Childhood and adulthood there was a shifting in

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childhood and adulthood, there was a shifting in sexual identity over the course of follow-up for some participants (e.g., one male identified as heterosexual at age 15, bisexual at age 16, and homosexual at age 20). We do not know, however, what factors contributed to the change in reported sexual identity. It is unclear, for example, if this shift represented a bona fide change in the participants’ sexual identity or whether there may have been other factors, such as social desirability, which rendered the participant unwilling to disclose their homosexual sexual identity as the earlier assessment conducted when he was 15-years-old. 49 “Coming out” is the process of sexual o rientation identity development for gay, lesbian, and bisexual individuals and is sometimes used synonymously with the disclosure of sexual identity to others (e.g., Heatherington & Lavner, 2008). While there is individual variation, stage theories suggest that the process generally begins with awareness of same-sex attraction, followed by same-sex, and sometimes opposite-sex, sexual experience and gradual acceptance and integration of a gay/lesbian/bisexual identity. Coming out is generally thought to culminate with disclosure (Floyd & Bakeman, 2006; Martin, 1991; McDonald, 1982).
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173 4.4.3 Multiple Long-term Psychosexual Outcomes for Boys with GID With gender identity and sexual orientation outcomes combined, there were diverse developmental outcomes for boys with GID, three of which were primary: (1) persistence of
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