For years, research has shown that the positive involvement of family support in care is one of the greatest predictors of mental health treatment success. For LGBTQ+ young adults, family support is especially important. According to the Family Acceptance Project, LGBTQ+ young adults who report high levels of family acceptance have higher levels of self-esteem, social support and general health. They are also half as likely to report suicidal thoughts or suicide attempts in the past six months.
This is why our treatment model at The Dorm integrates the entire family system in therapeutic work, engaging them in coaching, family therapy, and psycho-education. We spoke with a clinical supervisor at The Dorm to learn more about why this approach is so essential to mental health outcomes, and how the experience of affirming care for young adults comes to life at The Dorm.
Why Family Support is Imperative for LGBTQ+ Young Adult Mental Health
Queer individuals, and queer youth in particular, face adversity and challenges as a minority group. The role of the family, caregiver, parent, guardian or supportive “chosen family” individual, can help offset that adversity by offering unconditional love and support. These individuals offer a safe holding space for a young person’s growth, process of identity formation and self-discovery.
Mental Health Risks for LGBTQ+ Without Family Support
The immediate familial structure that one exists within has a major impact on mental health. If a young person grows up with individuals who are not supportive of their identity or personhood, or who are unavailable, psychologically or physically, it can be damaging. The ramifications of this can include increased rates of trauma, challenges with substance use, suicide risk and a higher incidence of mood, anxiety and depressive disorders. A lack of support in the home can also lead to homelessness as queer youth feel like they need to leave the home to feel safe or to live their truth. This has its own risk factors, of course.
I see some recurring themes among LGBTQ+ clients who have lacked familial/parental support in the past. These include:
Struggles with belonging and inclusion
As social human beings, we all need to feel that we belong. The absence of this emotional support and psychological safety is destabilizing. As young people get older, a lingering sense of not feeling “part” of the supportive unit also bleeds into other social relationships and interactions. It colors how queer people feel that they are visible in the world. It hinders how they may find or use their voice to advocate for themselves. And, importantly, it also impacts their experience and perception of love, connection and trust, which brings me to my next point.
Misdirection of love, trust and connection
Pro-social skills and behaviors are first learned and modeled by our parents or family unit. However, if this foundation is absent, or if the experience of healthy and supportive family dynamics is lacking, the hurdles can persist into adulthood. We might see patterns in queer young people who have experienced “love” as manipulation or abuse throughout their entire lives. These individuals, well into their 20s and 30s, may struggle with understanding what meaningful intimacy, connection, or trust looks like.
These are all areas that can be worked on in treatment, but the process takes time, and a tremendous amount of trust, at both a therapist/client level and within the social community milieu.
How Families Can Overcome a History of Difficult Family Dynamics
It is absolutely possible for family members and parents to overcome challenges and difficult family dynamics. The key ingredients are willingness and acceptance on the part of the family member/parent, or whoever is going to be representing that role in support of the client. What do I mean by that?
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- Parents and family members need to be able to confront their egos and acknowledge that the family system may have been less supportive or conducive to growth than they believed. For example, a parent might not realize that their specific parenting or communication style, though well intentioned, was not affirming for their LGBTQ+ child growing up.
- An important part of that process is for parents/family members to also accept that their child’s experience may differ from their own perception of the past. Nevertheless, that experience is valid and needs to be recognized.
When willingness and acceptance are in place, I always say that the possibilities for repair are endless. There is the ability to grow together and to make that a collaborative process. It may not be linear, but where there is a will there’s a way.
At that point, it’s the therapist’s or clinical coach’s job to help the family unit discover its strengths, capitalize on the positives that exist, and build on them. They assist the family in collectively confronting what needs to be brought to the surface and adapting to it in a way that moves everyone forward. One thing I tell families when they are starting on this journey is, “Everything is information. And once you gain that information, you can grow and develop as a unit together.”
How to Support Young LGBTQ+ Child: Guidance for Families
There are a few key principles I like to bring to my sessions with families—norms, if you will—that can help parents/family members, in particular, remain positively supportive.
- Lead with love. The therapeutic process can be messy, complicated and non-linear. Things might be said that are painful and disarming. But when we remember why we’re here and who the person is in front of us, the love that exists: it reminds us to focus on what’s most important.
- Assume the best. Offering someone the “benefit of the doubt” can be very hard to do in the thick of difficult conversations. However, if we assume positive intentions on the other’s part, it can be immensely helpful. It’s rare that anyone shows up to therapy or a family discussion with malicious intent.
- Hold space with honesty and authenticity. A lot of times trust has broken down within the family system and we need to course-correct. I encourage parents and family members to hold space with as much authenticity and honesty as they can muster. Even if that means saying something like “I don’t understand”: that’s honest. It’s a starting point. It’s information we can work with, such as focusing more on psychoeducation and gaining exposure to a situation or an individual’s unique queer experience.
- Allow for growing pains. The population we serve at The Dorm is at any important juncture in navigating their autonomy, exploring their identity and gaining confidence in who they are. Families need to make space for that and understand the patterns—sometimes unconscious—that might be holding this process back. Young adults need to make mistakes. They need to have the chance to practice and try again, to gain personal competence and confidence. It’s a wonderful thing to watch your loved one “step into themselves” and truly grow up in front of your eyes, if you allow for it .
Effective Treatment Support for LGBTQ+ Families
I’ve worked in Intensive Outpatient Programs (IOPs) and Partial Hospitalization Programs (PHPs) before, but what stands out here at The Dorm is the parent/family clinical coaching experience. This is a space for hands-on support, for learning, discovery, growth and, importantly, for family members to be challenged.
At The Dorm, coaching presents a unique opportunity for parents to come in and allow themselves to be supported and also challenged in a constructive way. I’ve never seen it done like this anywhere else.
What do I mean by being challenged? One example is helping families reframe goals and the type of introspective work taking place. Often, when we begin coaching, a parent or family member has a very specific idea of what they want the treatment goals to be for their young adult child. My job as a coach is to guide them toward considering the family’s perspective as a whole. This might involve exploring:
- What are the family goals as a unit?
- What are the problem areas we need to address and what are the growth opportunities?
- How can we each take responsibility for our role and contributions to the family dynamic?
- What will be helpful for everyone to learn and understand from each other? What skills can be developed to improve communication, boundary setting or connection?
At The Dorm, family work and family/parent coaching is approached as a central and core treatment modality and I’ve never seen that anywhere else. For this population, it’s extremely important and effective.
The experience and journey of queerness is individual and full of nuance. Families may feel a range of emotions through this process, including confusion, anger, and fear. However, if they can ultimately lead with openness, curiosity, and love, the impact on the treatment process can be profound and transformative. That is where the power of this work really shines.
Learn more about LGBTQ+ mental health treatment support family therapy services, treatment approach and research outcomes or contact our admissions team if you’re seeking support for a loved one or your family.
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Frequently Asked Questions
How does family rejection affect LGBTQ+ young adults’ mental health?
Family rejection is one of the most significant risk factors for poor mental health outcomes in LGBTQ+ young adults. Those who experience rejection from family members are significantly more likely to experience depression, anxiety, substance use, homelessness, and suicidal ideation. The Family Acceptance Project found that LGBTQ+ young adults who reported high levels of family rejection were more than eight times as likely to have attempted suicide compared to those with supportive families.
Does family acceptance reduce suicide risk in LGBTQ+ young adults?
Research shows that LGBTQ+ young adults with high levels of family acceptance are significantly less likely to report suicidal thoughts or suicide attempts. Even moderate increases in family support can dramatically improve outcomes, which is why family involvement is a core part of affirming mental health treatment at programs like here The Dorm.
What can parents do to support an LGBTQ+ young adult?
The most impactful things a parent can do are lead with unconditional love, use affirming language (including correct names and pronouns), and avoid making their young adult child’s identity a source of conflict or negotiation. Seeking out psycho-education — either independently or through a family therapist is also a powerful step.
Can families repair a history of non-affirming behavior toward an LGBTQ+ young adult?
Yes. Repair is absolutely possible, and it’s something our team of clinicians at The Dorm work on regularly with families. The key ingredients are willingness and acceptance — a genuine openness to hearing your loved one’s experience, even if it differs from your own perception of the past. Family therapy and parent coaching can help guide this process in a structured, supportive way.
