or vinyl gloves and lubricant for any manual sex that might cause bleeding. Mental When it was first described in medical literature, homosexuality was often approached from a view that sought to find an inherent psychopathology as its root cause. Much literature on mental health and homosexual patients centered on their depression, substance abuse, and suicide. Although these issues exist among people who are non-heterosexual, discussion about their causes shifted after homosexuality was removed from the Diagnostic and Statistical Manual (DSM) in 1973. Instead, social ostracism, legal discrimination, internalization of negative stereotypes, and limited support structures indicate factors homosexual people face in Western societies that often adversely affect their mental health. Stigma, prejudice, and discrimination stemming from negative societal attitudes toward homosexuality lead to a higher prevalence of mental health disorders among lesbians, gay men, and bisexuals compared to their heterosexual peers. Evidence indicates that the liberalization of these attitudes over the 1990s through the 2010s is associated with a decrease in such mental health risks among younger LGBT people. Gay and lesbian youth Gay and lesbian youth bear an increased risk of suicide, substance abuse, school problems, and isolation because of a "hostile and condemning environment, verbal and physical abuse, rejection and isolation from family and peers". Further, LGBT youths are more likely to report psychological and physical abuse by parents or caretakers, and more sexual abuse. Suggested reasons for this disparity are that (1) LGBT youths may be specifically targeted on the basis of their perceived sexual orientation or gender non-conforming appearance, and (2) that "risk factors associated with sexual minority status, including discrimination, invisibility, and rejection by family members...may lead to an increase in behaviors that are associated with risk for victimization, such as substance abuse, sex with multiple partners, or running away from home as a teenager." A 2008 study showed a correlation between the degree of rejecting behavior by parents of LGB adolescents and negative health problems in the teenagers studied: Crisis centers in larger cities and information sites on the Internet have arisen to help youth and adults. The Trevor Project, a suicide prevention helpline for gay youth, was established following the 1998 airing on HBO of the Academy Award winning short film Trevor. Law and politics Legality Most nations do not prohibit consensual sex between unrelated persons above the local age of consent. Some jurisdictions further recognize identical rights, protections, and privileges for