LGBT Young Adults Who Recalled More Family Acceptance as Teens Reported Less Depression and Fewer Suicide Attempts

Family Acceptance in Adolescence and the Health of LGBT Young Adults

Authors: Caitlin Ryan, Stephen T. Russell, David Huebner, Rafael Diaz, Jorge Sanchez
Journal: Journal of Child and Adolescent Psychiatric Nursing
Year: 2010
Source: https://doi.org/10.1111/j.1744-6171.2010.00246.x

Summary

This Family Acceptance Project study surveyed 245 LGBT young adults in California, asking them to recall how accepting their parents had been of their sexuality and gender expression when they were teenagers. Those who remembered more accepting parents reported better self-esteem, support and general health, and less depression, drug and alcohol problems and suicidal thinking and attempts. For example, 31% of the high-acceptance group had ever attempted suicide versus 57% of the low-acceptance group. The authors concluded that family acceptance protects LGBT youth and called for family programs. But the survey was done once and relies on adults' memories, so it cannot show that acceptance caused better health. Only about 22 people were trans, too few to say much about accepting a trans identity.

Key findings

245 LGBT young adults aged 21 to 25, split evenly between Latino and white, were found at 249 LGBT venues, bars and clubs in the San Francisco Bay Area region.
Only about 9% (roughly 22 people) identified as trans; most were gay or lesbian (70%).
Family acceptance was measured by asking adults to recall their teen years, using 55 questions based on the authors' own interviews with 53 LGBT teens and families.
Those recalling high acceptance had about half the depression scores of those recalling low acceptance, and less suicidal thinking in the past six months (19% vs 38%).
31% of the high-acceptance group had ever attempted suicide, versus 57% of the low-acceptance group; low acceptance was linked to more than 3 times the odds of suicidal thoughts and attempts.
Family acceptance was not linked to risky sexual behaviour.
Latino, immigrant, religious and lower-income families were, on average, rated as less accepting.

Abstract

ISSUE: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. METHODS: A quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245). FINDINGS: Family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. CONCLUSIONS: Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.

Conclusion

Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities. The authors describe the protective influence of specific family accepting behaviours as 'lasting' and 'dramatically protective', and recommend that nurses assess family reactions, educate parents and promote supportive behaviours such as supporting a child's gender expression.

Methodological limitations

Based on memory: Adults aged 21 to 25 described their parents' behaviour from ages 13 to 19. How they feel now may colour how accepting they remember their parents being, as the authors admit.
Measured once: Acceptance and health were measured in a single survey, so the study cannot show that acceptance came first or caused better health.
Cause may run the other way: Teens who were already more stable or less distressed may have drawn more acceptance from parents. Family factors such as warmth, conflict, parents' mental health and income could also drive both acceptance and health.
Timing of suicide attempts unknown: Lifetime suicide attempts may have happened before the young person came out, or before the accepting behaviours measured, which weakens the idea that acceptance protected them.
Not a representative group: People were found at LGBT groups, bars and clubs within 100 miles of the authors' office. No response rate is given, and results may not apply more widely.
Narrow group: Only Latino and white Californians could take part, because of funding limits.
Very few trans people: About 9% (around 22 people) were trans, so the results say little about accepting a trans identity or social transition specifically.
Authors' own scale: The 55-question acceptance scale came from the team's own interviews and had not been independently tested. It mixes general warmth with LGBT-specific actions, such as taking a child to LGBT events.
Few other factors accounted for: The study allowed for background, religion and parents' jobs, but not general parental warmth, mental health history, trauma or bullying. Acceptance explained only a modest share of differences in health.
Authors run the program they recommend: The lead author directs the Family Acceptance Project, which makes the family education materials and screening tool the paper recommends.
Claims go beyond the data: The paper says acceptance 'protects against' depression and suicide and calls its effects 'lasting' and 'dramatically protective', which a survey showing a link cannot prove.

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Summary

Key findings

Abstract

Conclusion