It's not clear whether gay and bisexual young men face a higher risk of health problems from the use of these anabolic steroids. Nor do researchers know why they report using steroids more, although there's speculation it's related to trying to look more attractive or to become stronger in case they're physically intimidated.
Whatever the case, "steroid use is very dangerous," said study author Aaron Blashill, a staff psychologist at Massachusetts General Hospital. It adds to a "growing list" of risks like substance abuse and depression that plague gay and bisexual boys in particular, he said.
The new study was published online Feb. 3 and will appear in the March print issue of the journal Pediatrics.
Athletes and bodybuilders use anabolic steroids to build muscle and boost stamina, although their use is illegal without a prescription.
In the study, researchers examined the results of surveys of more than 17,000 boys aged 14 to 18. The surveys were conducted in 2005 and 2007 in 14 cities and small states, including Boston, Chicago, New York City, San Diego, San Francisco and Vermont. Statistics by individual city or state weren't available. Of participants, about 4 percent said they were gay or bisexual.
Of the heterosexual adolescents in the survey, 4 percent said they'd ever used steroids, and less than 1 percent reported using them more than 40 times.
The numbers were much higher for those who said they're gay or bisexual: 21 percent said they'd used steroids, and 4 percent reported using them 40 or more times.
Researchers don't know why they used steroids or whether the adolescents were telling the truth. And the level of risk to the young men isn't clear.
Charles Yesalis, professor emeritus of health policy & administration and kinesiology at Pennsylvania State University, said steroids "are not major killer drugs like amphetamines or heroin, or tobacco for that matter. If you use these drugs at high doses for protracted periods of time, you're putting yourself in harm's way. But I can't classify them as a major killer drug."
However, steroids can lead to a variety of health problems, including breast growth in men and shrinking of testicles, cardiovascular problems, liver disease and aggression, the experts noted.
Study author Blashill speculated that gay and bisexual male adolescents -- whom studies suggest are more concerned with their appearance than their heterosexual counterparts -- might use steroids as a "very extreme way" to look more attractive.
Another expert concurred.
"Generally speaking, the gay male subculture places a greater emphasis on physical appearance than straight men do," said Marla Eisenberg, an associate professor with the department of pediatrics at the University of Minnesota.
However, the study didn't make it clear how many of the adolescents surveyed were out of the closet or were aware of the larger gay culture.
Blashill said the adolescents might be trying to boost their muscles to protect themselves. The findings suggest that steroid use among gay and bisexual adolescents could be higher because they're more likely to be bullied or to feel unsafe.
What to do? Blashill called for more research with an eye toward finding ways to target gay kids for prevention programs.
Visit the U.S. National Library of Medicine for more about anabolic steroids.