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  2. Families


Family acceptance and support are significant factors that promote well-being and protection from risks for all youth, including LGBT youth.1 The meaning of family varies by personal, cultural, and other factors and can include individuals who are not biologically or legally related to a youth (i.e., families of choice).2 Family responses to expressions of gender and sexual identity by youth may vary. Although some families are supportive, accepting, and even celebratory, others may respond and behave in ways that have negative consequences and result in trauma to the youth. Research demonstrates a strong link between family rejection of LGBT youth and negative physical and mental health outcomes for them.3 In contrast, family acceptance can serve as a protective factor against depression, substance use, and suicidal ideation and attempts.4 Research has found that compared with LGBT youth who experienced little or no parental/caregiver rejection, those LGBT youth who were highly rejected were

  • more than eight times as likely to attempt suicide;
  • almost six times as likely to report high levels of depression;
  • more than three times as likely to use illegal drugs; and
  • more than three times as likely to be at high risk for HIV and sexually transmitted diseases.5

A recent report of findings from a survey of more than 10,000 LGBT youth ages 13 to 17 (using a convenience sample, which may not be representative of all LGBT youth) also found that approximately one in four identified nonaccepting families as the most important challenge in their lives.6 These findings illustrate the importance of family acceptance and support in the lives of LGBT youth.

Youth-serving organizations and systems can build awareness about and encourage family behaviors that research has shown can affect outcomes for LGBT youth. Examples of behaviors that should be avoided and discouraged include

  • blocking access to LGBT friends, events, and resources;
  • blaming youth when they are discriminated against because of their LGBT identity; and
  • pressuring youth to be more (or less) “masculine” or “feminine”—and keeping their LGBT identity a “secret.”7

Rather, it is important for families to express support through such behaviors as

  • talking with youth about their LGBT identity in an affirming manner;
  • communicating that their young person can have a happy future as an LGBT adult;
  • working to ensure that other family members respect the young person;
  • talking with clergy and help their faith community support LGBT individuals; and
  • advocating for youth if they are mistreated because of their identity8

It is also important for youth-serving agencies and communities to enhance their cultural competence in working with LGBT-headed families, which are increasing in number.9 Youth who are not LGBT but have an LGBT caregiver may also experience bias and other negative outcomes because of reactions to their caregiver’s LGBT identity.


Family Acceptance Project
The Family Acceptance Project (FAP) is a community research, intervention, and education initiative to study the impact of family acceptance and rejection on the health, mental health, and well-being of youth who are LGBT. The project’s results are the basis for resources to help families provide support for youth who are LGBT. In addition, FAP is developing appropriate interventions, programs and policies; and will train providers to improve the quality of services and care that youth who are LGBT receive.

The getR.E.A.L (Recognize. Engage. Affirm. Love) initiative of the Center for the Study of Social Policy is designed to help transform child welfare policy and practice to promote the healthy development of all children and youth. It focuses on sexual orientation, gender identity, and expression (along with race, ethnicity, and disability) are part of the identity formation that occurs in adolescence. The getR.E.A.L name was crafted as a challenge to public systems working with children. It also provides lessons, implications, and a process for parents, caregivers, and all system-involved youth. The acronym is directed at all these stakeholders—and many others—as a means of meeting the initiative’s primary goal to improve the healthy sexual and identity development of all children and youth in child welfare systems.

A Practitioner's Resource Guide: Helping Families to Support Their LGBT Children (PDF, 18 pages)
This resource from the Substance Abuse and Mental Health Services Administration offers information and resources to help practitioners throughout health and social service systems implement best practices in engaging and helping families and caregivers to support their LGBT children.


1 Poirier, Fisher, Hunt, & Bearse, 2014
2 Poirier, Fisher, Hunt, & Bearse, 2014
3 Ryan et al., 2009; SAMHSA, 2014
4 Institute of Medicine, 2011; Ryan et al., 2010
5 Ryan, Huebner, Diaz, & Sanchez, 2009; SAMHSA, 2014
6 Human Rights Campaign, 2012a
7 SAMHSA, 2014
8 Ryan, 2009
9 Krivickas & Lofquist, 2011; For more information see the UCLA Williams Institute Census and Demographics LGBT Studies

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