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. Author manuscript; available in PMC: 2017 Jan 19.
Published in final edited form as: Adolesc Saude. 2015 Jul 1;12(3):53–73.

Table 5.

Recommendations for research on SMY

Recommendations References
Incorporate measures of gender and sexual orientation as well as sexuality-based prejudice in general health surveys: sexual attraction, self-identified gender and sexual orientation, partners’ gender; prejudice based on gender nonconformity and sexual orientation, including among heterosexual youth 18.
Increase the quality of research among SMY: 1) multiply sources of information besides self-report (e.g. parents, friends, teachers, school records). 2) Use multivariate statistics to examine homophobic-based abuse among SMY, including gender and sexual orientation variations within SMY and controlling for potential confounders for homophobia in multivariate analyses, including social desirability. 3) Implement longitudinal design to examine trends in health outcomes and better understand the lives of youth reporting varying types of same-sex attraction unfold over time in relation to their developmental context, such as sexual orientation development among questioning youth, the dynamic of parental acceptance and rejection and its effects throughout adolescents’ development and the relationships between homophobic victimization and school achievement. 4) Develop recruitment strategies for hard to reach SMY. 5) Increase the statistical power for underrepresented subgroups: undisclosed SMY; questioning, mostly heterosexual, non-exclusively heterosexual youth, bisexual, and transidentified youth; racialized groups, including two-spirit, indigenous and first nations, SMY from urban centers, suburb and remote area, SMY in communities as well as clinical settings. 6) Reinforce the design of the qualitative studies to explore the meanings of sexual behavior, intentions, pregnancy experiences among SMY; complex forms of parental reactions. 8; 19; 15; 20; 18; 5; 12; 9; 11; 22; 5; 6.
Better understand the process of coming out in relation to social climate and culture of violence regarding gender and sexual variations in different environments (e.g. urban, suburban, rural and remote area, school), taking into account the social positions that intersect with gender and sexual variations (e.g. race/colonialism, socioeconomic status/classicism, sex/sexism) and factors that predict homophobic bullying (e.g. gender nonconformity). 9; 2; 12.
Document protective and resilience factors among SMY, such as coping strategies (e.g. social support, academic strength, belonging to LGBT associations), reasons why they choose to live and characteristics leading SMY to express their identity in an adverse environment. 8; 19; 6.
Better understand risk or protective factors of health outcomes, such as social support, gay-straight alliance effect; internalized homophobia, concealment of sexual orientation; physical and sexual abuse, discrimination and harassment; variations in sexual orientation and gender identity. 8; 22; 6; 20; 12; 10; 11.
Cover a wider range of issues in surveys among SMY, including pregnancy involvement, suicidality, sexual health behaviors, degree of psychosexual development (e.g. age at first awareness of sexual status, self-identification as SMY, first sexual contact with same-sex partners). 12; 18; 11.
Assess the characteristics and the impact of health services on SMY: barriers in accessing health services; influence of supportive sexual health education; impact of supportive school environment on health disparities for SMY. 8; 18.