I know someone with this placement. He knows that he is gay, but I get the sense that he hates himself. I love this person with all my heart.....as a friend, but man is this a 'karmic' issue with him.
He tried to overdose with pills when he was 18 years old, I intuitively sense that it's because of his sexuality issues.
It's such a hard lesson for him to accept himself. I would never out him, no matter how flamboyant he is.
He also has it conjunct Pluto. Yeah,....
I can agree with that. I have Venus, Saturn, and Pluto in Scorpio.
From the time I hit puberty until I was almost 18 my Mom was constantly telling my sister and I that boys only wanted one thing, not to trust them, they would only use us and get us pregnant. All of her siblings were teen moms, and so were their daughters; she didn't want that for us, but also didn't have the emotional maturity to express it in a healthy way.
Little did she know she was setting my sister and I up for a lot of unhealthy sexual shame to overcome as adults. Once I discovered that and worked through it I went to the other extreme for a while, and made up for lost time.
I have Scorpio Saturn conjunct Pluto and I agree too with the above description. Same education as KayBee930: my parents used to tell me as a child that boys only want sex and I should pay attention not to be used and get pregnant. Plus, as a child I saw some sexual behavior/ gestures that hunted me for many years... I started my sexual life very late... and had to work hard on accepting that my sexual side is also part of who I am.
Thanks, both of you! 
I have Saturn in Scorpio exactly conjunct my Moon. There is a lot of guilt that comes with this Saturn placement when it comes to sexuality whether you're straight or gay. It takes the joy out of sexual pleasure unless you push back against your feelings of guilt for enjoying yourself and being who you are sexually. Dismiss your own negative thoughts. They're crap. You're entitled to be who you are.
You can work through it with the right partner, but also, you need to keep pushing back against the Saturn criticism of your sexuality that you tell yourself that is undermining you. It takes awhile, but once you do that, you can actually make the Saturn aspect your friend.