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prevalent health and social problems for gay teens are depression, family rejection,
suicide, substance abuse, running away, homelessness, prostitution, truancy, victim-
ization, violence, STDs, high - risk sexual behavior, and poor health maintenance
(Peterkin & Risdon, 2003). Additionally, compared to risk behaviors among hetero-
sexual youths, these risk behaviors are more prevalent, begin earlier, and are more
frequently clustered together (Hunter, Cohall, Mallon, Moyer, & Riddle, 2006).
Moreover, LGBT youths often have had negative experiences with health profes-
sionals (Garofalo & Katz, 2001). When LGBT youths fear rejection, stigmatization,

lack of confidentiality, and embarrassment, they will be reluctant to seek health ser-
vices, will avoid health education altogether, or will not reveal their sexual identity to
the health professionals (Ginsberg et al., 2002). Homophobia and heterosexism play a
distinct role in their rejection of health care and health education.
Sadly, issues surrounding LGBT youths provide fuel for controversy in the schools,

and for LGBT students nationwide, discrimination and harassment have become the
rule, not the exception (Woodiel et al., 2003). Homophobia and heterosexism create a
hostile environment that does not invite support from other students and teachers.

Therefore it becomes difficult for heterosexual students and teachers to be informed
and supportive about the special health issues of gay youths (Rienzo et al., 2006).
For instance, one report revealed that Boston ’ s lesbian, gay, and bisexual youths
were more likely than their heterosexual counterparts to be threatened or injured with
a weapon in school. They were also found to be much more likely than heterosexual
high school students to carry a gun or weapon and to be involved with a gang (National
Coalition for LGBT Health & Boston Public Health Commission, 2002). The average

high school student hears twenty - five antigay slurs each day. One out of three LGBT
youths in Chicago had had an object thrown at him or her and one out of fi ve had
been kicked, punched, or beaten because of his or her sexual orientation (Hunter
et al., 2006).

HEALTH ISSUES OF LESBIAN AND BISEXUAL WOMEN
The health care needs of lesbians and bisexual women are similar to those of all women.
However, homophobia and heterosexism can mean that lesbian and bisexual women will
experience additional risk factors and barriers to education and care, and these can affect
their health status. We will discuss some health conditions that disproportionately
affect lesbians and bisexual women and conditions that affect lesbian women differ-
ently than they do heterosexual women. However, not enough research has focused
solely on the concerns of both lesbian and bisexual women. The majority of the research

in this field focuses on lesbian women, and there is a definite lack of information about

the health concerns of bisexual women (Baernstein et al., 2006).
Among the main issues affecting lesbian and bisexual women are reproductive
cancers. Although there is nothing biological to suggest that lesbian and bisexual
women are more at risk than heterosexual women, lesbians are less likely to receive

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