This chapter focuses on a rarely-explored issue. Most people who think of adolescent pregnancy, assumes it is an issue exclusively among heterosexual youth. After all, pregnancy during the teen years usually requires penile–vaginal intercourse; there are no known countries where clinicians will provide artificial insemination to adolescents wishing to become pregnant, as adult lesbian women may do. After thinking about it, people might also consider bisexual adolescents to be at risk for teen pregnancy, because they could have opposite-sex partners, but gay and lesbian teens? A growing body of evidence suggests that not only do some lesbian, gay, bisexual, transgendered, and questioning (LGB) adolescents become pregnant or get someone pregnant, they are actually at higher risk for pregnancy involvement than their heterosexual peers. This chapter will review the global evidence of this higher risk for teen pregnancy, explore possible reasons for this risk among sexual minority young people, and whether this also translates to higher rates of teen parenthood among LGB teens. At the same time, the chapter will suggest some reasons that this has been a relatively hidden issue in adolescent reproductive health, what research is still needed, and what it means for teen pregnancy prevention efforts.
The first population-based evidence for higher rates of teen pregnancy involvement among sexual minority youth comes from the Midwestern United States in 1986, when a Minnesota statewide adolescent health survey of students in high school included a question about sexual orientation, attraction, and identity. An analysis of teen pregnancy by sexual orientation among girls in the survey found that girls who identified as lesbian or bisexual were twice as likely to report having been pregnant than girls who identified as exclusively heterosexual.