For the first time, researchers have established a clear link between accepting family attitudes and behaviors towards their lesbian, gay, bisexual and transgender (LGBT) children and significantly decreased risk and better overall health in adulthood. The study shows that specific parental and caregiver behaviors -- such as advocating for their children when they are mistreated because of their LGBT identity or supporting their gender expression -- protect against depression, substance abuse, suicidal thoughts and suicide attempts in early adulthood. In addition, LGBT youth with highly accepting families have significantly higher levels of self-esteem and social support in young adulthood.
The study is published in the Journal of Child and Adolescent Psychiatric Nursing.
Despite all the recent attention to health risks and disparities for lesbian, gay and bisexual youth, prior to this study, little was known about how families express acceptance and support for their LGBT children. Moreover, no prior research had examined the relationship between family acceptance of LGBT adolescents and health and mental health concerns in emerging adulthood.
"At a time when the media and families are becoming acutely aware of the risk that many LGBT youth experience, our findings that family acceptance protects against suicidal thoughts and behaviors, depression and substance abuse offer a gateway to hope for LGBT youth and families that struggle with how to balance deeply held religious and personal values with love for their LGBT children," said Dr. Caitlin Ryan, PhD, Director of the Family Acceptance Project at San Francisco State University. "I have worked on LGBT health and mental health for 35 years and putting our research into practice by developing a new model to help diverse families support their LGBT children is the most hopeful work I've ever done."
Ann P. Haas, Ph.D., Director of Prevention Projects for the American Foundation for Suicide Prevention, noted, "With this new groundbreaking study, Ryan and her colleagues have provided the strongest evidence to date that acceptance and support from parents and caregivers promote well-being among LGBT youth and help protect them from depression and suicidal behavior. These findings open the door to a whole new focus on how families can be helped to more fully engage in the kind of behaviors that reduce suicide risk in LGBT adolescents and young adults."
"Times have changed," said Stephen Russell, PhD, President Elect of the Society for Research on Adolescence and a consultant to the Family Acceptance Project. "More and more families want to be accepting of their children. Yet, many families still struggle when a child comes out as LGBT. It's essential to have research like this to deeply understand the ways that families show their acceptance, so that we can identify how to support families."
The study, authored by Dr. Caitlin Ryan and her team from the Family Acceptance Project, which shows that accepting behaviors of parents and caregivers towards their LGBT children are protective against mental health risks -- including suicidal behaviors -- has critical implications for changing how families relate to their LGBT children and how LGBT youth are served by a wide range of providers across disciplines and systems of care, including custodial care systems such as foster care. The study was funded by The California Endowment, a health foundation dedicated to expanding access to affordable, quality health care for underserved individuals and communities.
Major Research Findings:
- Family accepting behaviors towards LGBT youth during adolescence protect against suicide, depression and substance abuse.
- LGBT young adults who reported high levels of family acceptance during adolescence had significantly higher levels of self-esteem, social support and general health, compared to peers with low levels of family acceptance.
- LGBT young adults who reported low levels of family rejection during adolescence were over three times more likely to have suicidal thoughts and to report suicide attempts, compared to those with high levels of family acceptance.
- High religious involvement in families was strongly associated with low acceptance of LGBT children.
Dr. Ryan and her team at the Family Acceptance Project are currently developing a new evidence-based family model of wellness, prevention and care for LGBT adolescents, with funding from the Robert Wood Johnson Foundation. This model uses a behavioral approach to help ethnically and religiously diverse families decrease rejection and increase support for their LGBT children to reduce risk for suicide, depression, substance abuse, and HIV, to promote well-being and to prevent homelessness and placement in custodial care. This systems-level approach helps communities and providers to engage diverse families as allies in decreasing their LGBT children's risk and increasing their well-being while respecting the family's deeply held values. This work is being conducted in English, Spanish and Chinese with families from all ethnic backgrounds, including immigrant and very low income families, and those whose children are out-of-home in foster care and juvenile justice facilities.
The existing approach to serving LGBT adolescents by pediatricians, nurses, social workers, school counselors and others has focused almost exclusively on serving LGBT youth alone and through peer support, rather than in the context of their families, and does not consider the impact of family reactions on the adolescent's health and well-being.
In addition to providing direct services for families with LGBT children and working with communities in the U.S., the Family Acceptance Project is collaborating with organizations, providers, advocates and families to develop an international movement of family acceptance to promote wellness and healthy futures for LGBT children, youth and young adults.
"Family Acceptance in Adolescence and the Health of LGBT Young Adults" is the third in a series of research papers on outcomes related to family acceptance and rejection of LGBT adolescents, supporting positive LGBT youth development, school experiences and providing family-related care to be released by the Family Acceptance Project.
These studies will be published in peer-reviewed journals designed for providers, caregivers and practitioners from a wide range of disciplines and practice settings.
- Caitlin Ryan et al. Family Acceptance in Adolescence and the Health of LGBT Young Adults. Journal of Child and Adolescent Psychiatric Nursing, in press)
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