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Research team examines role of parenting on LGBTQ mental health, substance use

by Matthew Smith

A paper published in Adolescent Research Review by a team featuring University of North Carolina at Chapel Hill School of Social Work faculty and students sheds light on parenting and its effect on LGBTQ youth.

Headshot of UNC Associate Professor Melissa Lippold
Melissa Lippold, associate professor and Prudence and Peter Meehan Early Career Distinguished Scholar, was the lead investigator for a University of North Carolina at Chapel Hill research team that examine the effects of different parenting styles on the mental health of LGBTQ youth.
The study included a systematic review and analysis of 24 studies that examined the relationship between parenting and queer youth mental health and substance use. Queer youth have higher rates of mental health and substance use challenges than their heterosexual peers. The UNC team hoped to learn more about how parenting — both supportive parents and parents that reject their children — plays a role in influencing LGBTQ youth.

Led by Associate Professor and Prudence and Peter Meehan Early Career Distinguished Scholar Melissa Lippold, Associate Professor and L. Richardson Preyer Early Career Scholar William Hall, graduate research assistants Denise Yookong Williams and Hayden Dawes were co-authors on the paper. UNC School of Social Work alum Melissa Jenkins and UNC School of Education Professor Roger Mills-Koonce also contributed to the study.

Lippold expanded on the study, its findings, and how she hopes its findings can help parents care for their children in the future.

Read the full paper online at Adolescent Research Review.

What was the overall purpose of the study?

Even though there is substantial research on parenting and its impacts on mental health and substance use in general, there has not been a lot of research on parenting LGBTQ youth. This is important because we know families are powerful influences on development, and interventions for parents and queer youth could potentially have large impacts. We decided to systematically review the literature on parenting and queer youth mental health and substance use. We also conducted a meta-analysis, which quantifies the effect of parenting across multiple studies.

Historically, why have queer youth faced higher rates of mental health and substance use challenges?

Queer youth face more stressors than heterosexual youth. For example, they face higher rates of harassment, rejection and discrimination. We know from minority stress theory and other research that these increases in stress can take a toll and can increase the risk of mental health challenges and substance use.

What research questions did you address as part of the systematic review?

We had three questions: What parenting factors are risk factors for mental health or substance use outcomes among queer youth? What parenting factors are protective factors for mental health or substance use outcomes among queer youth? And lastly, what is the magnitude and direction of parenting factors associated with mental health and substance use outcomes among queer youth?

What did the findings of the review show?

The findings showed a few things. First, we found that parenting matters for queer youth — that more parental support and less rejection were associated with less depression/anxiety and less substance use. Secondly, there was some evidence in the meta-analysis that parental rejection had stronger effects than parental support on queer youth mental health. Lastly, there is a need for a lot more research on parenting queer youth. Most of the studies were cross-sectional and they did not follow youth over time, making it harder to fully understand the long-term effects of parenting. Importantly, our measures of parenting, especially support, are very limited. Expanded conceptual models and new measures are needed that can capture how parents can affirm queer youth identity and promote queer youth well-being.

Did any of the findings surprise you or make you reexamine existing ideas/norms related to how to parent queer youth?

I was surprised that there were not more studies on parenting queer youth, given how important we know parenting is during adolescence.

The findings suggest that parental rejection may have a bigger impact than parental acceptance. Why might this be the case?

There are a couple of reasons that the effects of rejection were stronger than support. First, negative experiences can elicit really strong emotions. We know that negative emotions and thoughts about experiences can linger and last longer than positive ones. This can be important as rumination about negative events — thinking about them often — can increase the risk for depression. Secondly, the field has really limited measures on positive aspects of parenting queer youth. A lot of studies use general support measures — things like if you feel loved by your parent. Such measures don’t capture the ways parents might affirm their child’s sexual orientation and support queer youth identity. In contrast, most studies on rejection do measure rejection due to sexual orientation. Because of this, our studies may be better at capturing the effects of rejection than support.

A major point of the review was comparing parental care between families with queer youth versus comparing queer youth families and heterosexual youth families. Why was this an important element of the review?

A lot of existing research focuses on comparing the experiences of queer youth to heterosexual youth. Such research can tell us important information. But in this study, we really wanted to center the queer youth experience. By identifying risk and protective factors within families of queer youth, rather than in comparison to heterosexual youth, we can gain an understanding of family processes among queer youth specifically.

After completing the review, what are some of the interventions that may work best for families with queer youth to ensure that their mental health needs are met?

Interventions that aim to reduce parental rejection may be really important. We know a lot of families that initially reject their children eventually become more accepting, but we don’t have a lot of interventions that help parents become more accepting. Interventions that can facilitate acceptance would be crucial. We need more interventions in this area.

How do you hope this review helps researchers and clinicians in the future?

I hope it highlights the important role that parents play in queer youth mental health and substance use and leads to the development of more parent-based interventions. Parents matter and developing programs that increase parent support and reduce rejection will improve queer youth well-being.

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