Special Concerns Related to Sexuality ~ Articles2day.Org

Special Concerns Related to Sexuality

Gay and Lesbian Youths
Youths often express their first concerns about sexual orientation during adolescence. These concerns may be prompted by teasing or name calling from peers, by their own concerns about emotional or physical attraction to a person of the same gender, by misinterpretation of behaviors or friendships by parents or other adults, or by direct overtures from another person. Cross-cultural studies indicate that least 4% to 6% of all people in many Western cultures identify themselves as gay or lesbian or have had gay or lesbian relationships in the past.19

An important developmental agenda of many adolescents concerns peer relationships and acceptance. Therefore the awareness of emotional or sexual ties to a person of the same gender immediately raises for most youths a sense of shame, fears about differentness and possible rejection by peers, concerns about parental and other adult rejection, and confusion about whether the issue is safe to discuss with anyone. The toll on the health of adolescents who identify themselves as gay or lesbian is high, primarily because of the social rejection that occurs.

Suicide attempts among gay youths are two to three times those of heterosexual youths.20 In New York City 40% to 50% of homeless youths identify as lesbian or gay; and the incidence of "survival sex," particularly with older male partners, is high with both gay and lesbian youths who are living on the streets.21 Thus whether to disclose sexual orientation becomes not simply a discretionary decision but often a matter of survival for adolescents who identify themselves as gay or lesbian.

The primary care provider can be a critical support person for youths struggling with this issue. Simply asking questions that are neutral about the possibility of homosexual feelings or liaisons allows a young person to discuss the issue in the health care setting. Helping youths to strategize about sexual safety, disclosure to family and friends, and dealing with peer rejection and ridicule can be life-saving conversations with this population. The provider should always remember that the critical task is to help the young person protect his or her health not to pass moral judgment on the acceptability of the sexual orientation concerns.

Additionally, there is an important role for the family doctor to provide counsel to parents of gay and lesbian youths who have "come out" to their families. Many of the concerns and reactions parents have are similar to those of their children: shame, confusion, guilt, and fears about the long-term consequences for children's health. PFTAG, an organization for parents and friends of lesbian and gay people, is a support and information resource and is often helpful to families struggling with this issue. There is literature that is helpful as well (see Appendix B at the end of the chapter).

Homeless Youths
There were 1.5 million youths living on the street in the United States in 1992.22 One of the major issues with this population is that they often are forced to engage in behaviors that jeopardize health in order to sustain their needs for food and shelter. Primarily these behaviors fall into two main categories: sexual favors for money and drug selling. With adolescent girls or boys who are homeless, the consequences of trading sex for money, usually with older adults, range from life-threatening (including HIV infection and violence) to life-"postponing." Youths in such situations are not able to set boundaries or even discover for themselves what they need and want in healthy intimate relationships.

Youths With Disabilities
Youths who have a cognitive, physical, or emotional disability are often viewed by both society and members of the health professions as asexual people. Conversations about sexuality with these groups of young people are ignored or actively avoided. Again, the feeling of "difference" in youths with disabilities magnifies and complicates the task of development toward adult social and intimate relationships. Youths with disabilities especially need correct information about their bodies, reassurance about their attractiveness as people, discussions about strategies for dealing with the cruelty of others, and information specific to sexual functioning that may be affected by a particular handicapping condition. Screening involves careful assessment to evaluate the risk of sexual abuse or the likelihood that a particular adolescent may be vulnerable to sexual misuse in an effort to reassure himself or herself of acceptability and attractiveness as a sexual partner.

Source: http://www.articles2day.org/2012/08/special-concerns-related-to-sexuality.html

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