Time and time again, athletes have been notoriously linked to anabolic-androgenic steroid (AAS) use because of the drug’s ability to boost muscle growth and strength. However, illicit steroid use is not only high among athletes but also in gay and bisexual teen boys. According to a recent study published in the journal Pediatrics, gay adolescents abuse steroids at a rate six times higher than their straight counterparts.

Steroids — consisting of any drug or hormonal substance chemically or pharmacologically related to testosterone — are commonly used to increase muscularity to enhance physical performance and appearance. Doses are generally taken orally or injected into the muscle, and abide by a cycle known as either “stack” or “pyramid." Users who stack doses usually take two or more different anabolic steroids, while those who use the pyramid scheme start at a low dose and gradually increase the dose as the cycle progresses. The Palo Alto Medical Foundation says five to 12 percent of all male high school students and one percent of female students have used steroids by the time they are high school seniors.

Now a team of researchers from the Fenway Institute, a Boston health center that treats gays and lesbians, has found this rate is much higher among gay and bisexual teens, possibly showing a link to body image and bullying issues. In the first study of its kind, Dr. Aaron Blashill and Dr. Steven Safren sought to compare the lifetime prevalence of illicit steroid use among gay, bisexual, and straight teen boys, and to conclude possible factors that may explain prevalence differences. Over 17,000 adolescent boys between 14 and 18 years old, from the nationally-represented 2005 and 2007 Youth Risk Behavior Surveys, participated in the study to accurately assess steroid rates among these groups.

The findings revealed 21 percent of gay and bisexual boys, compared to four percent of straight boys, used steroids, meaning they were six times more likely to report a lifetime prevalence of the drug. This group was also found four percent more likely to be heavy steroid users, compared to 0.7 percent of heterosexual boys. The researchers were surprised by the results, although they hypothesized a disparity would exist.

"It's a bit sad that we saw such a large health disparity, especially among the most frequent steroid users,” said Blashill, co-author of the study, The Associated Press reported. "Given the dramatic disparity ... it would seem that this is a population in which greater attention is needed," the authors said. However, other experts like Dr. Rob Garofalo, adolescent medicine chief at Lurie Children's Hospital in Chicago, believe the differences aren’t surprising, because gay youth are known to have body image issues.

The muscle culture that exists among gay males may attribute to what seems like an epidemic in steroid use. The pressure to adhere to the ideal male physique may compel some gay men to increase their muscle mass and, therefore, engage in heavy steroid use. In a study published in the journal Addiction, a team of researchers found one in seven gay gym-going men admitted to having used steroids in the previous 12 months. Moreover, steroid use was linked to being HIV positive, having suicidal thoughts, and feeling depressed.

The National Institute on Drug Abuse says depression, victimization, substance abuse, and self-perceived poor body image associated with bullying, verbal, and physical abuse, are several reasons why people choose to use steroids. An alarmingly high number of teens have been found to abuse this drug in hopes of improving their athletic performance or their appearance. In November, the Food and Drug Administration (FDA) issued a consumer update warning that teens and steroids are “a dangerous combination,” highlight more than a half-million high school boys and girls use steroids.

Teens are faced with a higher risk for health issues that may be permanent since their bodies are still maturing. Side effects of steroids include fertility problems, impotence, high blood pressure and cholesterol, and heart and liver abnormalities, with some cases of damage not reversible. Boys may experience a shrinkage of their testes or development of breast tissue, while girls may experience menstrual irregularities and the development of masculine traits such as facial and body hair, says the FDA. Both genders may also experience acne, mood swings and aggressive behavior with continued steroid use. Physicians may want to discuss steroid use with their teen patients, especially gay males.

Sources:

Blashill AJ and Safren SA. Sexual Orientation and Anabolic-Androgenic Steroids in US Adolescent Boys. Pediatrics. 2014.

Bolding G, Elford J, Sherr L. Use of anabolic steroids and associated health risks among gay men attending London gyms. Addiction. 2004.