Adolescence is the time when sexual identity is developing and many LGBT youth struggle with coming out issues. Since the 1950s, adolescents are the only population group that has not experienced an improvement in health.
LGBT adolescents are at risk of homelessness and the ensuing health consequences. Many LGBT youth suffer stresses in the family and are thrown out by homophobic parents. At the same time, many foster homes will not accept LGBT youth, leaving them with nowhere to go. Approximately 1/4 of gay or lesbian youth have suffered physical violence by their own families due to their sexual orientation and approximately half of all runaways and homeless youth self-identify as gay or lesbian. These facts are especially important to remember as a physician counseling youth about coming out issues   .
Gay youth also suffer from discrimination on the part of health care providers. In one survey of pediatricians, 41% believed that a physician should assume all gay or bisexual male adolescents are HIV positive until proven otherwise.
All youth may be at high-risk for STDs but gay male youth are even more vulnerable with 30% of young gay men being HIV positive, many before the age of 25. One possible explanation for this is that young gay and lesbian youth do not have peers to turn to, so they look to the adult gay and lesbian community for acceptance and support. While this may help young people become more comfortable with their own sexuality and sexual orientation, it may lead to sexual exploitation and sexual experiences with much older partners. LGBT youth are also at an increased risk for prostitution especially if they have experienced physical, sexual and emotional violence in the home or at school  .
LGBT youth are at increased risk of depression and suicide. While only 10% of the teen population self-identifies as gay or lesbian, they account for 30% of teen suicides and are up to 3 times as likely as their heterosexual counterparts to attempt suicide. Gay male adolescents are the most at risk group with the largest percentage of suicide attempts of any teen population. Gay and lesbian youth are also at an increase risk for substance use compared to their heterosexual peers   . When working with adolescents, trust and respect in the clinical relationship will facilitate communication.
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