A small percentage of the teenage population is homosexual. Aside from the normal stresses of adolescence, gay teens also have distinct health and psychosocial needs. Not all parents suspect or know that their son or daughter is gay, but those who do have a special responsibility for providing support and care. Parents, teachers, and doctors are all links in the chain that can provide support and encouragement for gay teenagers.

If medical care is not user-friendly, gay teens just may do without. "One of the biggest concerns about healthcare in the minds of gay or lesbian teens is how they are going to be treated," says Bret Rudy, MD, a director of an adolescent HIV program.

While many gay or lesbian teens struggle with their sexual identities, they still have the same healthcare concerns as other teenagers. For gay young men, the risk of getting HIV is higher than that for most other teens. The risk adds significantly to the health "worry" burden that teenagers normally face.

Lack of empathy or harsh bedside manner potentially turns teens off not just to the doctor, but away from healthcare altogether. Gay teens need to feel relaxed because sexual information must be very specific so the doctor can learn if the teenager is at risk. Moreover, the physician must also be very specific in telling young men or women about the skills needed to protect themselves.

"Healthcare providers should have some understanding of sexual behavior to approach gay and lesbian teens and treat them appropriately," Dr. Rudy says. For example, young lesbian women may deny need for birth control despite occasional sexual encounters with men. Only frank discussion between a teen and a doctor can identify important concerns and risks like this.

"A physician needs to take a very sensitive and complete medical and sexual history to be able to treat those kids appropriately," Dr. Rudy says.

Often, gay-and-lesbian friendly posters and brochures in a waiting room can be enough to put a teen at ease. Because many youths are still questioning and exploring their sexual identities, they may be ill at ease with the term "lesbian" or "gay." However, still other teens are farther along in their quest for sexual identity and may be comfortable using those terms to describe themselves. Most doctors avoid labeling and simply ask, "During your life, with whom have you had sexual contact?" The teen can answer none, males, females, or both.