and Europe, even the use of the word homosexual can be seen as insulting. In Washington state, The Safe Schools Coalition of Washington's Glossary for School Employees advises that gay is the preferred synonym for homosexual and goes on to advise avoiding the term homosexual, because it is clinical, distancing, and archaic.

The causes of homosexuality and bisexuality are unknown, although there are many controversial theories. These include genetic, biological, psychological, and social factors, as well as conscious choice. A majority of researchers believe sexual orientation is most likely determined by a combination of factors. Since about the 1970s, researchers have tended to rule out conscious choice. The reason can be answered in a question: Why would anyone choose a lifestyle which may well bring them discrimination, hatred, and even violence?

Much research suggests sexual orientation is set in early childhood. In surveys of gay men and lesbians, most say they believe they were born that way. This awareness usually occurs during puberty but sometimes earlier. Many experts believe sexual orientation, whether homosexual, bisexual, or heterosexual, is determined by a complex interaction between anatomical and hormonal influences during fetal development.

There is also no definitive research on the percentage of the population that is homosexual or bisexual. Studies in the 1940s and 1950s by biologist and sex researcher Alfred C. Kinsey (1894–1956) found that 2 percent of women and 10 percent of men were exclusively homosexual and that 37 percent of men reported having at least one same-sex experience after adolescence . The validity of this research, while often cited in scientific literature, is questionable, since most of the study subjects were over 30 years old, white, and not randomly selected.

School age

Several studies suggest that first sexual attraction, whether for homosexuals, bisexuals, or heterosexuals, begins in middle childhood at about age 10. At this time, the adrenal glands begin to produce sex steroids, which motivate sexual attraction as well as social and emotional behavior.

Development of sexual identity in middle childhood and early adolescence is a natural process but is more stressful for homosexual adolescents, according to the American School Health Association (ASHA). To avoid rejection and hostility, homosexual adolescents feel obliged to hide their sexual identities. Professionals generally agree that homosexual identity development usually occurs in stages, according to a March 2003 article in ASHA Journal of School Health.

The first stage is identified as "sensitization" or early awareness, where, around age 10, a child experiences same-sex attraction and feelings of being different than other children. The second stage is "identity confusion," in which simple awareness is no longer ignored. Gay male and lesbian children usually try to hide their sexual identities because society encourages heterosexuality. This stage is usually resolved by denying or hiding homosexual feelings, repressing same-sex attraction, or taking on a homosexual identity.

The next stage is "identity assumption," in which the person accepts their homosexuality but usually limits disclosure to others. The final stage is "identity consolidation," also known as "coming out," in which disclosure may be expanded and the homosexual identity may be incorporated into social activities.

After identifying themselves as homosexual or bisexual, adolescents face the often-difficult problem of deciding whom to tell that they are gay or bisexual. According to a 1999 report by Cornell University, the average coming-out age for a gay and lesbian young person in the United States is 14–15 years, significantly younger than the average age of 19–23 during the late 1970s and early 1980s, according to the advocacy group Tolerance.com. Confidence and openness about their sexual orientation at a younger age, however, almost invariably exposes young people to homophobia and abuse at an early age, the group states on its Web site (http://www.tolerance.org).

Common problems

In hiding their sexual identities, homosexual and bisexual adolescents deprive themselves and each other of positive role models. However, disclosure to family members may lead to pressure to change through psychological or religious "conversion" therapies, which the ASHA regards as ineffective. The ASHA and most other professional organizations say family support when an adolescent discloses that they are gay or bisexual is crucial to the child's mental and emotional health. Children and teens who reveal that they are gay or bisexual to non-supportive families are much more likely to become runaways and resort to prostitution for financial support.

Research shows inconsistencies regarding disclosure. To test how a family will react, a gay or bisexual child or teen will often first tell a sibling whom they feel they can trust and whom they believe is most likely to be supportive, most often a sister. Mothers are more often disclosed to than fathers because fathers tend to have a more negative reaction. Studies also show that parents react more negatively when a son tells them he is gay or bisexual than when a daughter reveals she is lesbian or bisexual.

Numerous studies show that gay and bisexual youth are at a higher risk of dropping out of school, of being kicked out of their homes, and becoming prostitutes, than their heterosexual peers. They also have a higher incidence of drug, alcohol, and tobacco use. Studies have also shown that gay and bisexual adolescents are two to seven times more likely to commit or attempt suicide compared to heterosexual children and teens. Other studies have found that 45 percent of gay males and 20 percent of lesbians were victims of verbal or physical abuse in middle and high school and were two to four times more likely to be threatened with a weapon compared to heterosexual students.

Parental concerns

Studies have shown that parents usually go through a series of stages when they learn a child is gay or bisexual. In the first stage, nearly all parents go through a grieving period after learning their child is gay or bisexual. The parents mourn the loss of what they assumes was their child's heterosexuality and "traditional" lifestyle, the lack of grandchildren and their role as potential grandparents, and the improbability of changing their child's sexual orientation.

Soon after disclosure, parents often experience fear and guilt and may deny their child is gay or bisexual. They may urge their child to change their sexual orientation or urge them to keep their sexuality secret. Also, parents often become angry and seek to blame someone for their child's sexual orientation, such as a gay teacher, a sexual abuser, or as often is the case with gay males, to blame the father for a lack of engaging the child in perceived masculine activities such as sports . During this anger stage, parents often threaten or abuse the child or try to force them to change. Any of these actions tends to drive a wedge between the parents and child and is the primary reason many gay and bisexual youth run away from home. Sometimes they are thrown out of the house by their parents and are forced to live on the streets, often turning to prostitution to survive.

The anger stage is usually followed by the bargaining stage, where parents try to get their child to change their sexual orientation, sometimes through God or religion, or through psychological intervention. In this stage, parents sometimes experience one or a combination of emotions, including shame, guilt, and depression.

The final stage is resolution, where the parents either accept or deny that their child is gay or bisexual, though studies show few fully accept it. Some families remain in denial indefinitely. Others ostracize the child through eviction from the home or family.

When to call the doctor

Gay and bisexual adolescents may need psychological help in dealing with their sexual orientation. The vast majority of experts say this counseling should be supportive and not seek to change the child's sexual orientation. Counseling that offers emotional support may be helpful for teens who are uncomfortable with their sexual orientation. Therapy may also help the adolescent adjust to personal, family, or school-related problems.

Therapy directed specifically at changing homosexual or bisexual orientation is not recommended and may be harmful for an unwilling teen, according to a behavioral health advisory issued in 2002 by the journal Clinical Reference Systems. It may create more confusion and anxiety by reinforcing negative thoughts and emotions with which the child is already struggling, the advisory states.

Signs that a child or teem may be gay or bisexual and is having problems dealing with it include social isolation, avoiding school, threats of running away , poorly developed dating skills, low self-esteem , self hatred, alcohol and/or drug abuse, harassment at school or home, feelings of inferiority, depression, threats of suicide, and eating disorders.

Advice for healthcare professionals

The American Academy of Pediatrics (AAP) has issued guidelines for pediatricians in dealing with gay and bisexual adolescents. An article in the June 2004 issue of the AAP journal Pediatrics states: "Pediatricians should be aware that some youths in their care may have concerns about their sexual orientation or that of siblings, friends, parents, relatives, or others. Health care professionals should provide factual, current, nonjudgmental information in a confidential manner."

The article states that pediatricians and other health-care professionals should be attentive of various psychological difficulties, offer counseling or refer for counseling when necessary, and ensure that all sexually active youths receive a physical examination, immunizations, appropriate laboratory tests, and counseling about sexually transmitted diseases , and appropriate treatment if necessary.

The Pediatrics article also states: "Not all pediatricians may feel able to provide the type of care [necessary]. Any pediatrician who is unable to care for and counsel nonheterosexual youth should refer these patients to an appropriate colleague."

Most gay and bisexual youth seen by pediatricians and other healthcare providers will not raise the issue of sexual orientation on their own. Therefore, healthcare professionals should raise issues of sexual orientation and sexual behavior with all adolescent patients or refer them to a colleague who can these issues, according to the AAP. Pediatricians should also consider displaying posters and offering brochures that demonstrate support for gay and bisexual teens. The AAP publishes a brochure dealing with sexual orientation, "Gay, Lesbian, and Bisexual Teens: Facts for Teens and their Parents."

Advice for teachers, counselors, and other school employees

Because students who discover they are gay or bisexual often experience rejection, discrimination, isolation, and violence, it is important for teachers and administrators to be supportive and highly sensitive to the stress gay and bisexual youth feel, according to the American School Health Association. Schools are legally obligated to protect students from discrimination and harassment from other students, from teachers, and from all other school employees. In 1996, a federal appeals court ruled that school officials can be held liable under the Equal Protection Clause of the U.S. Constitution for not protecting gay and bisexual students from harassment and discrimination.

The non-profit group Parents and Friends of Lesbians and Gays (PFLAG) makes the following recommendations for all schools:

  • have a harassment policy or student bill of rights that explicitly includes sexual orientation
  • provide annual, mandatory training for all school employees about sexual orientation and on intervention against bullying of gay and bisexual students
  • have a support group for gay, bisexual, and straight students
  • have information on display and readily available in the library on gay and bisexual issues
  • include gay and bisexual issues in the curriculum, including history, social studies, literature, political science, health, and arts


Adrenal glands —A pair of endocrine glands (glands that secrete hormones directly into the bloodstream) that are located on top of the kidneys. The outer tissue of the glands (cortex) produces several steroid hormones, while the inner tissue (medulla) produces the hormones epinephrine (adrenaline) and norepinephrine.

Coming out —The process by which gays and bisexuals become public or tell others about their sexual orientation.

Gay bashing —Physical or verbal violence directed against homosexuals.

Homophobia —An irrational hatred, disapproval, or fear of homosexuality and homosexuals.

Sexual orientation —The direction of somebody's sexual desire, toward people of the opposite sex (heterosexual or straight) or of the same sex (homosexual or gay), or of both sexes (bisexual).

Sodomy —Anal intercourse.

Transgender —Any person who feels their assigned gender does not completely or adequately reflect their internal gender, such as a biological male who perceives himself to be female.



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Bernstein, Robert A. Straight Parents, Gay Children: Keeping Families Together. New York, NY: Thunder's Mouth Press, 2003.

Jennings, Kevin, and Pat Shapiro. Always My Child: A Parent's Guide to Understanding Your Gay, Lesbian, Bisexual, Transgendered, or Questioning Son or Daughter. Norfolk, VA: Fireside, 2002.


Frankowski, Barbara L. "Sexual Orientation and Adolescents." Pediatrics (June 2004): 1827–1832.

Harrison, Therese W. "Adolescent Homosexuality and Concerns Regarding Disclosure." Journal of School Health (March 2003): 107–112.

Rosenberg, Miriam. "Recognizing Gay, Lesbian, and Transgendered Teens in a Child and Adolescent Psychiatry Practice." Journal of the American Academy of Child and Adolescent Psychiatry (December 2003): 1517–1521.

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The Gay, Lesbian, Straight Education Network. 121 W. 27th St., Suite 804, New York, NY 10001. Web site: http://www.glsen.org.

Gay-Straight Alliance Network. 160 14th St., San Francisco, CA 94103. Web site: http://www.gsanetwork.org.

The Healthy Lesbian, Gay, and Bisexual Students Project. American Psychological Association Education Directorate, 750 First St. NE, Washington, DC 20002. Web site: http://www.apa.org/ed/hlgb/.

Parents, Families, and Friends of Lesbians and Gays. 1726 M St. NW, Suite 400, Washington, DC 20036. Web site: http://www.pflag.org.


"Gay and Lesbian Youth Network." Mogenic: Inside and Out , 2004. Available online at http://www.mogenic.com (accessed October 22, 2004).

Ken R. Wells

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