~ By Luca Maurer
What does unplanned teenage pregnancy have to do with lesbian, gay, and bisexual (LGB) youth? Although on the surface these may seem to be subjects with little intersection, a growing body of research indicates otherwise. There is significant disparity between rates of pregnancy in LGB youth and heterosexual youth—and perhaps surprisingly, it is LGB youth that experience considerably higher rates than their heterosexual peers.
A previous blog post explored research which indicates that LGB young people who report high levels of family rejection during adolescence are more likely to report engaging in unprotected sex than LGB peers who did not experience high levels of family rejection. This groundbreaking study provided unique and vital information. Though to be even more complete, an exploration of the range of teen sexual behavior must investigate both high levels of unprotected sex, and its possible outcomes—including pregnancy involvement. A growing body of research also compares LGB and heterosexual youth in terms of pregnancy involvement (becoming pregnant, or getting someone pregnant), with some surprising findings. For instance, Saewyc and colleagues (2009) note LGB youth become involved with pregnancies at 2 to 7 times the rate of heterosexual youth. So although parents and professionals may assume LGB young people are at very low risk of experiencing pregnancy or parenting because of their sexual orientation, the research actually indicates the opposite. LGB adolescents are at much higher risk of experiencing pregnancy involvement than their heterosexual peers. Sexual orientation and sexual behavior are different and separate dimensions, and may intersect in unexpected ways, especially during adolescence.
Risks for Unplanned Pregnancies
Since research has found teen pregnancy prevalence overall to have been decreasing for the last two decades (McKay, 2006), high rates of pregnancy involvement for LGB youth is even more unexpected. Additional research has found:
- LGB adolescents report similar frequency of intercourse as heterosexual teens (Rotheram-Borus, Marelich, & Srinivasan, 1999)
- Lesbian and bisexual females are about as likely to have had sex with a male partner as heterosexual females, yet with a much higher rate of pregnancy (Saewyc, Bearinger, Blum, & Resnick, 1999)
- LGB youth are younger at first intercourse, report more sexual partners, and higher rates of pregnancy, than their heterosexual peers (Blake et al., 2001)
- One in three teen fathers and one in eight teen mothers report having sexual partners of both sexes or partners of the same sex (Forrest & Saewyc, 2004)
What are some of the factors that may put LGB youth at higher risk for pregnancy as well as sexually transmitted disease (since behaviors that result in pregnancy can also transmit STDs)? Existing research provides some clues, and currently focuses on three major themes: contraceptive use, alcohol and other drugs, and managing stigma related to sexual orientation.
- More LGB youth report alcohol use before their last sexual encounter than heterosexual youth, as well as higher rates of substance use. Both may also lead to unplanned or unprotected sex.
- LGB youth also use contraceptives less frequently than their heterosexual peers when engaging in sexual behavior that can lead to pregnancy.
- Several studies also suggest that LGB youth may engage in heterosexual dating, heterosexual sexual behavior, and pregnancy/parenting as strategies to avoid being identified as gay or lesbian, or otherwise reduce or manage stigma directed at them.
Under these circumstances, a hostile home, school, or social environments for LGB youth may contribute to unintended and unplanned teen pregnancy.
Implications for Practice
Data about LGB youth pregnancy involvement also points the way toward some strategies for reducing these disparities. Although LGB youth report more sexual partners than heterosexual youth and higher rates of alcohol use before last sex, that same study found LGB youth in schools with LGBT-inclusive curricula reported fewer sexual partners, less recent sex, and less substance use before last sex than did LGB youths in schools without this instruction.
Positive connections to family and school also play a role, since LGB young people who experienced rejection by their families were about three and a half times more likely to have engaged in unprotected sex (Ryan et al., 2009). Connectedness to family or school have been linked to lower rates of teen pregnancy, but many LGB youth feel less connected to these than their heterosexual peers. LGB youth may be more apt to seek caring connections through parenthood as a result of having fewer support resources upon which to draw (Kirby, Lepore, & Ryan, 2005). Specialized programs and interventions to support and strengthen school connections to these youth may help in addressing this. Resources for parents and caregivers that provide tips and skills for supporting their LGB children, such as the Family Acceptance Project’s Supportive Families, Healthy Children booklets, are important tools for families. Youth workers and community organizations may find useful tools in the Best Practice Guidelines for Serving LGBT Youth in Out-of-Home Care, and the American Bar Association’s Opening Doors initiative.
LGB youth may try to cope with stigma through heterosexual dating and sexual behaviors as they may feel more “camouflaged” in an attempt to avoid being identified. (This phenomenon gained more exposure and perhaps a wider audience when the topic was featured in a recent episode of the television program Glee.) Sexuality education efforts to prevent unintended teen pregnancy―programs almost exclusively designed to address the needs of heterosexual teens―have not been effective for LGB youth, and more effective strategies that actively name and address the needs of LGB youth may prove more effective. Attempts in general to address and reduce stigma, bullying, and harassment in the lives of LGB youth may also be key in reducing LGB pregnancy involvement.
Finally, since teen pregnancy and parenting is much more common among LGB youth than previously believed, programs that address the needs of teen parents may also require re-examination and re-tooling in order to provide the information LGB pregnant/parenting youth need to be successful parents as well as to avoid future unplanned pregnancies. Likewise, schools, parents, health care providers, and youth programs will all have to begin to challenge assumptions they may hold about the orientations of parenting teens; as previous research has shown identity and behavior are neither consistent nor static.
Blake, S.M., Ledsky, R., Lehman, T., Goodenow, C., Sawyer, R., & Hack, T. (2001). Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: The benefits of gay-sensitive HIV instruction in schools. American Journal of Public Health, 91, 940-946.
Forrest, R., & Saewyc, E.M. (2004). Sexual minority teen parents: Demographics of an unexpected population. Journal of Adolescent Health, 34, 122.
Goodenow, C, Netherland, J., & Szalacha, L. (2002). AIDS-related risk among adolescent males who have sex with males, females, or both: Evidence from a statewide survey. American Journal of Public Health, 92, 203-210.
Kirby D., Lepore G, & Ryan J. (2005). Sexual Risk and Protective Factors. Factors Affecting Teen Sexual Behavior, Teen Pregnancy, Childbearing, and Sexually Transmitted Disease: Which are Important? Which can you Change? Washington, DC: National Campaign to Prevent Teen Pregnancy.
Marshal, M.P, Friedman, M.S., Stall, R., King, K.M., Miles, J., Gold, M.A., Bukstein, O. G., & Morse, J. Q. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103, 546-556.
McKay A. (2006). Trends in teen pregnancy in Canada with comparisons to U.S.A. and England/Wales. The Canadian Journal of Human Sexuality, 15, 157-161.
Poon, C., Saewyc, E., Skay, C., Homma, Y., & Barney, L. (2006). Stigma and substance use in Asian GLB youth. Paper presented at the 7th International Conference on the Reduction of Drug Related Harm, May 1, 2006, Vancouver, Canada.
Robin, L., Brener, N.D., Donahue, S.F, Hack, T, Haie, K., & Goodenow, C. (2002). Associations between health risk behaviors and opposite-, same-, and both sex sexual partners in representative samples of Vermont and Massachusetts high school students. Archives of Pediatric and Adolescent Medicine, 156, 349-355.
Rotheram-Borus, M.J., Hunter, J., & Rosario, M. (1995). Coming out as gay or lesbian in the era of AIDS. In G. Herek, & B. Greene, (Eds.), AIDS, Identity, and Community: The AIDS Epidemic and Lesbians and Gay Men (pp. 150-168). Thousand Oaks, CA: Sage.
Rotheram-Borus, M.J., Marelich, W.D., & Srinivasan, S. (1999). HIV risk among homosexual, bisexual, and heterosexual male and female youths. Archives of Sexual Behavior, 28, 159-177.
Ryan, C., Huebner, D., Diaz, R.M., & Sanchez, J. (2009). Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults. Pediatrics, 123, 346-352
Saewyc, E., Bearinger. L., Blum, R., & Resnick. M. (1999). Sexual intercourse, abuse and pregnancy among adolescent women: Does sexual orientation make a difference? Family Planning Perspectives, 31, 127-131.
Saewyc, E., Poon, C., Homma, Y. & Skay, C. (2008). Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia. The Canadian Journal of Human Sexuality, 17(3), 123.
Saewyc, E.M.. Pettingell, S.L., & Skay, C.L. (2004). Teen pregnancy among sexual minority youth in population based surveys of the 1990s: Countertrends in a population at risk. Journal of Adolescent Health, 34, 125-126.
Saewyc, E.. Richens K., Skay, C.L., Reis, E., Poon, C, & Murphy, A. (2006). Sexual orientation, sexual abuse, and HIV-risk behaviors among adolescents in the Pacific Northwest. American Journal of Public Health, 96, 1104-1110.
Lis Maurer is the program director of the Center for LGBT Education, Outreach & Services at Ithaca College, and is on the Editorial Board of The Prevention Researcher.