Gender Differences in Sexual Well-Being and Sexual Identity Development among Youth Formerly in the Foster Care System in the United States


Little research has heretofore examined differences in the sexual well-being and sexual health outcomes between female and male youth in the foster care system. This cross-sectional study examined these differences and as well as how sexual identity development impacts sexual well-being using a sample of 217 youth formerly in the foster care system. It found that females have lower levels of overall sexual well-being, lower scores on several components of sexual well-being, and more negative sexual health outcomes than males. The four domains of sexual identity development explored all predicted overall sexual well-being for both females and males, with a pronounced negative impact of being a gay male. These results support the importance of sexual identity development and indicate that the sexual health needs of females within the foster care system are not being addressed as well as those of their male counterparts. To address these discrepancies professionals and caregivers working with youth in the foster care system need to be attuned to the specific needs of female youth and work to address these needs in a manner that considers their gender.

1. Introduction

Adolescence is a period when youth begin to solidify the beliefs, norms, and values that will become core components of their identities. While this process can be difficult for many youth, trauma experiences such as involvement with the child welfare system (CWS) or being placed into the foster care system (FCS) can inhibit the development of coherent identities, which can contribute to later difficulties with physical, social, and emotional functioning . Identity theory suggests that while individuals can be perceived as having a global identity of sorts, every person is really a collection of smaller identities that are continually in flux. At a given time, any specific identity may become more or less salient depending on the individual’s experiences or needs.

One identity that often becomes particularly salient during adolescence is youths’ sexual identity. While the phrase “sexual identity” is often conflated with “sexual orientation,” sexual identity is a larger concept that incorporates all aspects of individuals’ lives related to sex and sexuality. This can include their sexual desires, beliefs, actions (both individually and with others), and norms, as well as their sexual health and well-being. For many, sexual identity also includes related areas such as romantic desires, values, and actions, though these can be separate for some individuals. It can also incorporate aspects of gender due to interactions between gender, sex, and sexuality. Thus, while for many their sexual orientation is an important component of their sexual identity, it is only one piece.

The importance of understanding youths’ sexual identity development extends beyond just sexuality. Aspects of sexual identity development can influence all areas of youths’ lives, including their physical health, interpersonal relationships and interaction patterns, emotional well-being, and, of course, their sexual well-being. Yet youths’ sexual identity development often receives little attention, especially when the youth are forced to focus on areas such as having their basic needs met.

While there has been some movement toward recognizing the importance of sexual identity development and an emphasis on helping youth within the CWS as they explore and develop their sexual identities, a better understanding of how aspects of youths’ lives impact their sexual identity development and sexual health and well-being is needed. More specifically, despite the complexity of interactions between gender and sexuality, there is a dearth of research that has examined differences in the sexual well-being and sexual health outcomes between female and male youth. In fact, as discussed more below, no research was identified that looked at gender-based differences in multiple aspects of sexual well-being among youth within the United States using a single sample.

To begin to address this gap, this study examined differences in sexual identity development, sexual well-being, and sexual health outcomes between female and male youth who were formerly in the FCS. Recognizing the complexity of gender and gender labels, the terms “male” and “female” are used throughout this article as these were the term options selected by the participants. Understanding differences in the impact of sexual identity development and in sexual well-being between these groups will allow for more targeted interventions to assist youth within the CWS with their sexual identity development, which can then positively impact other areas of the youths’ lives.


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