Sexual Orientation and Gender Identity: All Guides

LGBTQ: Sexual Orientation

Key Facts
  • Sexual orientation refers to sexual and romantic feelings for people of the same gender, a different gender, or more than one gender.
  • Gender identity refers to a person’s internal feelings of being a woman, man, both, neither, or something else.
  • Youth often find it helpful to talk about their feelings in a safe environment with a trusted adult, counselor, or health care provider or join a youth group such as Gay Straight Alliance at school. Thinking through how others might react can help with deciding whether and when to come out to parents or family members.

What is sexual orientation?

Sexual orientation refers to the type of sexual and romantic feelings for other people. These people can be of the same gender, a different gender, or more than one gender. People who identify their sexual orientation as “straight” or “heterosexual” typically feel attracted to people of a different gender than themselves. People who identify as “lesbian” or “gay” typically feel attracted to people of the same gender as themselves. People who identify as “bisexual” typically feel attracted to more than one gender, such as being attracted to both women and men. “Pansexual” is a term used by people who feel attracted all genders, regardless of those persons’ anatomy. People who use the term “queer” may use it to mean lesbian, gay, bisexual, or pansexual, or they may use it because other terms don’t quite describe their experiences.

Some people might identify their sexual orientation one way, but experience attractions that don’t match the label they are using. For example, a person might identify as “straight,” but feel attracted to people of the same gender or more than one gender and sometimes act on those attractions. Sexual orientation can also change over time for some people. For example, a person might be attracted only to people of the same gender as themselves, and then later be attracted to more than one gender. This is normal! It just means that sexual orientation is complicated for some people. Sexual orientation is based on gender, not sex or anatomy. This means that a person who identifies as lesbian can be attracted to all women, including cisgender and transgender women.

How do I know my sexual orientation?

People usually know their sexual orientation based on how they feel romantically or sexually toward other people over time. For example, people who have repeated crushes and/or pleasurable body experiences with people of the same gender as themselves but have no crushes or pleasurable experiences with people of a different gender than themselves may identify themselves as “gay” or “lesbian.”. People who have repeated crushes and/or pleasurable body experiences with people of a different gender then themselves but have no crushes or pleasurable experiences with people of a similar gender than themselves may identify themselves as “straight.” However, having one or even a few romantic or sexual experiences with someone of the same gender does not automatically make you lesbian, gay, or bisexual, just as having one or even a few romantic or sexual experiences with someone of a different gender does not automatically make you straight. Sometimes it takes a long time to understand our sexual and romantic feelings and how our bodies react to other people. Someone’s sexual orientation can also change over time. How you identify now may be different from how you identify later. Regardless, only you can identify your sexual orientation.

When will I know my sexual orientation?

There is no official time when people know their sexual orientation. For some people, adolescence is the time when they figure out their sexual orientation, but for other people it may not happen until young adulthood or even later in life. During adolescence, our brains start to release certain hormones that help our bodies go through puberty and change. This happens over many years. At the same time, we may start developing crushes towards other people, which may lead to having pleasurable sexual experiences. For some people, this gives them a clue about who they might have sexual and romantic feelings towards, and what their sexual orientation might be. Sexual orientation can change over time. It’s okay to identify with different orientations as you get older.

Is it okay to be lesbian, gay, bisexual, or queer?

Yes! Although some religions and cultures may have traditional beliefs that these types of feelings shouldn’t be expressed as behaviors, current medical, psychological, and psychiatric organizations believe that being lesbian, gay, bisexual, or queer (LGBQ) is normal. Many religions and cultures are inclusive and welcoming of LGBQ people. Regardless, many LGBQ people are able to keep their religious values and cultural identity and feel comfortable expressing their sexuality.

What’s the difference between gender identity and sexual orientation?

Many people confuse the two, but here is a simple way to understand the difference: gender identity is more about “who you are” (boy, girl, both, or neither) and sexual orientation is about “who you have a crush on.”

Can I be both transgender and LGBQ? What about transgender and straight?

Yes and yes. Being transgender is about gender identity, not sexual orientation. Everyone has a sexual orientation, regardless of what their gender identity is. Transgender people, just as cisgender people, may be attracted to people of the same gender based on their own gender identity, attracted to people of a different gender based on their own gender identity, or they may be attracted to more than one gender.

What are homophobia and biphobia?

Homophobia is a term that describes negative feelings and attitudes toward people who are attracted to people of the same gender (e.g., lesbian or gay), and biphobia is a term that describes negative feelings and attitudes toward people who are attracted to more than one gender (e.g. bisexual or pansexual).

What are some examples of homophobia and biphobia?

Negative feelings and attitudes about lesbian, gay, bisexual, and queer (LGBQ) people can be shown in different ways. Some ways are obvious and intentional; for example, direct insults, threats, bullying, physical harm or violence, and discrimination. Some ways are less obvious. Examples of these hidden forms of homophobia, biphobia, or transphobia include people who aren’t comfortable around LGBQ people; not including LGBQ persons in your activities, groups, or events; the use of slurs/words in an unintentional way; and avoiding discussions about LGBQ issues due to feeling uncomfortable. All types of homophobic and biphobic attitudes and behaviors can be hurtful and sometimes dangerous to LGBQ people.

Why do homophobia and biphobia exist?

There is no easy answer to this question! The best way to understand it is to realize that mainstream culture often feels uncomfortable with differences, and minority groups can be labeled as “different.” Minority is a term used to describe any group of people who experience a relative disadvantage in living their day to day lives as compared to the mainstream or dominant group. Other minorities such as racial/ethnic groups are also discriminated against. Even though being LGBTQ is common, these groups are still minorities, as minorities are not necessarily small in numbers. The good news is that through advocacy and social change mainstream people are becoming more welcoming and inclusive of diverse people, and hopefully homophobic and biphobic behaviors will become less common in the future. Even if you do not identify as LGBTQ, you can help support your friends who are by ensuring they feel welcome.

Helpful Resources

 


LGBTQ: Sexual Orientation and Gender Identity: Mental Health and Resources

Adolescence can be an exciting but also a challenging time, since it is a period when bodies change, schoolwork is more difficult, and friends and families might not understand your feelings and thoughts. Sometimes adolescents feel more anxious, depressed, or even suicidal. Other times, adolescents can turn to risky behaviors such as drugs, alcohol or sex. Lesbian, gay, bisexual, and queer youth, and youth who identify as transgender or gender nonconforming experience the same mental health issues as other adolescents. However, they may also feel alone and might not share their feelings about sexual orientation or gender identity because they fear people will reject them. Having this extra burden can cause these adolescents to have a higher risk for these serious mental health issues.

What do I do if I feel suicidal?

Stay safe and do not make an impulsive dangerous decision! The most important thing to do is to find someone supportive who you know. You don’t have to share all the details about what you are feeling right away, although it might help. If you can’t think of anyone supportive, try calling a hotline (see resources below) or even 911 so you can talk to a mental health professional, or go to the closest emergency room.

Who should I tell about my sexual orientation and/or gender identity?

Not everyone will be accepting of lesbian, gay, bisexual, queer, and/or transgender or gender nonconforming identities. Deciding who to tell can be a difficult decision. You may choose to share your sexual orientation or gender identity with everyone you know or just a few close personal friends or family members. It’s important to find at least one supportive person you trust to tell so you don’t have to carry the heavy burden of a secret alone. If you can’t think of a supportive person in your life, you should contact a mental health professional or one of the professional online resources listed below so you won’t feel alone with these feelings. Don’t pick random unknown websites for support; they may not be helpful or knowledgeable about sexual orientation and gender identity.

Will my therapist force me to tell my parents, family, and/or friends about these feelings?

No. Therapists and other mental health professionals are trained to maintain strict confidentiality about your sexual feelings and behaviors as well as gender identity questions. However, at your first appointment make sure to discuss confidentiality with your mental health provider and how and if information is shared with parents or others.

Will my therapist tell my parents about my sexual orientation and/or gender identity?

In general, no. Therapists are always concerned about your health and safety so they will break your confidentiality in the event that your actions/thoughts might lead to an unsafe situation for you or others (for example, if you were feeling suicidal). However, they would only discuss the details needed to get you the services you need. An ongoing conversation with your therapist about confidentiality is important.

Where can I get support?

This is an individual decision for every person. The most important thing is to find someone who you think will be accepting of you regardless of your sexual orientation and/or gender identity.

This may include:

  • An accepting friend
  • An accepting parent or other family member
  • Someone who you know who is lesbian, gay, bisexual, queer and/or transgender or gender nonconforming
  • An accepting guidance counselor
  • A Gay-Straight Alliance at your school (this group may have a different name at your school, such as the Queer-Straight Alliance or the Pride Club)
  • An accepting school teacher
  • Health care or mental health provider
  • Lesbian, gay, bisexual, transgender, queer (LGBTQ) support organization

If you can’t think of anyone who will be supportive of your thoughts and feelings, you don’t have to be alone. Usually, a mental health professional can help you figure out who might be a good support person.

“I can’t think of a single person who will be supportive of my feelings.” What are some trusted online resources I can turn to?

There are plenty of online professional resources and hotlines for the many adolescents who have similar thoughts and feelings about their sexual orientation and/or gender identity. See below for a list of resources.

“I have a friend who just told me about their feelings related to their sexual orientation and/or gender identity. How can I help them?”

Even if you are uncomfortable with your own feelings about sexual orientation and gender identity, let your friend know that you will support them and be there for them no matter what. Anyone who is willing to share private feelings and thoughts with you probably trusts you as a close friend and support person. Advise them to talk with their health care provider or start seeing a therapist so they don’t have to feel alone. You can also share with them some of the online resources listed below.

“I have a lesbian, gay, bisexual, queer, and/or transgender or gender nonconforming friend who just told me about having suicidal thoughts. How can I help them?”

Again, let that friend know that they are not alone. Find out if they are with someone who can support them. Let them know that you won’t break their secret about their sexual orientation and/or gender identity, but that you still have to let someone know about their unsafe feelings. Then, stay with your friend and right away let a supportive adult know, call a hotline, or even 911 to make sure your friend stays safe!


Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.