Sexual orientation

Sexual orientation is a person's pattern of emotional, romantic or sexual attraction to other people, or the lack of it. It isn't a choice or an illness: it is part of human diversity. WHO removed homosexuality from its classification of diseases in 1990.

What sexual orientation is

WHO and the American Psychological Association (APA) agree that sexual orientation has three aspects, which don't always line up:

• Attraction: who you desire or fall for.
• Behaviour: who you have relationships with.
• Identity: how you describe yourself.

Someone may be attracted to people of more than one gender without ever acting on it, or be in a long-term relationship with one person and identify in a different way. According to WHO, orientation can stay the same or change over a lifetime.

The most common orientations

• Heterosexual: attraction to people of another gender.
• Gay or lesbian: attraction to people of the same gender.
• Bisexual: attraction to more than one gender.
• Pansexual: attraction in which the other person's gender isn't a deciding factor.
• Asexual: little or no sexual attraction. Many asexual people do feel romantic attraction and have partners.

Labels help people understand each other; they aren't boxes. The person best placed to name their orientation is the person themselves.

How many people are LGB+

Figures depend on how the question is asked and how safe it is to answer honestly in each country. In England and Wales, the Office for National Statistics (ONS) Census 2021 found that 3.2% of people aged 16 and over, around 1.5 million, identified as gay or lesbian (1.5%), bisexual (1.3%) or another non-heterosexual orientation (0.3%). A further 7.5% chose not to answer, a reminder that these figures are estimates.

How orientation develops

The APA explains that there is no scientific consensus on why someone has a particular orientation. Genetic, hormonal, developmental, social and cultural factors have all been studied, and none of them alone determines it. What we do know:

• The core attractions usually emerge between middle childhood and early adolescence.
• They can appear without any prior sexual experience.
• There is no evidence that parenting style, trauma or other people's influence causes it.

Talking about diversity at school doesn't change anyone's orientation. It does help make adolescence safer, as we explain in sex education in adolescence.

Sexual orientation and gender identity are different

• Sexual orientation: who you are attracted to.
• Gender identity: the gender you identify with.
• Sex assigned at birth: the category recorded on the basis of biological sex.
• Gender expression: how you show your gender outwardly.

They are independent: knowing one tells you nothing about the others. A trans person can have any orientation, just like a cisgender person.

Common myths

• "It's a trend or a phase": sexual diversity is documented in every era and culture. More people naming it today doesn't mean there are more.
• "Therapy can change it": there is no reliable research showing that "conversion therapy" works or is safe. WHO calls these practices unscientific and harmful. Spain banned them in 2023, even with the person's consent, and France in 2022.
• "You can tell by looking": appearance says nothing about orientation.
• "Bisexuality is indecision": it is an orientation in its own right, as the APA and WHO recognise. In the 2021 Census for England and Wales, 1.3% of adults identified as bisexual.

Health and well-being

Orientation itself doesn't cause health problems; stigma does. According to WHO, lesbian, gay and bisexual people have 1.5 times the rates of suicide attempts, depression and anxiety of their heterosexual peers. LGBTI people are two to three times more likely to report long-lasting emotional problems. The cause is rejection and discrimination, including in healthcare. Support from family, school and the law is protective: respect for diversity is part of sexual rights.

If someone comes out to you, or you're unsure

• Listen and thank them for trusting you. You don't need to have all the answers.
• Don't tell others without permission: who to tell is their decision.
• If you're unsure about your own orientation, there's no need to decide in a hurry.
• If you feel very low, talk to your GP. If you are thinking about harming yourself, call Samaritans free on 116 123, any time, or 999 in an emergency.