Anabolic steroids have been known to change the game in professional athletics, but little is known about the use of steroids for in the social context. A recent study published in the journal Pediatrics suggests that gay and bisexual adolescent boys are five to six times more likely to use anabolic-androgenic steroids than heterosexual adolescent boys.

Anabolic-androgenic steroids synthetic versions of the male hormone testosterone. Steroids promote muscle growth, strength and endurance. The side effects are detrimental and include heart and liver problems, high blood pressure, acne and aggressive behavior. Teen, especially, face an intensified risk for problems that may be permanent, according to the Food and Drug Administration. Steroids are legally available only by prescription.

Researchers Aaron Blashill and Steven Safren, both associated with the Massachusetts General Hospital and Harvard Medical School, were stunned at how much more steroid use affects sexual minorities.

Though the researchers are still debating on the reason for these differences, they said it’s possible that gay and bisexual teens feel more pressure to bulk up in order to fit the “ideal” male physique or to defend themselves against bullies.

Researchers analyzed government surveys from 17,250 adolescent boys who were from different 14 jurisdictions around the United States. The data collected were surveyed from 2005 and 2007. Of the participants, 635 were classified as “sexual minorities” centered on their answers to questions with sexual identity, attraction, and behavior. Transgender identity was not asked in this study.

In the surveys, participants were asked the amount of times taking steroid pills or shots without a physician’s prescription, and questions regarding depression and suicidal thoughts. Also, the participants answered questions in reference to substance abuse and victimization. Asthma was asked because some steroids are used as treatment for asthma. 

The researchers found that 21 percent of adolescent boys who were classified as sexual minorities abused anabolic-androgenic steroids at some point of their lives, compared to four percent of heterosexual boys. Boys who were sexual minorities also had a greater likelihood of experiencing depression, suicidal thoughts, victimization, and substance abuse. Blashill considers that body image issues could explain the link between steroid misuse and sexual orientation, but the study did not directly study views of body image.

Having symptoms of depression or having been victimized does not automatically mean it drives people to use anabolic-androgenic steroids. This is a correlational study. Also, the study did not address the drug use pattern in rural vs. urban settings.

Lastly, a possible design flaw could be that participants answered questions about using "steroids" without a prescription, not "anabolic-androgenic steroids," could have been thinking about corticosteroids. Corticosteroids are drugs resembling cortisol, a hormone produced by the adrenal glands, not testosterone.

This study hopes to raise awareness of steroid use due to body image concerns. "If we know that a boy has body image concerns, then we definitely should be assessing what sort of behaviors he might be engaged in, in response to that dissatisfaction," Blashill said. 

Additional Resource:

Sexual Orientation and Anabolic-Androgenic Steroids in US Adolescent Boys