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Significance There has long been skepticism among both scientists and laypersons that male bisexual orientation exists. Skeptics have claimed that men who self-identify as bisexual are actually homosexual or heterosexual. (The existence of female bisexuality has been less controversial.) This controversy can be resolved using objective, genital responses of men to male and female erotic stimuli. We combined nearly all available data (from eight previous American, British, and Canadian studies) to form a dataset of more than 500 men, much larger than any previous individual study, and conducted rigorous statistical tests. Results provided compelling evidence that bisexual-identified men tend to show bisexual genital and subjective arousal patterns. Male sexual orientation is expressed on a continuum rather than dichotomously., The question whether some men have a bisexual orientation—that is, whether they are substantially sexually aroused and attracted to both sexes—has remained controversial among both scientists and laypersons. Skeptics believe that male sexual orientation can only be homosexual or heterosexual, and that bisexual identification reflects nonsexual concerns, such as a desire to deemphasize homosexuality. Although most bisexual-identified men report that they are attracted to both men and women, self-report data cannot refute these claims. Patterns of physiological (genital) arousal to male and female erotic stimuli can provide compelling evidence for male sexual orientation. (In contrast, most women provide similar physiological responses to male and female stimuli.) We investigated whether men who self-report bisexual feelings tend to produce bisexual arousal patterns. Prior studies of this issue have been small, used potentially invalid statistical tests, and produced inconsistent findings. We combined nearly all previously published data (from eight previous studies in the United States, United Kingdom, and Canada), yielding a sample of 474 to 588 men (depending on analysis). All participants were cisgender males. Highly robust results showed that bisexual-identified men’s genital and subjective arousal patterns were more bisexual than were those who identified as exclusively heterosexual or homosexual. These findings support the view that male sexual orientation contains a range, from heterosexuality, to bisexuality, to homosexuality.

To critically assess the prevalence, mental health, and heterogeneity of bisexual men and to highlight their inextricable linkage with each other When an inclusive definition of male bisexuality is used, prevalence rates increase from the standard 1 to 2% to a more accurate 10 to 20%. Previously documented physical, mental, and social health deficiencies of bisexual men are likely the result of sampling bias, disregard for sexual orientation domains, especially romantic dimensions, and failure to acknowledge bisexual subgroups (primary, concealed, transient, situational, sensation-seeking, clinical). These oversights, whether intended or not, have profound implications for healthcare providers. To accurately determine the prevalence, mental health, and heterogeneity of bisexual men, future research should investigate various sexual and romantic domains, assume a continuous rather than a categorical approach, acknowledge the diversity of bisexuality by considering types of bisexual men, and study the positive attributes of bisexual men.

Recent evidence suggests it is useful to distinguish sexual identities among young men at the gay end of the spectrum because of group differences between primarily gay, mostly gay and gay orientations on several assessed physiological, behavioural and self-report measures. However, little is known about individuals' rationales for choosing sexuality labels beyond traditional gay or bisexual categories. We addressed this issue by interviewing 24 young men with a non-exclusive gay orientation about their sexual desires and histories, drawing on both qualitative and numeric data. Undertaking an inductive analysis, we found four distinct rationales for identification with a sexual orientation label: sexual, romantic, intellectual and internalised homophobia. By examining what young men mean when they classify themselves as primarily gay, mostly gay or bisexual-leaning gay, this article provides data to understand these issues and proposes that greater focus should be placed on sexual identity for non-exclusive gay men. Although the sexual and affectional components of sexual orientation are meaningful, previous research has not sufficiently accounted for the importance of intellectual, cultural and romantic factors in non-exclusive sexual orientations. To address these issues, the use of in-depth interviews should be incorporated in future studies.

The degree to which bisexual-identified individuals are distinct from either heterosexual or homosexual individuals in their sexual orientation is an ongoing debate. We examined potential differences between these groups with respect to a strong correlate of sexual orientation, gender nonconformity (femininity in males, masculinity in females). Across pooled data, we compared self-reports of childhood gender nonconformity (n = 919) and adulthood gender nonconformity (n = 1265) and observer ratings of adulthood gender nonconformity (n = 915) between sexual orientations. Most analyses suggested a steady increase in gender nonconformity from exclusively heterosexual to exclusively homosexual. However, in some analyses, bisexual men were closer to homosexual men than to heterosexual men in their gender nonconformity. The intermediate status of bisexual people in gender nonconformity was not due to the sample having a mixture of very gender-conforming and very gender-nonconforming individuals. In total, men and women with bisexual orientations appeared neither like heterosexual nor homosexual individuals, at least with respect to their gender-related traits.

Pupil dilation to explicit sexual stimuli (footage of naked and aroused men or women) can elicit sex and sexual orientation differences in sexual response. If similar patterns were replicated with non-explicit sexual stimuli (footage of dressed men and women), then pupil dilation could be indicative of automatic sexual response in fully noninvasive designs. We examined this in 325 men and women with varied sexual orientations to determine whether dilation patterns to non-explicit sexual stimuli resembled those to explicit sexual stimuli depicting the same sex or other sex. Sexual orientation differences in pupil dilation to non-explicit sexual stimuli mirrored those to explicit sexual stimuli. However, the relationship of dilation to non-explicit sexual stimuli with dilation to corresponding explicit sexual stimuli was modest, and effect magnitudes were smaller with non-explicit sexual stimuli than explicit sexual stimuli. The prediction that sexual orientation differences in pupil dilation are larger in men than in women was confirmed with explicit sexual stimuli but not with non-explicit sexual stimuli.

Lesbian, gay, and bisexual (LGB) young people experience a variety of developmental trajectories that consist of milestones, the sequence and timing of which differ across individuals. They include early feelings of being different from peers, the onset of same-sex attraction, questioning one's sexuality, first same-sex sexual experience, recognition and self-labelling, disclosure to others, first romantic relationship, and self-acceptance. The invention of 'gay youth' during the 1970s and 1980s is briefly reviewed with an emphasis on the ways in which the portrait created by early research fails to capture the developmental trajectories of millennial young people. Although some young people struggle with mental health problems as they navigate these milestones, research documents the complexity, variety, and normative nature of the vast majority of LGB young people. A growing chorus of developmental, behavioural, and social scientists now emphasize that many contemporary young people forego sexual confusion, recognize the sex or gender to which they are attracted to and love, and believe they are as mentally healthy as heterosexual young people.

Sexual orientation is typically assumed to be independent of factors such as personality. Although this is probably accurate for heterosexual and homosexual orientations, personality may play a role in bisexuality. It was hypothesized that bisexuality is potentiated by personality traits that allow sexual behavior to occur independently of sexual response systems that are specifically “oriented” to male or female sexual stimuli. If so, such traits should be elevated in bisexual women and men. Because female sexual response is relatively independent of the sex of the partner it was also hypothesized that such relationships would be stronger for bisexual women than bisexual men. This was tested in two online studies. Study 1 ( N = 828) tested for elevated levels of two relevant personality traits; sexual sensation seeking and sexual excitability. Study 2 ( N = 655) assessed sexual curiosity, and tested whether the relationship between sexual curiosity and bisexuality was independent of the Big Five. Elevated levels of sexual sensation seeking and sexual curiosity were found for bisexual women and men; only bisexual women reported elevated levels of sexual excitability. The predicted sex difference was found for each trait, and sexual curiosity was elevated independently of the Big Five.

We reviewed empirical evidence regarding whether mostly heterosexual exists as a sexual orientation distinct from two adjacent groups on a sexual continuum—exclusively heterosexual and substantially bisexual. We addressed the question: Do mostly heterosexuals show a unique profile of sexual and romantic characteristics that distinguishes them as a separate sexual orientation group? We found sufficient data in four areas to support an affirmative answer. Individuals who acknowledged a mostly heterosexual orientation were distinct from adjacent sexual orientation groups in having a small degree of same-sex sexual and/or romantic attraction and, occasionally, same-sex behavior; constituted a substantial prevalence in the population; were relatively stable in their orientation over time; and reported that this sexual identity was subjectively meaningful to them. Findings suggested that self-identification as mostly heterosexual or an acknowledgment of slight same-sex sexuality increases during the teenage years, peaks around the early twenties (somewhat sooner for men than women), and remains relatively high during young adulthood. Limited evidence suggested that prevalence is lower among older participants. These findings have implications for our conceptualization of sexual orientation as a continuum, the nature of sex differences in sexuality, developmental changes in sexuality, biologically based assessments of sexual orientation, and an etiological theory of mostly heterosexuality.

This exploratory study assessed physiological, behavioral, and self-report measures of sexual and romantic indicators of sexual orientation identities among young men (mean age = 21.9 years) with predominant same-sex sexual and romantic interests: those who described themselves as bisexual leaning gay (n = 11), mostly gay (n = 17), and gay (n = 47). Although they were not significantly distinguishable based on physiological (pupil dilation) responses to nude stimuli, on behavioral and self-report measures a descending linear trend toward the less preferred sex (female) was significant regarding sexual attraction, fantasy, genital contact, infatuation, romantic relationship, sex appeal, and gazing time to the porn stimuli. Results supported a continuum of sexuality with distinct subgroups only for the self-report measure of sexual attraction. The other behavioral and self-report measures followed the same trend but did not significantly differ between the bisexual leaning gay and mostly gay groups, likely the result of small sample size. Results suggest that romantic indicators are as good as sexual measures in assessing sexual orientation and that a succession of logically following groups from bisexual leaning gay, mostly gay, to gay. Whether these three groups are discrete or overlapping needs further research.

Currently, little is known about heterosexually identified individuals who nonetheless acknowledge same-sex interests. To address this shortcoming, the prevalence of same-sex attractions, fantasies, and experiences among heterosexually identified college students was examined, as well as differences between those who are exclusively heterosexual in their interests and those who are nonexclusive because they report some same-sex attractions or fantasies. Students (N = 243) at a large, Northeastern university completed an online survey providing information about their sexual orientation identity; same- and other-sex attractions, fantasies, and behaviors; and demographic, sexual history, and sexual attitudes variables. Compared to exclusive heterosexual women, nonexclusive women were more liberal in their political and sexual attitudes and had greater sexual experience. Nonexclusive men were virtually indistinguishable from exclusive heterosexual peers on assessed variables. Results are discussed in terms of implications for the nature and meaning of non-heterosexuality in contemporary Western society.

Studies with volunteers in sexual arousal experiments suggest that women are, on average, physiologically sexually aroused to both male and female sexual stimuli. Lesbians are the exception because they tend to be more aroused to their preferred sex than the other sex, a pattern typically seen in men. A separate research line suggests that lesbians are, on average, more masculine than straight women in their nonsexual behaviors and characteristics. Hence, a common influence could affect the expression of male-typical sexual and nonsexual traits in some women. By integrating these research programs, we tested the hypothesis that male-typical sexual arousal of lesbians relates to their nonsexual masculinity. Moreover, the most masculine-behaving lesbians, in particular, could show the most male-typical sexual responses. Across combined data, Study 1 examined these patterns in women's genital arousal and self-reports of masculine and feminine behaviors. Study 2 examined these patterns with another measure of sexual arousal, pupil dilation to sexual stimuli, and with observer-rated masculinity-femininity in addition to self-reported masculinity-femininity. Although both studies confirmed that lesbians were more male-typical in their sexual arousal and nonsexual characteristics, on average, there were no indications that these 2 patterns were in any way connected. Thus, women's sexual responses and nonsexual traits might be masculinized by independent factors. (PsycINFO Database Record

This is a rebuttal of David M. Hall's review in which he misrepresents the contents of my book, The New Gay Teenager. Only the worst of his distortions are highlighted; this is not a point-by-point refutation. A restatement of the book's true themes concludes this response. Same-sex attracted youth can be healthy, resilient, proud, and ordinary adolescents and many choose to base their personal identity on aspects of their lives other than their sexuality.

Using 6-year longitudinal data from the National Longitudinal Survey of Adolescent Health (Add Health) and multiple measures of puberty as it occurs and of sexual orientation (romantic attraction, sexual identity), the present study attempted to replicate previous research which reported that homosexuals and heterosexuals differed in their age of pubertal onset. The study hypotheses were not confirmed for either males or females: on most pubertal measures, same-sex oriented groupings did not differ from heterosexuals. The only significant findings regarding homosexual males indicated that they were more likely to report having a later rather than an earlier onset of puberty, and the significant findings regarding homosexual females were contradictory--they tended to have an earlier onset of puberty. These findings are attributed to methodological improvements in the present study that reduced retrospective bias, used multiple indicators of sexual orientation and puberty timing, and assessed less eroticized measures of puberty.

To answer the question “Who's gay?”—and its logical follow-up, “Does it matter?”—researchers usually define homosexuality with reference to one of three components or expressions of sexual orientation: sexual/romantic attraction or arousal, sexual behavior, and sexual identity. Yet, the three components are imperfectly correlated and inconsistently predictive of each other, resulting in dissimilar conclusions regarding the number and nature of homosexual populations. Depending on which component is assessed, the prevalence rate of homosexuality in the general population ranges from 1 to 21%. When investigators define the homosexual population based on same-sex behavior or identity, they enhance the possibility of finding a biological basis for homosexuality and a compromised mental health (suicidality).

The study examined mental health outcomes for samesex attracted youth with a Christian background based on their differential internalization of attitudes toward homosexuality and gay issues that are socialized by most major Christian denominations. Data from 339 young men and 56 young women ages 13–25 who participated in the OutProud/Oasis Internet Survey of Queer and Questioning Youth were analyzed. In comparison to those who reported “no conflict” between their religious and sexual identities, youth who did not adopt a lesbian/gay/bisexual identity and believed change in sexual orientation is possible had higher internalized homophobia. Those who left Christianity and had difficulty believing God loves them had both higher internalized homophobia and poorer mental health. Responses from youth who resolved or ignored the conflict were not significantly different from those who experienced no conflict.

A review of over 60 studies published from 1994 to 2012, covering 26 different samples from Australia, Canada, New Zealand, Norway, the United Kingdom, and the United States that included sufficient data for participants to be designated as mostly heterosexual (Kinsey 1s) concluded that such individuals showauniqueprofileof sexualandromanticcharacteristics that differentiate them as a distinctive sexual orientation (SavinWilliams & Vrangalova, in press). Mostly heterosexuals differed from two adjacent groups, exclusively heterosexuals and substantiallybisexuals, in reportingasmalldegreeofsame-sex sexual and/or romantic attraction, fantasies, and, occasionally, same-sex behavior. In addition, they constituted a substantial prevalence in the general population (the second most prevalent sexual orientation group, claimed by a mean of 7.6–9.5 % women and 3.6–4.1 % men), were relatively stable in their orientation over time, and felt that this sexuality was valid and meaningful to them. Onerecommendation fromthis reviewwas toassess whether a mostly heterosexual orientation is reflected in physiological sexual arousal—withspecificbenefitsaccrued if theanswerwas affirmative. Because all previous investigations of mostly heterosexuals have been based on self-report, an important question has not been addressed: Is a mostly heterosexualorientation basedonsubjective reportsof sexualandromanticattraction, fantasy, behavior, and identity manifested in physiological sexual responses? Given the general relationship between self-report andphysiologicalassessmentsofsexualorientation, it isexpected that the two would be congruent among most men. That is, unlike for many women, self-reported sexual orientation is usually strongly reflected in men’s sexual arousal (Bailey, 2009; Chivers, Seto, Lalumiere, Laan, & Grimbos, 2010). Reviewing physiological sexual arousal studies, we found that only a few includedmostly heterosexuals in their samples and none provided a separate analysis of this group. However, mostly heterosexual patterns of arousal were apparent among some heterosexual men. For example, one genital arousal study concluded that most men‘‘may possess a certain capacity for bisexual arousal’’ (Rieger, Chivers, & Bailey, 2005, p. 582); some heterosexual men showed an arousal pattern that can be interpreted as mostly heterosexual, with major arousal toward women and slight arousal toward men. Although an fMRI study scanned self-identified heterosexual and homosexual men, heterosexuals had‘‘exclusive or nearly exclusive sexual activity and feelings’’ for women (Safron et al., 2007, p. 23, emphasis added). A large majority of men show sexual arousal patterns consistentwith their self-reported sexualorientation (Bailey,2009). Thus, we expected that mostly heterosexual men would have considerable physiological sexual responses to females, similar to heterosexual men, and, in addition, some sexual response to males, more so than exclusively heterosexual men but less so than bisexual leaning heterosexual men. We had access to two previously published datasets from separate research programs that allowed us to test this congruence (for research design details, see Rieger & Savin-Williams, 2012; Rosenthal, Sylva, Safron, & Bailey, 2011, 2012). In thefirst study,dataassessing102men’spenile tumescence to erotic stimuli were collected with a focus on three groups: heterosexual, bisexual, and homosexual men (Rosenthal et al., 2011, 2012). This research included data on self-reported sexual attraction that allowed us to compare mostly heterosexuals to other men in their genital arousal patterns. R. C. Savin-Williams (&) G. Rieger Sex & Gender Lab, Department of Human Development, Cornell University, Ithaca, NY 14853, USA e-mail: savin-williams@cornell.edu

To adequately understand the diversity of child and adolescent homoeroticism, a differential developmental trajectories perspective is proposed that integrates recent research about the development of sexual orientation, sexual behavior, and sexual identity. Only the latter two can be altered therapeutically. Biologic theories of homosexuality are reviewed. Homoerotic youth are shown to be similar and dissimilar to heterosexual youth; more variability occurs within than among sexual orientation groups. Contemporary homoerotic youth recognize their sexuality, self-label, and accept their sexuality at earlier ages than previous generations and many are rejecting traditional identity labels. Clinical recommendations offer ways to assess sexual orientation and help patients to achieve acceptance of their sexuality.

Researchers disagree on how to assess adolescent sexual orientation. The relative importance of various dimensions (e.g. attraction, relationships, behavior, self-labeling) is unknown, which calls into question the validity of studies assessing adolescent sexual orientation. To address this issue, 50 male and female adolescents of varied sexual orientations participated in focus groups and interviews. Two types of sexual attraction-one a physiologic reaction and the other a cognitive response-were central to adolescent sexual orientation. Participants did not perceive sexual behavior and self-identification as necessarily relevant. Preliminary items to measure sexual attraction were developed based on these adolescents' perceptions.