The semantic confusion in the use of the terms sexual and gender identity and role is discussed. Theories concerning the development of the sense of sexual identity in normals have been based largely on the sense of sexual identity in sexually deviant subjects. It is suggested that such subjects may have a stronger and more consistent sense of sexual identity than subjects unaware of sexually deviant impulses. Male medical students in two consecutive years anonymously completed a questionnaire concerning their sexual orientation, preference, role, and identity. In both years, students aware of a homosexual component answered the items investigating their sexual identity with greater consistency than did the students unaware of a homosexual component.