It is complicated: gender and sexual orientation identity in LGBTQ youth

J Clin Nurs. 2016 Dec;25(23-24):3665-3675. doi: 10.1111/jocn.13419.


Aims and objectives: To explore the variations of sexual orientation and gender identity as well as the intersections of those identities in a sample of lesbian, gay, bisexual, transgender, queer, and questioning youth.

Background: Identity development is a key task of adolescence. Among the multiple identities that young people navigate are sexual orientation and gender identity. Challenges with solidifying and integrating aspects of one's identity can contribute to poor physical and mental health outcomes.

Design: Cross-sectional descriptive survey.

Methods: A convenience sample was recruited via collaborations with community organisations and Internet groups who provide information and services for LGBTQ youth under the age of 25.

Results: Of the 175 respondents, one-third of the sample reported a gender identity that was not congruent with their sex assigned at birth. Those assigned female sex at birth reported noncongruent gender identities as well as fluid and nonbinary identities such as genderqueer and agender more frequently that respondents assigned male at birth. Individuals with noncongruent gender identities were more likely to identify with a sexual orientation other than lesbian, gay or bisexual than individuals with gender identities congruent with their sex assigned at birth.

Conclusions: Adolescent sexual orientation and gender identity are complex and nuanced. Nurse scientists and clinical nurses can contribute to understanding of these identities, their meaning to the young person and the unique health implications by regularly inquiring about sexual orientation and gender identity in their practice.

Relevance to clinical practice: Nurses in clinical practice need to be aware of the sometimes complicated nature of adolescent identity and its related terminology so that they can ask relevant questions and provide culturally safe care.

Keywords: adolescents; diversity; gender; identity; sexuality.

MeSH terms

  • Adolescent
  • Cross-Sectional Studies
  • Female
  • Gender Identity*
  • Humans
  • Male
  • Sexual Behavior / psychology*
  • Sexual Behavior / statistics & numerical data*
  • Young Adult