Welcome to my facts page! My goal here is to summarize some of the research relevant to LGBT issues. This is not a comprehensive treatment of the science of human sexuality, but it is an attempt to highlight basic information about a variety of LGBT topics, especially facts which challenge misinformation about sexual minorities. I hope this compilation will be a valuable resource to anyone interesting in knowing more about the science or sociology of sexual orientation and gender expression. I’ve included links to some individual research studies in the citations list at the bottom of the page, but often you’ll need access to a research library for the full contents of any specific article. This page is a work-in-progress (and some topics are poorly addressed), so please return at a future time for updates and additions. I welcome suggestions about important studies that I have not included below, so feel free to send me a message!

Version: 15 January 2018


Section 1: Prevalence of sexual minorities in the human population
Section 2: The biological origins of homosexuality
Section 3: Homosexuality in other species
Section 4: Stability and fluidity of sexual orientation
Section 5: LGBT relationships
Section 6: LGBT physical and mental health

SECTION 1. Prevalence of sexual minorities in the human population.

1.1 What percentage of people are gay, lesbian, bisexual or transgender?

There are different answers to this seemingly simple question, depending on how sexuality is defined. For example, sexuality can be defined based on attraction, based on behavior, or based on self-identity (Bailey et al. 2016). Behavior or identity doesn’t always coincide with romantic or sexual attraction, so some people may have had a lifetime of same-sex attraction but no sexual experiences with the same sex. Similarly, some people may have had same-sex sexual experiences at some point in life, but don’t chose to identify as gay or bisexual (Bailey et al. 2016).

Alfred Kinsey published the earliest well-known studies of the prevalence of same-sex behaviors during the 1940s-1950s. He concluded that 37% of men had had at least one same-sex sexual encounter during their lifetime (Sell et al. 1995). Kinsey’s numbers have been criticized because they were not based on a representative sample of adults which would provide a more accurate estimate of the incidence of same-sex behavior in the human population as a whole.

Sell et al. (1995) studied the prevalence of same-sex attraction and behavior in men and women from the US, the UK, and France. They found that since age 15, between 18-21% of Americans had experienced either homosexual behavior or attraction. They found similar percentages in Europe. During the 5 year period just before the study, 6.2% of US male participants and 3.3% of US female participants reported some same-sex sexual contact.

Figure 1. Percentage of sexual minority groups among the
LGBT population. Data from Pew (2013).
Those who identify as LGBT appear to be a smaller percentage of people than those who have had some same-sex experiences during their life. The Williams Institute (affiliated with UCLA’s School of Law) compiled information from four recent nation-wide population studies of LGBT identity in the US (Gates 2014). Each of the four primary studies were conducted on thousands of people. Together they suggest that between 2.2 and 4.0% of adult Americans identify as lesbian, gay, bisexual, or transgender (5.2-9.5 million US adults). Similar estimates have been obtained from non-western cultures (Bailey et al. 2016). Estimates of gay and lesbian-identified Americans ranged from 1.4 to 1.8%, while estimates of people who identify as bisexual were more varied among the studies, ranging from 0.6% to 2.6%. There were no detailed figures available on the percentage of transgender people among American adults.

The studies reviewed by Gates (2014) also revealed several other demographic trends about LGBT people in the United States. First, more women tend to identify as LGBT than men. Second, younger individuals are more likely to identify as LGBT than older Americans. Finally, in most studies the racial and ethnic makeup of the LGB population is similar proportionally to the non-LGB population (in other words, no particular racial group is more likely to be LGBT than others).

One factor that might make it difficult to carefully determine the percentage of LGBT persons in the general population is the hesitancy to self-report sexual behaviors or identity. Individuals who are in the closet may not accurately answer survey questions about their romantic attractions or sexual experiences. The magnitude of this phenomenon is unknown, but in-so-far as non-disclosure affects the accuracy of survey results, the proportion of LGBT people in a population is more likely to be underestimated than overestimated.

In the United States, LBGT people live all over the country, but a Gallup poll conducted in 2012 suggests that states vary in their percentages of LGBT-identified individuals. The District of Columbia, Hawaii, Vermont, and Oregon topped the list with the highest percentages of LGBT people (10.0, 5.1, 4.9 and 4.9% respectively), while Tennessee, Mississippi, Montana and North Dakota had the lowest percentages (only 1.7 to 2.6%).

Interestingly, Gallup polling conducted as recently as 2011 suggests that Americans vastly over-estimate the percentage of gay people in the US population. On average, Americans estimated that 25% of all people living in the US are gay. Only 4% of American adults correctly guessed that less than 5% of Americans are LGBT.

- Bailey et al. 2016 Psychol Sci Public Interest
- Gates 2014. LGBT demographics
- Sell et al. 1995. Archiv Sexual Behavior

1.2 What do the letters in the acronym LGBTQIA stand for?

L = lesbian; G = gay, B = bisexual; T = transgender; Q = queer or questioning; I = intersex; A = asexual (or it is sometimes used to denote a straight ally)

1.3 What is bisexuality?

Human sexuality is not simply binary. It exists on a continuum, from homosexuality to bisexuality (attraction to both sexes) to heterosexuality. One way to depict this continuum in a semi-quantitative way is through use of the Kinsey scale. On this scale, an exclusively heterosexual person is a 0, an exclusively homosexual individual is a 6, and bisexually-oriented people fall between 1 and 5. On the Kinsey scale, a person who identifies as straight and is primarily attracted to the opposite sex, but who has occasional same-sex attraction or behaviors might be classified as a 1 or 2.

Although the gay or lesbian community sometimes seems to be more visible (and discussed) in American society than bisexuals, some survey data, including the 2006-2010 National Survey of Family Growth, found that more Americans may identify as bisexual than gay or lesbian (Gates 2014). However among surveys, the prevalence of bisexuality appears to vary considerably.

Bisexuality exists in both men and women, it but tends to be more prevalent for women. A compilation of recent surveys from the William Institute suggests that 68-77% of bisexuals are female (Gates 2014). Consistent with this finding are studies that suggest that men tend to have a more “polarized” sexual orientation than women (Lippa 2007). In other words, they tend to fall pretty close to either end of the Kinsey scale (Lippa 2007) with less incidence of bisexuality (Mock & Eibach 2011). Differences in the incidence of bisexuality among men and women may due to socialization factors as children grow up (e.g., gender non-conforming behavior may be more accepted in girls in some societies), or differences in hormone-induced changes to the young human brain during development (Lippa 2007). In a worldwide study of over 200,000 people responding to a BBC survey, Lippa (2007) found consistent patterns of sexual orientation polarization between men and women, suggesting that biological factors lead to these differences. As addressed below, women also tend to have greater fluidity in their sexual orientation than men.

Some have postulated that bisexuality is a transitional period in the course of greater self acceptance that one is gay, or a period of same-sex experimentation for people who are truly heterosexual. However, long-term observation of bisexual/unlabeled women by Diamond (2008) shows more support for bisexuality as a relatively stable sexual orientation.

- Diamond 2008. Developmental Psychol
- Gates 2014. LGBT demographics.
- Lippa 2007. Archiv Sexual Behavior
- Mock & Eibach 2011. Archiv Sexual Behavior

1.4 Does sexuality encompass more than sexual behaviors?

Yes, human sexuality encompasses a range of feelings and behaviors including sex, courtship, romance, and social status. For example, a gay person may be likely to be strongly attracted to the same sex emotionally as well as sexually. While the Kinsey scale measures the degree of same-sex sexual interest, this second (emotional) dimension of sexuality can also be represented in a conceptual framework. In 1985, Klein and co-authors introduced the Klein Sexual Orientation Grid that incorporates multiple dimensions of attraction and orientation. Thinking about sexuality as occurring along two, three, or even more dimensions of human attraction, shows the diversity of romantic, emotional, and sexual attraction manifest in human beings.

Figure 2. The Klein Sexual Orientation Grid, illustrating that sexual
orientation encompasses multiple aspects of attraction.

- Klein et al. 1985. J Homosexuality

1.5 When do people first report feelings of same-sex attraction?

Anecdotally, many of us have heard of LGBT people who knew they were “different” at a very young age. In a 2013 survey of about 1200 LGB Americans, the Pew Research Center found that the median age at which LGB Americans first thought they were not heterosexual ranged from 10 years old (gay men) to 13 (lesbian women and bisexuals). The median age at which non-heterosexuals first disclosed their feelings (“came out”) to other people ranged from 18 years old in gay men, to 20 for bisexuals, and 21 for lesbians. These data show that most LGBT people wait several years between personally discovering that they belong to a sexual minority population and disclosing that information to others.

- Pew Research Center. 2013. A survey of LGBT Americans.

1.6 What is asexuality?

A small percentage of people describe themselves as asexual. These individuals may have little or no interest in sexual activities with either biological sex. However, other components of human attraction, such as romantic feelings, may be important to asexual people. Some asexual individuals are sexually active (e.g., with a spouse) although their interest in sex may be minimal. While public discussion of LGBT issues has exploded in recent years, there is still very little discussion about asexuality.

Sex drive tends to be higher overall in men than in women (Lippa 2007). Additionally, there appears to be very small differences in sex drive between sexual orientations: in an international sample, gay and bisexual men reported a slightly lower sex drive than straight men, and bisexual women reported a slightly higher sex drive than straight and lesbian women. Other data suggests that bisexuals may be more sexually active on average than exclusively heterosexual or homosexual individuals (van Wyk & Geist 1995).

- Lippa 2007. Archiv Sexual Behavior
- van Wyk & Geist 1995. J Homosexuality

1.7 What does transgender mean?

Being transgender is a fairly different phenomenon from being gay, lesbian, bisexual or asexual. Those identities are concerned with who a person is attracted to and how. Transgender individuals feel that they have a different gender identity than the one they were born with, or grew up with. Transgender people may or may not choose elective surgery or hormone therapy so that their physical bodies more closely resemble their gender identity. Many gay, lesbian, bisexual or asexual people feel that their gender identity is consistent with their biological sex (they are “cis-gender”). To put it simply, gender identity is how one feels about oneself, while sexual orientation is how one feels about other human beings.

SECTION 2. The biological origins of homosexuality

2.1  Is human sexuality due to biological factors or personal choice?

The exact origins of homosexuality in humans are not fully known, nor can sexuality necessarily be attributed to a single factor for all people. Several biological factors may play a role in the development of sexual orientation (feelings and attractions). These all appear to happen early in life (including at conception in the case of potential genetic effects). They include genetic makeup, epigenetic expression of genes, hormone effects on brain development in the fetus (Robinson & Manning 2000), and possible maternal immune responses during pregnancy that affectsfetal brain development (Bogeart 2006). Personal choice plays more of a role in sexual behavior and identity, but it is unlikely to be the primary factor that influences attractions themselves.

- Bogaert. 2006. Proc Natl Acad Sci USA
- Robinson & Manning 2000. Evol Human Behavior

2.2 Is there a genetic basis for homosexuality?

Studies of twins provide evidence that homosexuality may have at least a partial genetic component (but see discussion of epigenetics below). Bailey & Pillard (1991) and Kendler et al. (2000) studied the prevalence of homosexuality within families, patterns which help shed light on whether sexuality is due to biological factors or the environment in which children are raised. Bailey & Pillard (1991) studied 161 homosexual and bisexual men with twin, non-twin, and adoptive brothers to ascertain the degree of similarity in sexual orientation among these different pairs of brothers. The researchers found a relatively high degree of shared homosexual orientation among mono-zygotic (identical) twins, but less concordance of sexual orientation for dizygotic (fraternal), non-twin brothers, or adoptive brothers. Their data are consistent with a biological origin (genetic and/or pre-natal development) of sexual orientation, but also suggest that genetics are not solely responsible for sexual orientation. If sexual orientation was determined exclusively by genetics, one would expect that identical twins would either both be gay or both be straight 100% of the time of the time.

Figure 3. Degree of concordance of homosexuality in different
types of sibling pairs. If sexual orientation was exclusively
determined by rearing environment or social factors, one would
expect the incidence of same-sex attraction to be similar
between non-twin siblings, fraternal twins, and identical twins.
Data from Bailey & Pillard (1991).
Kendler et al. (2000) also studied identical and fraternal twin pairs along with non-twin sibling pairs across the US to assess whether there was a correlation between sexual orientation in sibling pairs. Across all of the individuals in the study, 2.8% were non-heterosexual. Among all identical twins in the study, there was a 31.6% concordance of non-heterosexual orientation within twin pairs. In other words, for these twins, if one twin was gay or bisexual, there was a nearly 1 in 3 chance that the other identical twin was also gay or bisexual. In fraternal twin pairs, there was 8.3% concordance between non-heterosexual identity, a 1 in 12 chance that both twins were gay or bisexual. Among all other pairs of siblings (fraternal twins, and non-twin siblings), there was a 15.1% concordance of non-heterosexuality. Like Bailey & Pillard (1991) the higher concordance of a gay or bisexual identity in identical twins seen by Kendler et al. suggests that sexual orientation is inherited (genetically or epigenetically) to some degree.

One landmark study of genetics and sexual orientation was published in the prestigious journal Science (Hamer et al. 1993). This study recruited 40 families with pairs of gay brothers with no gay relatives on the paternal side. Analyzing 22 gene sections on the X chromosome (the sex chromosome men inherit from their mothers), the authors found that 5 loci on the q28 region of the X chromosome had statistically high rates of concordance between the pairs of gay brothers , suggesting genetically-linked inheritance of male homosexuality through the maternal side of their families. However, a subsequent study with a larger sample size of gay men was not been able to corroborate the results of the original study (Rice et al. 1999).

Modern sequencing techniques enable studies of large sections of the DNA library present in all human cells (the “genome”). A recent study by Sanders et al. (2017) examined a large percentage of human DNA in hundreds of homosexual and heterosexual men to identify potential areas of the genome that might be associated with homosexuality. They identified several sections of DNA (on chromosomes 13 and 14) that showed strong statistical differences in frequency of occurrence between gay and straight men. One gene they identified is related to development of a part of the brain, the diencephalon, which is known to differ in size according to sexual orientation. Another gene they identified is related to thyroid function. More study is needed to explore potential genetic differences between gay and straight men, and to determine the potential roles of genetics for determination of female sexual orientation and bisexuality for all people.

- Bailey & Pillard 1991. Archives Gen Psychiatry
- Hamer et al. 1993 Science
- Kendler et al. 2000. Am J Psychiatry
- Rice et al. 1999. Science
- Sanders et al. 2017. Scientific Reports

2.3 Is sexual orientation determined by hormone exposure during development?

Sex determination in humans and other animals starts at conception when a fertilized egg becomes either genetically female (XX) or genetically male (XY). (Note that although most individuals are XX or XY, other variations in the sex chromosome arrangement, including some that are non-fatal, exist for other individuals). For XX fetuses, a default pathway of development leads to female sex characteristics and a feminine brain. As an XY fetus develops, male hormones (androgens) direct an alternative developmental pathway towards a male reproductive system and masculinization of the brain (van Wyk and Geist 1995). In animals, hormone intervention can alter the developmental pathway despite genetic chromosomal makeup (van Wyk and Geist 1995). 

In addition to biological sex determination, differences in levels of exposure to sex hormones in developing fetuses appear to also have effects on sexual orientation.

One apparent correlate of prenatal sex hormone exposure is the length of the index finger relative to the length of the ring finger (a value known as the 2D:4D ratio), which is a physical human trait that appears to persist from childhood into adulthood (Robinson & Manning 2000). Lower 2D:4D values are associated with higher testosterone exposure, so men typically have 2D:4D ratios that are lower than women. Additionally, Robinson and Manning (2000) found that 2D:4D ratios in the left hands of gay and bisexual men were lower than straight men. The implication of this finding is that prenatal testosterone exposure for gay men is higher than for straight men, and may be even higher yet for bisexual men. Williams et al. (2000) found that homosexual women had a lower 2D:4D ratio than heterosexual women (suggesting they were more masculinized during development), but did not find differences in finger length ratios between gay and straight men.

Figure 4. A hormonal theory for the development of sexual orientation
and its relationship to finger length in men.

- van Wyk & Geist 1995. J Homosexuality
- Williams et al. 2000. Nature

2.4 Are their other biological factors that could affect sexual orientation?

Other developmental processes during pregnancy or early childhood could potentially play a role. Ellis & Cole-Harding (2001) studied thousands of pairs of mothers and their children to examine the incidence of homosexuality and bisexuality in children in relation to the stress levels of the mother during pregnancy. They found that there was a somewhat higher chance that mothers stressed early in pregnancy would have a gay son, although this correlation was not seen for daughters.

Another potential effect of the prenatal environment on sexual orientation is manifest as the correlation observed between the number of older brothers and the incidence of homosexuality in gay men. For example, data from Robinson & Manning (2000), Bogaert (2006), and Vasey and VanderLaan (2007) show that non-heterosexual men tend to have a greater number of older brothers. This “birth order effect” does not appear to correlate with sexual orientation in women (Bogaert & Skorska 2011).

Why would more older brothers affect younger brother sexuality? It is hypothesized that this phenomenon arises because as a woman has more male children, she tends to develop more antibodies in later pregnancies that may target pathways involved in male brain development (Bogaert & Skorska 2011). Bogaert & Skorska (2011) review findings that suggest the birth order effect is due to a pre-natal mechanism, not social rearing environment, because the effect is manifest even when older brothers are raised separately from their younger siblings. Although the mechanism is speculative, Bogaert & Skorska (2011) review some supportive evidence and also note its similarity to Hemolytic Disease of the Newborn, a phenomenon where Rh- mothers develop an immune response against Rh+ fetuses. Very recent research by Bogaert et al. (2017) offers additional support for the immune response mechanism by noting that mothers of homosexual sons have higher levels of antibodies against the protein involved in male brain development (NLGN4Y) than mothers of heterosexual sons or who don’t have children.

- Bogaert. 2006. Proc Natl Acad Sci USA
- Bogaert et al. 2017. Proc Natl Acad Sci USA
- Bogaert & Skorska M. 2011. Front Neuroendocrinol
- Ellis & Cole-Harding 2001. Physiol Behavior
- Robinson & Manning 2000. Evol Human Behavior
- Vasey & VanderLaan 2007. Proc Royal Soc B

2.5 What is epigenetics and what is its relationship with homosexuality?

The field of epigenetics is fairly recent. To put it simply, genetics deals with the set of traits (encoded in DNA sequences) that a person inherits through their biological parents while epigenetics deals with how that set of DNA codes is expressed by cells during the course of life. Put another way, epigenetics is how a cell turns on or off the genes that are already present in the genome of an individual.

In developing a hypothesis of epigenetic control of sexuality, Rice et al. (2012) noted that other biological explanations such as the maternal immune response hypothesis failed to account for all instances of male homosexuality, and provided no account of the origins of female homosexuality. Drawing on data from developmental biology, they proposed an epigenetic model that could account for the development of non-heterosexuality in both sexes.

Their idea centers on the phenomenon of “epimarks” which are small changes to the external structure of DNA (not the base sequences themselves) that affect the expression of DNA as it is transcribed in the cell. Normally, most epimarks do not carry over from one generation to the next. In the case of sexual orientation, the authors suggest that epimarks involved in hormone-induced sexual differentiation (development of a male or female fetus) sometimes carry over from one generation to the next. The epimarks in this instance may affect one of several steps in the development of a male or female child based on the amount of sensitivity of the child to androgen hormones, notably development of sexual orientation in the brain. (Female development occurs for example, in XX embryos that have low sensitivity to androgens like testosterone).

If a mother passes certain feminizing epimarks to a male child (that are not erased around the time of conception) and these affect sexual orientation but not gonad development, he may be more likely to become homosexual or bisexual. Similarly, if a father passes along masculinizing epimarks to a daughter, she may also be more likely to develop a non-heterosexual orientation. Epimarks relevant to sexual development may be passed on in part from parents, but can also be modified individually in offspring very early in embryonic development.

The authors explain that this model of occasional inter-generational transmission of epimarks could explain the seeming genetic inheritance of homosexuality within families (i.e., Hamer et al. 1993), but the lack of 100% congruence of homosexuality in twin studies (e.g., Kendler et al. 2000) that would be expected if sexual orientation was exclusively genetically determined.  While it is an intriguing theory consistent with lines of evidence from many studies, more data are needed to confirm the scope of its applicability to determination of sexual orientation.

- Hamer et al. 1993 Science
- Kendler et al. 2000. Am J Psychiatry
- Rice et al. 2012. Quarterly Review Biol

SECTION 3. Homosexuality in other species

3.1 Do other species exhibit same-sex behaviors?

Bailey & Zuk (2009) and Neill (2009) reviewed examples of same-sex behavior in other species. Examples include attempted mating with the same sex (sexual behaviors), courtship, and pair-bonding. Same-sex behaviors have been observed in many types of animals including other primates, whales, cats, lions, elephants, birds, bats, reptiles, amphibians, insects, mollusks and nematodes. In lizards, both male-male and female-female attempted mating have been observed.

In other animal species there is generally not much evidence for life-long associations between individuals of the same-sex. Additionally, despite many examples of same-sex behavior, there do not tend to be many examples of same-sex preference. However, there are some exceptions to these general patterns including big horn sheep and chinstrap penguins. Stable same-sex associations have also been observed among pairs of birds that typically live together for years in heterosexual pairings (Neill 2009). Elie et al. (2011) observed stable and strong same-sex pairings in a song bird species after experimentally manipulating ratios of males-to-female birds in a population.

- Bailey & Zuk. 2009. Trends Ecol Evol
- Elie et al 2011. Behav Ecol Sociobiol
- Neill J. 2009. The origins and role of same-sex relations in human societies.

3.2 Are same-sex behaviors adaptive in humans or other animals?

Because same-sex behaviors (such as attempted mating) cannot lead to successful reproduction, it is easy to assume that these behaviors are maladaptive because they do not lead to successful transmission of genes across generations. However, the prevalence of same-sex behaviors across many different types of animal species, and the fact that they persist over evolutionary time, suggests that these behaviors may present some adaptive advantage (or at least be neutral with respect to organism fecundity). Bailey & Zuk (2009) explore some of the evolutionary explanations for the occurrence of same-sex behavior in nature. There are at least three hypotheses about how same-sex behavior may be adaptive. First, it could aid in the formation and maintenance of social groups that are present in some species (example: bottlenose dolphins). Second, same-sex behaviors may increase or decrease intra-sexual conflict among individuals (e.g., bonobos). Third, in young animals, same-sex behaviors may simply be “practice” for successful heterosexual reproduction.  

One interesting example of the potential adaptive outcome of same-sex associations in animals comes from gulls in South America. During El NiƱo years when coastal waters are warmer than usual and there is less fish available for forage, the incidence of female-female pairs of birds increases in the population (Neill 2009). By rejecting males, some female birds help raise the broods of young birds born of other females, thus increasing the chance of survival of the young birds during climate conditions when food supplies are scarce.

In humans, Robinson & Williams (2000) speculate that high testosterone in men (which is correlated with a greater chance of homosexuality or bisexuality), is important for male fitness since it ensures proper cardiovascular and urogenital development in the body. Thus, high testosterone concentration may have a physiologically adaptive value even though it is also coupled with a greater likelihood of homosexual or bisexual orientation.

- Bailey & Zuk. 2009. Trends Ecol Evol
- Neill. 2009. The origins and role of same-sex relations in human societies.
- Robinson and Williams 2000. Evol Human Behavior

SECTION 4. Stability and fluidity of sexual orientation

4.1 Is sexuality fluid?

Sexual orientation can change over time for some individuals. However, most people do not seem to experience large changes in sexual orientation over long periods of time (Kinnish et al. 2005, Mock & Eibach 2011). Rosario et al. (2006) investigated the frequency at which LGB youth aged 14-21 changed, or didn’t change, their sexual orientation identity over the course of a year. They found that most gay-identified and half of bisexual-identified youth retained the same identity over that period. They also found that nearly half of bisexual-identified youth later identified as gay, and that a small percentage of LGB-identified youth later identified as straight.

The degree of change in sexual preference tends to differ between men and women. Several studies suggest that women who identify as lesbian or bisexual may be more likely to change their identity over time (Mock & Eibach 2011). In contrast, a heterosexual identity was relatively stable for both men and women in this study. Diamond (2008) studied sexual orientation in 79 lesbian, bisexual and unlabeled young adult women over a ten year period and found that two thirds of the study participants changed their sexual orientation at least once during the decade. Interestingly, many of the women with bisexual and unlabeled identities simply switched between those two groups; lesbians were less likely to switch identities. Diamond (2008) also found that some lesbians in her study had had some sexual contact with men, suggesting that there may not be strict differences in behavior between lesbian and bisexual women, even if there are differences in self-identity. In contrast to the general assumption that women have greater sexual fluidity, Rosario et al. (2006) found that among young LGB people who changed their identity over the course of a year, males were more likely to change than females.

- Diamond 2008. Developmental Psychol
- Kinnish et al. 2005. Archiv Sexual Behavior
- Mock & Eibach 2011. Archiv Sexual Behavior
- Rosario et al. 2006. J Sex Research

4.2 Is it possible to change sexual orientation?

As demonstrated in several studies, sexuality has some fluidity, such as in youth who are developing a sexual orientation identity (e.g., Rosario et al. 2006). However, for many people, sexuality cannot be changed by seeking out therapy specifically for that purpose. Proactive efforts to change sexuality through counseling, religious practices, or other means are known as “sexual orientation change efforts” (SOCE). There was a prominent and controversial study suggesting that sexual change orientation can be changed (Spitzer 2003). However, Spitzer’s study has been criticized based on its methodology and the author retracted his study about a decade after its publication. While some individuals may experience some change in same-sex feelings (naturally), the data suggest that most LGB people remain non-heterosexual.

- Spitzer 2003. Archiv Sexual Behavior
- Rosario et al. 2006. J Sex Research

SECTION 5. LGBT relationships

5.1 How many people are in same-sex relationships?

A national survey in the US conducted in 2013 suggested that about 700,000 people in the US were in same-sex relationships (Gary 2014b). About 40% of LGB people were in committed relationships or co-habiting with a partner (either same or opposite sex), with rates of relationships tending to be higher for women than men. About 1 in 5 LGB couples or single individuals were raising one or more minor children at home.

Gates 2014b. LGB Families and Relationships: Analyses of the 2013 National Health Interview Survey

5.2 Are gay relationships healthy?

They certainly can be. Peplau et al. (1996) provided some early discussion and statistics about same-sex relationships. Although heterosexuals sometimes believe that same-sex relationships are less fulfilling than straight relationships, there is no evidence that they are less so on average than heterosexual unions. One study from the early 1980s examined the separation rate (over an 18 month period) of couples that had been together for at least 10 years. Separation rates were 4% for straight couples, 4% for gay couples, and 6% for lesbian couples.

Interestingly, the stability of shorter-term relationships (couples together for ≤ 2 yrs) appeared to be affected by the presence or absence of societal sanction of those relationships. Among these shorter-term couples, the separation rate was 4% for married couples, 16% for gay couples, 22% for lesbian couples, and 17% for non-married heterosexual couples.

Peplau et al. 1996. Gay and lesbian relationships. Reprinted in Kimmel and Plante. Sexualities, 2004.

5.3 Which factors improve same-sex relationship quality?

Many of the same factors that promote happiness in heterosexual relationships are expected to be important in same-sex relationships. However, because of some unique aspects of same-sex relationships (contending with homophobia, less traditionally-defined gender roles), there may be unique considerations for gay couples. Clausell and Roisman (2009) studied 30 gay and 30 lesbian couples and concluded that being more open (more “out”) about one’s sexuality equated to better contentment in the relationship.

Clausell and Roisman. 2009. J Social Personal Relationships

5.4 What is a mixed orientation marriage?

A mixed orientation marriage (MOM) is a marriage between a gay or bisexual person and a heterosexual person. The exact number of mixed orientation marriages in the US is unknown, but is estimated to be as high as 2 million (Kays and Yarhouse 2010).

Higgins (2004) studied why some gay or bisexual men might be more likely to enter into mixed orientation marriages. He found support for the hypothesis that gay and bisexual men that had previously married women tended to come from families with somewhat more fundamentalist religious backgrounds, but he didn’t find support for other hypotheses explaining the differences in these two groups of non-heterosexual men such as differences in sexual orientation (e.g., married men were more likely to be bisexual), or differences in internalized homophobia. He concluded that the reasons why gay and bisexual men marry women are poorly understood.  Kays and Yarhouse (2010) note that some LGBT people report that their sexuality was actually a reason to get married – by marrying an opposite sex partner, they thought they might overcome same-sex attractions. Others marry to meet the expectations of their families or society, or because they wanted a family, or because of love and affection for their opposite-sex partner.

Higgins. 2004. J. Homosexuality
Kays & Yarhouse 2010. Amer J. Family Therapy

5.5 How often do mixed orientation marriages end in divorce? What factors help them succeed?

About two thirds of mixed orientation marriages are expected to end in divorce after the non-heterosexual spouse comes out (Kays and Yarhouse 2010). After disclosure, the straight spouse in the relationship often has to go through several stages of adjustment to the news, including acceptance, reevaluation of expectations, and “moving on”, a process that can typically take up to three years. Notably, the gay or bisexual spouse has also typically gone through a similar process prior to the straight spouse.

Several factors appear to help improve the longevity and quality of mixed orientation marriages. First, if the same-sex attracted individual in the marriage is bisexual, the marriage is more likely to last. Men or women who are higher on the Kinsey scale tend to have larger divorce rates. Second, continued mixed orientation marriage success often requires relationship flexibility such as an agreement that one or both partners will have additional relationships outside the marriage (a phenomenon often called “open marriage”; Ross 1983). Other factors like honest communication in the relationship, a strong emotional bond between marriage partners, support from others, and flexibility in redefining expectations within the relationship can help mixed orientation marriages stay together (Kays & Yarhouse 2010).

Kays & Yarhouse 2010. Amer J Family Therapy
Ross. 1983. The married homosexual man. Routledge & Kegan Paul, London.

SECTION 6. LGBT physical and mental health

6.1 How common is suicide ideation and attempted suicide in the LGBT community? How does this compare with the general population?

Ryan et al. (2010) found that rates of suicidal thought and suicide attempts doubled among LGBT youth from less accepting families than from more accepting families.

- Ryan et al. 2010. J Child Adolescent Psychiatric Nursing

6.2 How many LGBT youth are homeless?

Although nationally representative data on LGBT homelessness may be lacking, some survey work can help provide estimates. Durso and Gates (2012) conducted a survey of over 200 US organizations providing services to homeless and at-risk youth (straight and LGBT). They found that approximately 40% of the youth served by these organizations were LGBT. The National Alliance to End Homelessness estimates that there are perhaps 80,000 homeless LGBT youth nationwide, comprising 20% of homeless minors (NAEH 2012).

- Durso and Gates. 2012. The Williams Institute.
- National Alliance to End Homelessness 2012. LGBTQ National Youth Policy Statement.

6.3 What are some things that parents and allies can do to support LGBT youth?

One of the keys to self-esteem for LGBT youth is “social connectedness”, which can be achieved for example, through youth participation in gay-centered groups (Detrie & Lease 2007). Another important factor for psychological well-being identified by Detrie and Lease was “perceived support” from family and friends. Ryan et al. (2010) found that family acceptance (parents showing accepting behaviors towards youth about their sexual identity) was positively correlated with greater youth self esteem and general health and was associated with less depression, substance abuse, and suicide attempts. In contrast, a large majority (68%) of LGBT youth who were homeless or at risk of homelessness had a history of rejection from their families, with more than half of these youth citing abuse at home (Durso & Gates 2012).

Figure 5. Percentage of youth who believe that they can be
happy as an LGBT adult according to the level of parental
support they receive. Data from Ryan (2009).
The Family Acceptance Project at San Francisco State University has compiled important information about how family members can support young gay, lesbian, bisexual, and transgender individuals. For example, in a publication titled “Supportive Families, Healthy Children”, Ryan (2009) notes that some of the ways parents sometimes think they are helping LGBT youth such as shielding them from LGBT friends or resources or pressuring them to be more gender conforming may actually be harmful. In contrast, supportive behaviors from parents including extending affection to LGBT youth, helping them connect with LGBT events and organizations, having open discussions with their children about their LGBT identity, and standing up for the youth to other family members who may be less accepting.

Parental support is also correlated with the overall mental health of LGB young adults too (Needham & Austin 2010). LGB young men and women tend to receive lower levels of parental support than their heterosexual peers, which is associated with a number of negative health outcomes including a greater incidence of suicidal thoughts, depression, and drug use. Continued parental support is thus important to LGB individuals as they enter young adulthood.

- Detrie & Lease. 2007. J Homosexuality
- Durso & Gates. 2012. The Williams Institute.
- Needham & Austin 2010. J Youth Adolescence
- Ryan 2009. Supportive families, healthy children. Family Acceptance Project.
- Ryan et al. 2010. J Child Adolescent Psychiatric Nursing 

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