Introduction

Teenage or adolescence is the time when there are a lot of physical, emotional and psychological changes taking place. A child when enters adolescence keeps his first step towards becoming an adult. On-going physical and psychological changes makes an adolescent discover his new found sexuality. Sexual orientation develops during early childhood. One's gender identity is established by age 2 years, and a sense of masculinity or femininity usually solidifies by age 5 or 6 years. Homosexual adults describe homosexual feelings during late childhood and early adolescence, years before engaging in overt homosexual acts.

What is sexual orientation?

Sexual orientation cannot be described by just any random sexual activity rather it is persistent pattern of physical and/or emotional attraction to members of the same or the opposite sex. It not only includes the sexual engagement but also includes different aspects of sexuality, including sexual fantasy, emotional attraction, sexual behaviour and self-identification.

Sexual orientation cannot just be defined as homosexuality or heterosexuality rather it is a thing that should not be stereotyped. A person can be homosexual, heterosexual and bisexual at the same time.

Homosexuality refers to a persistent pattern of same-sex arousal, accompanied by weak or absent arousal from opposite sex; and bisexuality refers to attractions for both genders. Homosexual refers to both males and females, whereas the term gay applies specifically to men and lesbian to women.

What causes homosexuality?

Males and females develop and experience sexual orientation in very different ways. Physiological and psychological growth influences sexual orientation development to an extent and affects males and females in a different manner. There are many mechanisms that are controlled by brain which regulate the release of hormones have also been suspected to play a role in developing homosexuality.

• In males having a greater number of older brothers leads to attraction towards the males which is known as the fraternal birth order effect. It is a concrete reason in case of males but does not stand true for females. So development of homosexuality in males and females is believed to have different mechanism.

• In females the Development of homosexuality has been attributed to the in-vitro (inside womb) exposure of foetus to androgens. The relative concordance of homosexuality in monozygotic twins, as compared to dizygotic and non-twin siblings, highlights the role of genetic make-up, especially in males. A candidate gene for an X-linked type of male homosexuality is under investigation.

How does homosexuality manifests?

The development of sexual orientation is not same for all the individuals. It varies widely among individuals and is based on many factors like race, cultural background, social impact and maturity levels. The process is very gradual and typically manifests as an initial awareness of same-sex attractions as early as the 1st decade in life. This is the first thing which is followed by sexual orientation identification, sexual debut, and possibly disclosure to others during adolescence and young adulthood.

The development of homosexual identity in adolescence commonly progresses through two stages.

1. The adolescent feels different, develops a crush or an infatuation towards the person of the same sex. At this time the individual might not be aware of the sexual identity or his/her own sexual orientation. Sexual attractions might be the earliest and best indicator of ultimate sexual identity. Once the person has a continuous attraction he/she discovers his/her own sexual identity and then there is a typical phase known as coming out phase in which sexual identity is even revealed to others. The coming-out phase may be a difficult period for the young person and the family.
2. The young adolescent are very naïve and they live in a world of their own whims and fancies. They see world through their own rose coloured glasses. Having a different sexual orientation which is not same as of the majority makes them very introvert, shy and afraid of society's bias which seeks to reject homosexual feelings.
3. This struggle with identity may include episodes of both homosexual and heterosexual promiscuity, sexually transmitted infections, depression, substance abuse, attempted suicide, school avoidance and failure, running away from home, and other crises.

Altered or specific sexual orientation comes to notice when the adolescent is brought for treatment of sexually transmitted infections, depression, substance abuse, attempted suicide, school avoidance and failure, running away from home, and or other crises.

Issues related to homosexuality

Homosexuality is not a physical, psychological or physiological disease. It is just a deviation from a behaviour which is noticed in most of us. Just like most of us right handed and only a few have active left hand. In the same way most of us have a heterosexual behaviour but there is a minority who might be homosexuals or bisexuals. They have problems which they have to face. Some of the issues related to homosexuality are as follows-

1. Homophobia

   Homosexuals are usually biased in our society as altered sexual orientation is taken as a stigma. Homosexuals don’t have support of friends, family or peers and this result in development of homophobia. Homophobia is an irrational fear, hatred, or otherwise distorted perception of homosexuality that can manifest in personal discomfort, stereotypes, prejudice, and violence. Compared with classmates, homosexual students are more likely to fear for their safety and to be attacked and injured. With repeated exposure, homosexual youths might internalize negative stereotypes and engage in self-defeating behaviours.

2. Social Issues

   Homosexuals are usually socially withdrawn and are shy and introvert. These kids usually don’t have many friends. Academic underachievement, school avoidance, and dropping out are common consequences of abuse and violence at school. Some parents are unable to adopt a supportive attitude, and a substantial number of homosexual children run away or are evicted.

3. Mental Health Issues

   Homosexual adolescents are just like other adolescents except that they are devoid of love and care that they deserve. This creates an emotional void and these kids start seeking respite in alcohol and drugs. Substance abuse, anxiety, depression, suicide attempts, and disordered eating behaviours are quite common in these adolescents. Compared with heterosexual peers, homosexual youths initiate tobacco and alcohol use at younger ages and are more likely to smoke regularly. Rates of attempted suicide among homosexual youths, especially males, are consistently higher than expected in the general population of adolescents.

4. Medical Threats to Health

   Homosexual adolescents generally have the same medical concerns as heterosexual youths. Risky sexual behaviours, not sexual orientation, endanger health. The most common and serious sexually-related conditions arise from unprotected anal intercourse. Unprotected oral sex also has the same complications.

Summary

Living with an identity which is different from the mainstream is very difficult. There are lot of problems that these special adolescents have to face and there is usually no support to them. They just require your little bit of love, affection and understanding to be in the mainstay. Adolescents with an altered sexual orientation are no aliens but one amongst us. Sexual orientation is by many physiologic and hormonal problems and having a social bias against us would be our foolishness.

A little bit of understanding, counselling by a healthcare professional and being a part of a support group can help homosexuals lead a normal life.

Well-informed professionals can help adolescents and their parents to explore their feelings and learn about topics related to homosexuality and its cause, psychological normalcy, spiritual and cultural implications, disclosure to a significant other, preventive care, and community resources. With appropriate support from families, school, and communities, homosexual youths have the same potential as others to lead happy, healthy, and productive lives.

References

1. Nelson textbook of paediatrics, 19th edition, Kliegman, Stanton, St. Geme, Schor, Behrman. Elsevier publication. ISBN: 978-1-4377-0755-7. Chapter-104.
2. Current Pediatric Therapy, 18th edition, Frederic et al, ISBN-13: 978-0-7216-0549-4. Chapter-6