This paper presents a conceptual formulation, derived from developmental object relations theory and ego psychology, of the passage in male adolescence that culminates with the achievement of a masculine heterosexual identity. Themes of psychosexuality, male gender attributes, masculinity and object preference, and sexual orientation are discussed with reference to the adolescent stage. Finally, the critical tasks, core conflicts, and internalizations of prior developmental stages, as well as the integration that is required of adolescence proper relative to a sexual identity as heterosexual and masculine, are highlighted through an extensive case illustration of an adolescent male with sexual identity confusion.A vast literature exists on the subject of identity confusion in adolescence as does considerable developmental theory to explain the clinical features of these disorders. Identity confusion has been addressed relative to object relations capacities (