Young Sexual Minority Males in America

HIV incidence among 13‒24-year-old males who have sex with males has risen in recent years, and this age-group represents half of all individuals whose HIV infections are undiagnosed. Yet, it has been difficult for public health programs to develop effective HIV-related services for young sexual minority males, partly because the basic profile of the population has not been thoroughly understood. Many studies that have focused on gay or bisexual men, as well as other men who have same-sex partners, have excluded individuals younger than 18 or defined sexual orientation on the basis of behavior only.  To address these shortcomings, in a 2016 Perspectives article, Amy M. Fasula and colleagues included adolescents and used a broad definition of sexual minority status, hinging on any report of same-sex identity, attraction or behavior.

The researchers analyzed 2002‒2013 data from the National Survey of Family Growth on some 8,000 males aged 15‒24. Ten percent of these individuals—representing more than two million males in the United States—were classified as sexual minorities. Among them, 24% reported all three same-sex attributes, while 15% endorsed same-sex identity but not behavior, 22% said they were heterosexual and had engaged in same-sex behavior, and 39% were attracted to men but did not report same-sex identity or behavior.  The prevalence of sexual minority status differed by men’s age, race and ethnicity, religious affiliation, income and residence.

In providing a population-level description of sexual minority males who are making the transition from adolescence to adulthood, this study laid a foundation for future research on men’s sexual trajectories, discordance between identity and behavior, HIV risk and targeted HIV services.

Cover illustrations of Margaret Sanger © Matthew and Eve Levine