In 1974, the American Psychiatric Association ended its classification of homosexuality as a mental disorder, labeling it rather as an alternate choice of sexual expression. This decision was based on the beliefs of the majority that there were insufficient data to label such individuals as being ill and that the deleterious social consequences of the pathologic designation were so grievous as to demand the declassification.1

Although theories regarding the etiology of homosexuality have been based on genetic, hormonal, psychological, and environmental models, there is little reason to believe that any one of the arguments alone explains all homosexual orientation or behavior.2 Homosexuality has existed in most societies for as long as recorded descriptions of sexual beliefs and practices have been available. Although little agreement exists concerning the etiology of homosexuality, and any definition of terms will be arbitrary, some operational definitions are necessary (Table).3

Four assertions can be made regarding homosexuality during the teenage years:

1. Some homosexual experimental behavior is experienced by many adolescents. This may include fondling of the body or genitalia or mutual masturbation. In the vast majority of cases these homosexual encounters do not predispose to later obligatory homosexuality, but appear to be a common exploratory behavior en route to conventional heterosexual development.

2. Homosexual4 characteristics appear to be established before adolescence. Although many individuals do not participate in overt homosexual play during childhood, the self-conscious psychological state probably often exists before adolescence.

3. Some previously heterosexually oriented adolescents will become involved in homosexual activities if circumstances reinforce this behavior or if heterosexual alternatives are not available.

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