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An appreciation for the aforementioned predictors of conversion will allow appropriate planning by the patient, the institution, and the surgeon.

Sexual minority adolescents who attended school reported higher HIV risk behaviors, and higher prevalence of sexual victimization may partially explain these risks.

Objectives-We compared protective factors among bisexual adolescents with those of heterosexual, mostly heterosexual, and gay or lesbian adolescents.Methods-We analyzed 6 school-based surveys in Minnesota and British Columbia. Sexual orientation was measured by gender of sexual partners, attraction, or self-labeling. Protective factors included family connectedness, school connectedness, and religious involvement. General linear models, conducted separately by gender and adjusted for age, tested differences between orientation groups.Results-Bisexual adolescents reported significantly less family and school connectedness than did heterosexual and mostly heterosexual adolescents and higher or similar levels of religious involvement. In surveys that measured orientation by self-labeling or attraction, levels of protective factors were generally higher among bisexual than among gay and lesbian respondents. Adolescents with sexual partners of both genders reported levels of protective factors lower than or similar to those of adolescents with same-gender partners.Conclusions-Bisexual adolescents had lower levels of most protective factors than did heterosexual adolescents, which may help explain their higher prevalence of risky behavior. Social connectedness should be monitored by including questions about protective factors in youth health surveys.Adolescence is a key developmental period with long-term effects on physical and psychological health, and adolescents negotiate a variety of environmental challenges during these years. Although public health practice often focuses on preventing or decreasing health risks, in the past decade increasing attention has been paid to identifying protective factors that can foster healthy development. Protective factors are events, circumstances, and life Requests for reprints should be sent to Elizabeth M. Saewyc, University of British Columbia School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada (e-mail: saewyc@interchange.ubc.ca). Contributors E. M. Saewyc originated the study, supervised all aspects of implementation, and led the development of the article, including revising the final draft. Y. Homma contributed to literature review and analyses, and wrote several drafts of the article. C. L. Skay guided the statistical analyses and psychometric evaluation of the measures and edited the article. L. H. Bearinger and M. D. Resnick helped create many of the original protective factor measures and contributed to conceptualization of the study and to the analytic strategies and interpretation. E. Reis assisted with the interpretation of the analyses. All authors helped to conceptualize ideas, interpreted findings, and reviewed drafts of the article. Human Participant ProtectionThe institutional review board of the University of Minnesota reviewed and approved this study, as did the behavioral research ethics board of the University of British Columbia. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2010 ...