The expression of sexual behaviors and lifestyle is a choice for all teenagers, regardless of sexual orientation. This expression is a concern for adolescents in the same way that relationships, intimacy, trust, and competent decision-making are also general concerns. When the gay or lesbian adolescent is given the opportunity to develop within a supportive, nurturing, and accepting environment, the probability of serious mental health issues is no more likely than in the general adolescent population. Contemporary practice in adolescent medicine makes it important that child psychiatrists, pediatricians, and family practitioners are able to deal with some of the primary care concerns surrounding adolescent sexuality such as teenage pregnancy, sexually transmitted diseases, and the fact that there are still a very large number of adolescents who are uneducated in the content arena of sexuality. This Clinical Consultation Breakfast aids the general child psychiatrist and primary care provider to better understand basic principles of how to assess, plan treatment, and provide a supportive medical base for gay, lesbian, bisexual, and transgender youth.