Bonita F. Stanton, MD, Consulting Editor

Moreover, for a range of reasons, LGBT youth may face a higher likelihood of certain diseases and/or adverse social situations. For example, as most pediatricians are doubtless aware, LGBT face higher rates of several sexually transmitted diseases. In 2014, gay and bisexual men accounted for an estimated 83% (29,418) of HIV diagnoses among men and 67% of all diagnoses. As another example, LGBT are much more likely to be homeless; while overall 5% to 10% of adolescents and young adults in the United States are LGBT, an estimated 20% to 40% of homeless adolescents are LGBT.

Equally important, but perhaps less recognized by pediatricians, are structural inequalities resulting in stigma, facing LGBT, such as accommodations based on physical evidence of gender rather than sexual orientation. A parent, teacher, or physician unaware of the magnitude associated with such rules may unwittingly further complicate an already distressed youth.

Pediatric practice requires a skillful mix of risk reduction and strength maximization. Effectively offering such counsel in the absence of a robust understanding of the hopes and dreams, the fears and trials, the potential risks, and the available supports impacting LGBT children and youth is not possible.

This sensitively and thoughtfully organized and written description of the many aspects of sexual orientation and identity and their impact on childhood and adolescence is a must-read for all child–health care providers. I suspect that there is no one who reads this who will not learn from it—and in so doing, become a better pediatrician and/or child–health care provider. Through such enhanced understanding, we can help to normalize what is not a sickness or disability but just a variation within normal maturation and development.