Although lesbian, gay, bisexual, transgender (LGBT) youth face many sexual health inequities, including increased risk of human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and pregnancy, providers have the opportunity to help young people to grow up to become sexually healthy adults.

Pediatricians can support the development of healthy sexual identities and behavior by discussing sexual orientation and behavior in a nonjudgmental, respectful, and confidential manner.

It is imperative to screen for HIV and recognize symptoms of acute HIV infection among all adolescents, but special attention should be paid to young men who have sex with men and young transgender women who are disproportionately affected; early diagnosis, linkage to, and retention in care with effective treatment improves both patient-specific and public health outcomes.

LGBT youth, like their heterosexual counterparts, are at risk for syphilis, gonorrhea, chlamydia, trichomonas, and human papilloma virus (HPV), and providers should be familiar with the recommendations for screening of these STIs.

Providers should offer sexual health preventive services, including safer sex counseling, HIV pre-exposure and postexposure prophylaxis, and vaccination for hepatitis A, B, and HPV, as well as discussion of sexual transmission of hepatitis C by HIV-infected men who have sex with men.