General Articles

Family Rejection and the Health of Lesbian, Gay, and Bisexual Youth

Source: Caitlin Ryan, David Huebner, Rafael M. Diaz, Jorge Sanchez, “Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults,” Pediatrics (2009): 346-352.
This study was designed to explore a possible link between family reactions to their children’s sexual orientation and future health problems for those young people. Two hundred and twenty four lesbian, gay, and bisexual (LGB) individuals participated in the study which focused on young adults between 21–25 years who were non-Latino white or Latino. Participants in the study self-identified as LGB, homosexual, or queer/non-heterosexual during adolescence, had at least one parent or guardian aware of their sexual orientation, and lived with at least one parent or guardian during adolescence at least part-time. The study was conducted around San Francisco, California at various LGB venues such as social organizations, bars, and clubs.
The study looked at family rejection and nine negative health outcomes centered around mental health, substance use and abuse, and sexual risk behavior. Participants were asked whether their parents or caregivers ever blamed or rejected them because of their sexual orientation. Participants’ mental health was measured with questions asking whether they currently suffered from depression, had suicidal thoughts in the last six months, and how many times they had attempted suicide in their lifetime. Substance use and abuse was also measured in three ways, with participants being asked to report heavy alcohol drinking in the past six months, use of illicit drugs in the past six months, and substance use-related problems in the last five years. Risky sexual behavior was characterized as any unprotected anal and/or vaginal sex with a casual, non-monogamous, or HIV-serodiscordant[1] partner within the last six months or at last occurrence of sexual intercourse.  Finally, participants were asked whether or not they had ever been diagnosed with an STD. 
Key Findings:
  • More than half (54.7%) of LGB adults reported at least one substance use-related problem and 40.6% reported at least one lifetime suicide attempt.
  • Men were more likely to report family rejection than women.
  • Latino men reported the highest number of negative family reactions to their sexual orientation and higher rates of depression, suicidal thoughts and HIV-risk behavior. 
  • Family rejection was associated with poorer health outcomes in all categories except heavy drinking in the past six months and STD history.
  • LGB young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times mores likely to report high levels of depression, 3.4 times more likely to report illegal drug use, and 3.4 times more likely to report having engaged in unprotected sexual intercourse when compared with LGB peers who experienced little or no family rejection.
SIECUS Analysis:
Prior to this study, there have been several published reports on the increased risk of emotional and health-related issues for lesbian, gay, and bisexual adolescents. These population-based studies found that LGB adults had higher levels of suicide attempts, substance abuse, symptoms of depression, mental health problems, sexually transmitted diseases, and unplanned pregnancy than heterosexuals. Previous studies, however, did not directly address the influence families have on LGB children’s lives. This study by Pediatrics found a link between parental and caregiver rejecting behaviors and negative health problems for young LGB adults. 
This research demonstrates the vital role parents and caregivers play in their children’s lives and highlights that they are often not adequately equipped to have conversations about sexuality with their children. SIECUS believes that parents should be the primary sexuality educators of their children and supports programs that include parent training and education on how to talk with children about issues regarding sexuality. The study authors note that there are lots of groups working on this issue already, such as Parents, Families, and Friends of Lesbians and Gays (PFLAG) and the Family Acceptance Project, and that it’s imperative that schools work more closely with these groups and through outlets like gay-straight alliances and school counselors both to help parents strengthen relationships with their LGBT children and to make schools a safe space for LGBT adolescents who may already have trouble at home.  
The researchers acknowledge, however, that they were not able to include LGB individuals who did not have a relatively stable living situation. LGB youth are over- represented in the homeless population, the foster care system, and juvenile detention centers, and one of the primary reasons they’re kicked out of their homes is their sexual orientation or gender identity. Further research on this population of young people can help us understand how their family experiences led to their current living situation and possible health issues.
The study is also limited in that it doesn’t include transgender individuals (the sample was too small), those who questioned their sexual orientation, those who kept their sexuality secret throughout adolescence, or other racial or minority groups. Morever, the study was also conducted in San Francisco and the results may not be relevant in other cities or more conservative parts of the country. 
Nonetheless, this research sheds more light on the often under-studied topic of LGB young people’s health. With this new information and future studies, we can better advocate for policies that encourage connections between schools, community groups, parents, and youth around the topics of sexual orientation and gender identity.

[1] Serodiscordant relationships are those in which one partner is HIV-positive and the other partner as HIV- negative.