Relationships and sexuality

Sexuality

Quick links on this page:

• What is sexual orientation?
• Sexually Transmitted Infections (STIs)
• Contacts

What is sexual orientation?

Sexual orientation is an enduring emotional, romantic or sexual attraction to another person. It is easily distinguished from other components of sexuality including biological sex, gender identity (the psychological sense of being male or female) and the social gender role (adherence to cultural norms for feminine and masculine behaviour).

Sexual orientation exists along a continuum that ranges from exclusive homosexuality to exclusive heterosexuality and includes various forms of bisexuality. Bisexual persons can experience physical, sexual and emotional attraction to both their own sex and the opposite sex. Persons with a homosexual orientation are sometimes referred to as gay (both men and women) or as lesbian (women only).

Sexual orientation is different from sexual behaviour because it refers to feelings and self-concept. Persons may or may not express their sexual orientation in their behaviours.

What causes a person to have a particular sexual orientation?

It is generally agreed that sexual orientation is most likely the result of a complex interaction of environmental, cognitive and biological factors. In most people, sexual orientation is shaped at an early age. There is also considerable recent evidence to suggest that biology, including genetic or inborn hormonal factors, play a significant role in a person's sexuality. It is important to recognise that there are probably many reasons for a person's sexual orientation and the reasons may be different for different people.

Do I have a choice over my sexual orientation?

No, human beings can not choose to be either gay or straight. Sexual orientation emerges for most people in early adolescence without any prior sexual experience. Although we can choose whether to act on our feelings, psychologists do not consider sexual orientation to be a conscious choice that can be voluntarily changed.

How do I know if I'm gay?

Many people will be attracted to someone of the same gender at some time in their lives. Some people might act on this; some people don't even admit it.

But it's a very common thing – so don't worry, you're not alone!

It is not uncommon for individuals particularly young people to have feelings towards others of the same sex, and wonder whether this means that they are gay. For many these feelings can be very intense and alienating. Some people who are attracted to others of the same sex are gay and go on to have sexual relationships with people of the same sex. But other people who have gay feelings find that these change over time and they become attracted to those of the opposite sex.

Other individuals are attracted to men and women, and have relationships with both. Some people are not attracted to anyone and wonder if this is a sign of homosexuality. Often it is only time that will resolve these feelings.

There isn't a questionnaire you can fill in or a test to take! While your sexuality is developing, many teenagers will become attracted to someone of the same gender – it doesn't mean that you'll always be attracted to people of that gender. Some people can be quite old before they have their first same-sex attraction. For some people, the only way to know for sure is to wait and see. Other people seem to have known they were gay since they were really young – everyone's different.

For many people who were brought up thinking they were straight, it can come as quite a surprise to realise that they're attracted to people of the same gender. Sometimes something might happen to make you suddenly aware of these feelings – or you might have become aware of them slowly, over a long time.

Is "coming out" difficult?

For some gay and bisexual people the coming out process is difficult, for others it is not. Often lesbian, gay and bisexual people feel afraid, different, and alone when they first realise that their sexual orientation is different from the community norm. This is particularly true for people becoming aware of their gay, lesbian, or bisexual orientation as a child or adolescent, which is not uncommon. And, depending on their families and where they live, they may have to struggle against prejudice and misinformation about homosexuality. Children and adolescents may be particularly vulnerable to the effects of bias and stereotypes. They may also fear being rejected by family, friends, colleagues, and religious institutions. Some gay people have to worry about losing their jobs or being harassed at school if their sexual orientation became well known. Unfortunately, gay, lesbian and bisexual people are at a higher risk for physical assault and violence than are heterosexuals.

What should I consider before telling my parents and family?

Be clear in your own mind

• Are you sure about your sexual orientation? Don't raise the issue unless you're able to respond with confidence to the question "Are you sure?" Confusion on your part will increase your parents' confusion and decrease their confidence in your judgment.
• Are you comfortable with your gay sexuality? If you're wrestling with guilt and periods of depression, you'll be better off waiting to tell your parents. Coming out to them may require tremendous energy on your part; it will require a reserve of positive self-image.
• Do you have support? In the event your parents' reaction devastates you, there should be someone or a group that you can confidently turn to for emotional support and strength. Maintaining your sense of self-worth is critical.
• Are you knowledgeable about homosexuality? Your parents will probably respond based on a lifetime of information from a homophobic society. If you've done some serious reading on the subject, you'll be able to assist them by sharing reliable information and research.
• What's the emotional climate at home? If you have the choice of when to tell, consider the timing. Choose a time when they're not dealing with such matters as the death of a close friend, pending surgery or the loss of a job.
• Can you be patient? Your parents will require time to deal with this information if they haven't considered it prior to your sharing. The process may last from six months to two years.
• What's your motive for coming out now? Hopefully, it is because you love them and are uncomfortable with the distance you feel. Never come out in anger or during an argument, using your sexuality as a weapon.
• Do you have available resources? Homosexuality is a subject most non-gay people know little about. Have available at least one of the following: a book addressed to parents, a contact LGBT organisation from which they can get information and support.
• Are you financially dependent on your parents? If you suspect they are capable of withdrawing college finances or forcing you out of the house, you may choose to wait until they do not have this weapon to hold over you.
• What is your general relationship with your parents? If you've gotten along well and have always known their love – and shared your love for them in return – chances are they'll be able to deal with the issue in a positive way.
• What is their moral societal view? If they tend to see social issues in clear terms of good/bad or holy/sinful, you may anticipate that they will have serious problems dealing with your sexuality. If, however, they've evidenced a degree of flexibility when dealing with other changing societal matters, you may be able to anticipate a willingness to work this through with you.
• Is this your decision? Not everyone should come out to their parents. Don't be pressured into it if you're not sure you'll be better off by doing so – no matter what their response.

What do I do if someone "comes out" to me?

Learning that a close friend or loved one is gay, lesbian, bisexual or transgender can be a difficult discovery. It can send you on an emotional roller coaster ride. You may feel like you have lost someone very close to you. Remember that this person is the same one that you loved or be-friended before they came out to you – they have just shared another part of themselves with you. Feelings of grief, guilt, disappointment and denial are natural given some of our society's attitudes towards homosexuality and gender variance. However, you owe it to your loved one – and yourself – to move towards acceptance and understanding. Whatever your reaction, reassure the person that they still have your friendship or love.

Why are some people open about their sexual orientation?

Because sharing that aspect of themselves with others is important to their mental health. In fact, the process of identity development for lesbians, gay men and bisexuals called "coming out", has been found to be strongly related to psychological adjustment – the more positive the gay, lesbian, or bisexual identity, the better one's mental health and the higher one's self-esteem.

Can therapy change my sexual orientation?

No. Even though most homosexuals live successful, happy lives, some homosexual or bisexual people may seek to change their sexual orientation through therapy, sometimes pressured by the influence of family members or religious groups to try and do so. The reality is that homosexuality is not an illness. It does not require treatment and is not changeable.

However, not all gay, lesbian, and bisexual people who seek assistance from a mental health professional want to change their sexual orientation. Gay, lesbian, and bisexual people may seek psychological help with the coming out process or for strategies to deal with prejudice, but most go into therapy for the same reasons and life issues that bring straight people to mental health professionals.

Does being gay mean that I have a mental health problem?

No. Psychologists, psychiatrists and other mental health professionals agree that homosexuality is not an illness, mental disorder or an emotional problem. Over 35 years of objective, well-designed scientific research has shown that homosexuality, in itself, is not associated with mental disorders or emotional or social problems. Homosexuality was once thought to be a mental illness because mental health professionals and society had biased information. In the past the studies of gay, lesbian and bisexual people involved only those in therapy, thus biasing the resulting conclusions. When researchers examined data about these people who were not in therapy, the idea that homosexuality was a mental illness was quickly found to be untrue.

What does transgender mean?

A transgender person is someone whose gender identity or expression differs from conventional expectations for their physical sex. The term transgender is used to describe several distinct but related groups of people who use a variety of other terms to self-identify. Transgender people can include transsexuals (not all transsexual people need or want sex reassignment surgery), masculine women, feminine men, drag queens/kings, cross-dressers, gender queers, two-spirit, butches, transmen, transwomen, etc. Like other people, transgender people can be straight, gay, lesbian or bisexual.

Can lesbians, gay men, and bisexuals be good parents?

Yes. Studies comparing groups of children raised by homosexual and by heterosexual parents find no developmental differences between the two groups of children in four critical areas: their intelligence, psychological adjustment, social adjustment, and popularity with friends. It is also important to realise that a parent's sexual orientation does not dictate his or her children's.

Another myth about homosexuality is the mistaken belief that gay men have more of a tendency than heterosexual men to sexually molest children. There is no evidence to suggest that homosexuals are more likely than heterosexuals to molest children.

What can be done to overcome the prejudice and discrimination the gay men, lesbians, and bisexuals experience?

Research has found that the people who have the most positive attitudes toward gay men, lesbians and bisexuals are those who say they know one or more gay, lesbian or bisexual person well – often as a friend or co-worker. For this reason, psychologists believe negative attitudes toward gay people as a group are prejudices that are not grounded in actual experiences but are based on stereotypes and prejudice.

Why is it important for society to be better educated about homosexuality?

Educating all people about sexual orientation and homosexuality is likely to diminish anti-gay prejudice. Accurate information about homosexuality is especially important to young people who are first discovering and seeking to understand their sexuality – whether homosexual, bisexual, or heterosexual. Fears that access to such information will make more people gay have no validity—information about homosexuality does not make someone gay or straight.

Are all gay and bisexual men HIV infected?

No. This is a commonly held myth. In reality, the risk of exposure to HIV is related to a person's behavior, not their sexual orientation. What's important to remember about HIV/AIDS is it is a preventable disease through the use of safe sex practices and by not using drugs.

Sexually Transmitted Infections (STIs)

What is a sexually transmitted infection?

Those infectious diseases which spread from person to person during intimate sexual contact are "sexually transmitted infections" (STIs).

Can you tell me more about these infections?

• STIs affect men and women of all backgrounds and economic levels. They are most prevalent among teenagers and young adults. Nearly two-thirds of all STIs occur in people younger than 25 years of age.
• The incidence of STIs is rising, in part because in the last few decades, young people have become sexually active earlier yet are marrying later.
• Most of the time, STIs cause no symptoms, particularly in women. When and if symptoms develop, they may be confused with those of other diseases not transmitted through sexual contact. Even when an STI causes no symptoms, however, a person who is infected may be able to pass the disease on to a sex partner. That is why many doctors recommend periodic testing or screening for people who have more than one sex partner.
• Health problems caused by STIs tend to be more severe and more frequent for women than for men, in part because the frequency of asymptomatic infection means that many women do not seek care until serious problems have developed.
  • Some STIs can spread into the uterus (womb) and fallopian tubes to cause pelvic inflammatory disease (PID), which in turn is a major cause of both infertility and ectopic (tubal) pregnancy. The latter can be fatal
  • STIs in women also may be associated with cervical cancer. One STI, human papillomavirus infection (HPV), causes genital warts and cervical and other genital cancers
  • STIs can be passed from a mother to her baby before, during, or immediately after birth; some of these infections of the newborn can be cured easily, but others may cause a baby to be permanently disabled or even die.
• When diagnosed and treated early, many STIs can be treated effectively. Some infections have become resistant to the drugs used to treat them and now require newer types of antibiotics. Experts believe that having STIs other than AIDS increases one's risk for becoming infected with the AIDS virus.

HIV infection and AIDS

AIDS (acquired immunodeficiency syndrome) is caused by a virus that destroys the body's ability to fight off infection. People who have AIDS are very susceptible to many life-threatening diseases, called opportunistic infections, and to certain forms of cancer. Transmission of the virus primarily occurs during sexual activity and by sharing needles used to inject intravenous drugs.

Chlamydial infection

This infection is now the most common of all bacterial STIs. In both men and women, chlamydial infection may cause an abnormal genital discharge and burning with urination. In women, untreated chlamydial infection may lead to pelvic inflammatory disease, one of the most common causes of ectopic pregnancy and infertility in women. Many people with chlamydial infection, however, have few or no symptoms of infection. Once diagnosed with chlamydial infection, a person can be treated with an antibiotic.

Genital herpes

Genital herpes infections are caused by the herpes simplex virus (HSV). The major symptoms of herpes infection are painful blisters or open sores in the genital area. These may be preceded by a tingling or burning sensation in the legs, buttocks, or genital region. The herpes sores usually disappear within two to three weeks, but the virus remains in the body for life and the lesions may recur from time to time. Severe or frequently recurrent genital herpes is treated with one of several antiviral drugs that are available by prescription. These drugs help control the symptoms but do not eliminate the herpes virus from the body. Suppressive antiviral therapy can be used to prevent occurrences and perhaps transmission. Women who acquire genital herpes during pregnancy can transmit the virus to their babies. Untreated HSV infection in newborns can result in mental retardation and death.

Genital warts

Genital warts are also caused by a virus related to the virus that causes common skin warts. Genital warts usually first appear as small, hard painless bumps in the vaginal area, on the penis, or around the anus. If untreated, they may grow and develop a fleshy, cauliflower-like appearance. Genital warts are treated with a topical drug (applied to the skin), by freezing, or if they recur, with injections of a type of interferon. If the warts are very large, they can be removed by surgery.

Gonorrhea

The most common symptoms of gonorrhea are a discharge from the vagina or penis and painful or difficult urination. The most common and serious complications occur in women and, as with chlamydial infection, these complications include PID, ectopic pregnancy, and infertility. Historically, penicillin has been used to treat gonorrhea, but in the last decade, four types of antibiotic resistance have emerged. New antibiotics or combinations of drugs must be used to treat these resistant strains.

Syphilis

The incidence of syphilis has increased and decreased dramatically in recent years. The first symptoms of syphilis may go undetected because they are very mild and disappear spontaneously. The initial symptom is a chancre; it is usually a painless open sore that usually appears on the penis or around or in the vagina. It can also occur near the mouth, anus, or on the hands. If untreated, syphilis may go on to more advanced stages, including a transient rash and, eventually, serious involvement of the heart and central nervous system. The full course of the disease can take years. Penicillin remains the most effective drug to treat people with syphilis.

Other diseases that may be sexually transmitted include trichomoniasis, bacterial vaginosis, cytomegalovirus infections, scabies, and pubic lice.

What can I do to prevent STIs?

The best way to prevent STIs is to avoid sexual contact with others. If you decide to be sexually active, there are things that you can do to reduce your risk of developing an STI.

• Have a mutually agreed single sex relationship with an uninfected partner
• Correctly and consistently use a male condom
• Use clean needles if injecting intravenous drugs
• Prevent and control other STIs to decrease susceptibility to HIV infection and to reduce your infectiousness if you are HIV-infected
• Delay having sexual relations as long as possible. The younger people are when having sex for the first time, the more susceptible they become to developing an STI. The risk of acquiring an STI also increases with the number of partners over a lifetime.

What should I do if I am sexually active?

Have regular checkups for STIs even in the absence of symptoms, and especially if having sex with a new partner. These tests can be done during a routine visit to the doctor's office.

• Learn the common symptoms of STIs. Seek medical help immediately if any suspicious symptoms develop, even if they are mild
• Avoid having sex during menstruation. HIV-infected women are probably more infectious, and HIV-uninfected women are probably more susceptible to becoming infected during that time
• Avoid anal intercourse, but if practised, use a male condom
• Avoid douching because it removes some of the normal protective bacteria in the vagina and increases the risk of getting some STIs.

What should I do if I have a diagnosed STI?

• Be treated to reduce the risk of transmitting an STI to an infant
• Discuss with a doctor the possible risk of transmission in breast milk and whether commercial formula should be substituted
• Notify all recent sex partners and urge them to get a checkup
• Follow the doctor's orders and complete the full course of medication prescribed. A follow-up test to ensure that the infection has been cured is often an important step in treatment
• Avoid all sexual activity while being treated for an STI.

Sometimes people are too embarrassed or frightened to ask for help or information. Most STIs are readily treated, and the earlier a person seeks treatment and warns sex partners about the disease, the less likely the disease will do irreparable physical damage, be spread to others or, in the case of a woman, be passed on to a newborn baby.

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