Sexual intercourse, abuse and pregnancy among adolescent women: Does sexual orientation make a difference?

Context: Although a limited amount of research has retrospectively explored the childhood and adolescent heterosexual experiences of lesbians, little is known about the prevalence of heterosexual behavior and related risk fac tors or about pregnancy histories among lesbian and bisexual teenagers. Methods: A secondary analysis was conducted using responses from a subsampl e of 3,816 students who completed the 1987 Minnesota Adolescent Health Surv ey. Behaviors, risk factors and pregnancy histories were compared among ado lescents who identified themselves as lesbian or bisexual, as unsure of the ir sexual orientation and as heterosexual. Results: Overall, bisexual or lesbian respondents were about as likely as h eterosexual women ever to have had intercourse (33% and 29%, respectively), but they had a significantly higher prevalence of pregnancy (12%) and phys ical or sexual abuse (19-22%) than heterosexual or unsure adolescents. Amon g sexually experienced respondents, bisexual or lesbian and heterosexual wo men reported greater use of ineffective contraceptives (12-15% of those who used a method) than unsure adolescents (9%); bisexual or lesbian responden ts were the most likely to have frequent intercourse (22%, compared with 15 -17% of the other groups). In the sample overall, among those who were sexu ally experienced and among those who had ever been pregnant, bisexual or le sbian women were the most likely to have engaged in prostitution during the previous year. Conclusions: Providers of reproductive health care and family planning serv ices should not assume that pregnant teenagers are heterosexual or that ado lescents who say they are bisexual, lesbian or unsure of their sexual orien tation are not in need of family planning counseling. Further research shou ld explore the interactions between adolescent sexual identify development and sexual risk behaviors.