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Anabolic-Androgenic Steroid Misuse Five Times Higher For Gay and Bisexual Boys

Gay or straight, obsessive desire to look better driving half of teenage steroid use, experts say

A new study from The Fenway Institute, a Boston health center for the LGBT community, shows that gay and bisexual boys use anabolic-androgenic steroids (AAS) at rates much higher than their straight counterparts. Teenage steroid user using syringe

Published online in the journal Pediatrics, the study[1] found that 21% of gay and bisexual boys compared to 4% of heterosexual boys used AAS at least once in their lives. Gay and bisexual boys were also much more likely to be heavy users of AAS (4% compared to 0.7% of heterosexual boys).

Previous research suggests that between 1% and 5.9%[2] of adolescent boys have used AAS; however, no known studies have examined the prevalence of AAS use among gay and bisexual boys.

Aaron Blashill, PhD, and Steven Safren, PhD, investigators at The Fenway Institute and psychiatrists at Massachusetts General Hospital, utilized a nationally-representative dataset of 17,250 US adolescent boys ages 14 - 18 years old to assess if there were higher rates of AAS use among gay and bisexual boys compared to heterosexual boys.  The data used was excerpted from a research project being supported by the Center for Population Research in LGBT Health at The Fenway Institute. 

"We hypothesized that a disparity would exist; however, we were rather shocked at the magnitude, with gay and bisexual boys being over 5 times more likely to use AAS compared to heterosexual boys," said Dr. Blashill.

LGBT (lesbian, gay, bisexual and transgender) young people experience bullying, verbal and physical harassment at rates much higher than their straight peers. The Fenway researchers suggested that gay and bisexual boys may be at elevated risk of AAS use due to increased symptoms of depression, victimization, substance use, and poor body image because of their sexual orientation.

"The results are consistent with previous research indicating that AAS misue is strongly associated with a variety of other substances, with substance abuse viewed as a "salient pathway from sexual minority status to AAA misuse," the study says.  While not directly assessed, body dissatisfaction has been shown to be a strong predictor of AAS misuse, with gay males tending to report higher levels of body dissatisfaction compared with their heterosexual counterparts.

"These results underscore yet another avenue in which a health disparity exists for sexual minorities," write Blashill and Safren.

Teen steroid use: only half are athletes

"As parents, we are shocked to learn how many youth are using Appearance and Performance Enhancing Drugs (APEDs)," said Don Hooton, president of the Taylor Hooton Foundation, which he formed after his son, a 16-year-old Texas high school baseball player, died after using anabolic steroids.

"Steroid use goes way beyond the athletic fields and extends to boys and girls that are resorting to these drugs out of an obsessive desire to look beter - to feel better about themselves."  In fact, Hooton said, athletes may now represent only half of today's middle school and high school abusers of APEDs. An estimated 1.5 million middle and high school students admit in recent surveys to using APEDs, Hooton says, which represents 5.9% of boys and 4.6% of girls. "That means that there are as many as 25-45 students using steroids in the average high school in America ... or about one student using anabolic steroids in every high school classroom in America," he said.

"Frankly, I'm not surprised that adults are unaware.  Our kids keep this behavior secret and deny their usage, just like their role models do. And while we focus non-stop attention on the subject whenever an elite athlete is accused of doping, few have focused on the more serious component of this behavior, the fact that so many of our children are using these drugs."

Danger not appreciated

Anabolic-androgenic steroids (testosterone and synthetic derivatives) are substances typically used to increase strength, performance, and muscularity. Unfortunately, chronic use of AAS is associated with poor health outcomes, including cardiovascular, neurological, endocrine, and psychiatric complications.  

"Most young steroid users, straight or gay, have no concept of the dangers of the drugs they are taking," Hooton said. "Many don't realize these are illegal drugs - Schedule III Controlled Substances like Vicodin and hydrocodone. And, most think that the anabolic steroids being sold in the gyms and over the Internet are 'real' steroids that were developed in a pharmaceutical environment and somehow were diverted from a hospital or pharmacy. Nothing could be further from the truth. Virtually all of the "street" steroids that are sold in America originate in China. The raw materials are developed in filthy environments that are not suitable for making anything destined for consumption by animals, let alone human beings. And, they are easily available to our children via the Internet or from a bodybuilder in the local gym."

"These counterfeit steroids carry with them the same risks that the real steroids do: cardiovascular damage, liver problems, stunted growth, gynecomastia (breast growth in boys), testicular atrophy, and much, much more," said Hooton.

1. Blashill AJ, Safren SA. Sexual Orientation and Anabolic-Androgenic Steroids in US Adolescent Boys.  Pediatrics. 2014;133(3):1-7; doi:10.1542/peds.2013-2768 (published online ahead of print, February 3, 2014)

2.  Eisenberg M, Wall M, Neumark-Sztainer D. Muscle-enhancing Behaviors Among Adolescent Girls and Boys.  Pediatrics 2012;130(6). DOI: 10.1542/peds2012-0095)(published online ahead of print)(accessed November 19, 2012)