High-Risk Behavior among Gay Adolescents: Implications for Treatment and Support

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ABSTRACT

This article contrasts the experiences of most adolescents during social and psychological development with the special challenges faced by those developoing on awareness of their homosexuality. Emphasis is placed upon the interplay between societal prejudices and discrimination toward homosexuality and personal development and risk-taking behavior in gay adolescents. The implications of these life stressors for gay adolescents are also discussed in terms of their consequences for mental health policy and treatment.

Society, or at least its most powerful constituencies, tends to define what is right and acceptable through very narrow blinders; what is beyond the periphery of these blinders often is intended to remain invisible to the rest of the world. By the time children reach adolescence, they are very much aware of what society defines as "normal" a keen recognition of the norms of their family, peer group, and other significant social contexts (e.g., school, community, religious group), and, perhaps more importantly, an implicit understanding of what is necessary to achieve acceptance from these groups. As they move away from the shelter of childhood and attempt to navigate the uncertainties en route to the independence and responsibility of adulthood, it becomes crucial for adolescents to find some sense of belonging, some way to connect with those around them. When they suspect that they are "different" from other members of these groups-particularly if that difference is in sexual orientation-a tremendous challen ge to their quest for identity may result.

Though numerous studies have focused on the Sturm und Drang of adolescence, relatively few have considered the effect of coming to terms with homosexuality upon adolescents' social and psychological development. The intent of this article is to explore the impact of a society which defines exclusive heterosexuality as the only acceptable option upon adolescents whose orientation is homosexual, and to consider means by which the mental health community can support, nurture, and mentor these adolescents, and help them to heal societal-and self-inflicted wounds.

Challenges of Normal Adolescent Development

Adolescence is defined here as including not only the "teen years" (ages 13--19), but also between the onset of puberty (approximately ages 10--14) and the time of exit from the parental home (frequently ages 18--21). A primary developmental task of this period is to individuate, or separate, from the family of origin in order to establish a mature identity and capacity for intimacy, which allow one to assume adult roles and responsibilities (Crespi & Sabatelli, 1993). By the time normal, healthy children enter adolescence, they have, at least in theory, successfully negotiated the stages of psychosocial development that deal with basic trust, autonomy, initiative, and industry (Erikson, 1959). Children have learned to see themselves as beings separate from the primary caregiver, have developed a sense of self-control and the ability to make choices, and have begun to experience the desire to explore the world and to achieve mastery over it. The symbiotic, fused attachment that characterizes the parent-child relationship during early infancy (Mahler, 1975) has evolved into a dependent, symmetrical parent-child relationship during middle and later childhood (Anderson & Sabatelli, 1990).

With adolescence, however, there are at times an overwhelming number of intrusions upon their relatively ordered world. From the dramatic physical changes of puberty and the accompanying "awakening" of sexuality, to demands by peers for increased involvement in social activities and a resulting need for additional independence, to burgeoning expectations of responsibility and performance (at school, in the home, and in other social contexts), adolescents may begin to exhibit "a sensitivity toward their own helplessness, loss of control, and transparency" (Amanat & Beck, 1994, p. …