For gay and lesbian individuals, consistency in parents’ attitudes toward their child’s sexual orientation, even when they are negative, is an important factor in positive mental health outcomes, new research shows.
Study investigator Matthew Verdun, MS, a licensed marriage and family therapist and doctoral student at the Chicago School of Professional Psychology at Los Angeles, Los Angeles, California, found that gays and lesbians whose parents were not supportive of their sexual orientation could still have good outcomes.
The findings were presented at the virtual American Psychiatric Association (APA) 2021 Annual Meeting.
High Rates of Mental Illness
Research shows that members of the gay and lesbian community experience higher rates of mental illness and substance use disorders and that psychological well-being declines during periods close to when sexual orientation is disclosed.
Verdun referred to a theory in the literature of homosexual identity formation that describes how individuals go through six stages: confusion, comparison, tolerance, acceptance, pride, and synthesis.
Research shows a U-shaped relationship between subjective reports of well-being at these six stages. The lowest rates occur during the identify comparison and identify tolerance stages.
“Those stages roughly correspond with the time when people would disclose their sexual orientation to parents and family members. The time when a person discloses is probably one of the most anxious times in their life; it’s also where their rate of well-being is the lowest,” said Verdun.
Verdun said he “wanted to know what happens when a parent is supportive or rejecting at that moment, but also what happens over time.”
To determine whether parental support affects depression, anxiety, or substance abuse in members of the gay and lesbian community, Verdun studied 175 individuals who self-identified as gay or lesbian (77 males and 98 females) and were recruited via social media. Most (70.3%) were of White race or ethnicity.
Participants completed surveys asking about their parents’ initial and current level of support regarding their sexual orientation. They also completed the nine-item Patient Health Questionnaire (PHQ-9), the seven-item General Anxiety Disorder (GAD-7), and the 20-item Drug Abuse Screening Tool (DAST-20).
The investigators categorized participants into one of three groups on the basis of parental support:
Negative to positive
A fourth group, positive to negative, was excluded from the analysis because it was too small.
Verdun was unable analyze results for substance abuse. “The DAST-20 results violated the assumption of homogeneity of variances, which meant the analysis could result in error,” he explained.
Analyses for the PHQ-9 and GAD-7 showed that the consistently positive group had the lowest symptom scores.
“People whose parents were accepting had the lowest scores for anxiety and depression,” said Verdun.
For both the PHQ and GAD, the findings were significant (P < .05) for the consistently positive and the consistently negative groups in comparison with the negative-to-positive group.
The difference between the consistently positive and the consistently negative groups was not statistically significant.
Previous research has shown that current levels of parental support relate to better mental health, so Verdun initially thought children whose parents were consistently supportive or those whose parents became supportive over time would have the best mental health outcomes.
“But, interestingly, what I found was that people whose parents vacillated between being accepting and rejecting over time actually had significantly more mental health symptoms at the time of the assessment than people whose parents were consistently accepting or consistently rejecting,” he said.
Although the study provided evidence of better outcomes for those with consistently unsupportive parents, Verdun believes some hypotheses are worthy of further research.
One is that people with unsupportive parents receive support elsewhere and could, for example, turn to peers, teachers, or other community members, including faith leaders, and that symptoms of mental illness may improve with such support, said Verdun.
These individuals may also develop ways to “buffer their mental health symptoms,” possibly by cultivating meaningful relationships “where they’re seen as a complete and total person, not just in terms of their sexual orientation,” he said.
Gay and lesbian individuals may also benefit from “healing activities,” which might include engagement and involvement in their community, such as performing volunteer work and learning about the history of their community, said Verdun.
Mental health providers can play a role in creating a positive environment by referring patients to support groups, to centers that cater to gays and lesbians, to faith communities, or by encouraging recreational activities, said Verdun.
Clinicians can also help gay and lesbian patients determine how and when to safely disclose their sexual orientation, he said.
The study did not include bisexual or transsexual individuals because processes of identifying sexual orientation differ for those persons, said Verdun.
“I would like to conduct future research that includes bisexual, trans people, and intersectional groups within the LGBTQIA [lesbian, gay, bisexual, transgender, queer, intersex, asexual] community,” he said.
Commenting on the study, Jeffrey Borenstein, MD, president and CEO of the Brain and Behavior Research Foundation and editor-in-chief of Psychiatric News, said the work is “extremely important and that it has the potential to lead to clinical guidance.”
The finding that levels of depression and anxiety were lower in children whose parents were accepting of their sexual orientation is not surprising, said Borenstein. “It’s common sense, but it’s always good to have such a finding demonstrate it,” he said.
Parents who understand this relationship may be better able to help their child who is depressed or anxious, he added.
Borenstein agreed that further research is needed regarding the finding of benefits from consistent parenting, even when that parenting involves rejection.
Such research might uncover “what types of other supports these individuals have that allow for lower levels of depression and anxiety,” he said.
“For this population, the risk of mental health issues is higher, and the risk of suicide is higher, so anything we can do to provide support and improved treatment is extremely important,” he said.
American Psychiatric Association (APA) 2021 Annual Meeting: Abstract 5426. Presented May 3, 2021.