Cathy Renna

Accept your LGBTQ kids - could it be more simple?

Filed By Cathy Renna | December 29, 2008 12:00 PM | comments

Filed in: Living
Tags: Caitlin Ryan, Family Acceptance Project, LGBT families, LGBT youth, PFLAG

This week we are helping get media attention for one of the most important projects I have ever worked on in my career. No way to overstate that, which is saying something. Our community now has a tool that all of us should look at, use and be thankful for, something that will change the way we treat LGBTQ youth and how we look at the role families play in living our lives to the fullest.

LGBT Family Intervention Project 2008.jpg

You will be seeing a lot of media attention (as much as we can the week between Christmas and New Year's, but you all know how relentless we are here at Renna Communications) for the first of a number of research papers published by Dr. Caitlin Ryan and her Family Acceptance Project. Not heard of her? For shame.

Caitlin is a community treasure and has been working on LGBT health and youth issues for over 25 years. The research coming out this week is the first public release of data that will change the way we look at and treat families with LGBTQ youth. Caitlin has been taking this research across the country and around the world and the proof of the desperate need for this data is evident in the calls and emails from around the country and around the world that we are fielding today.

A bit of information is below - I cannot encourage you enough to take a look and use this information. It has been a labor of love for our community and we owe Caitlin and her team a great debt. She has been a dear friend and much respected colleague for many years and it is an honor to help her get her work out into the world. As she says, this research can help change the world, one family at a time. Let's start now.

Groundbreaking Research on Family Rejection of Lesbian, Gay and Bisexual Adolescents Establishes Predictive Link to Negative Health Outcomes

Paper Authored by Dr. Caitlin Ryan of San Francisco State University's "Family Acceptance Project" to be Published in the journal, Pediatrics

San Francisco, CA - For the first time, researchers have established a clear link between rejecting behaviors of families towards lesbian, gay and bisexual (LGB) adolescents and negative health outcomes in early adulthood. The findings will be published in the January issue of Pediatrics, the journal of the American Academy of Pediatrics, in a peer-reviewed article titled "Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay and Bisexual Young Adults." The paper, authored by Dr. Caitlin Ryan and her team at the César E. Chávez Institute at San Francisco State University, which shows that parents' rejecting behaviors towards their LGB children dramatically compromises their health, has far reaching implications for changing how families relate to their LGB children and how LGB youth are served by a wide range of providers across systems of care. The study and development of resource materials was funded by The California Endowment, a health foundation dedicated to expanding access to affordable, quality health care for underserved individuals and communities.

"For the first time, research has established a predictive link between specific, negative family reactions to their child's sexual orientation and serious health problems for these adolescents in young adulthood--such as depression, illegal drug use, risk for HIV infection, and suicide attempts," said Caitlin Ryan, PhD, Director of the Family Acceptance Project at the César E. Chávez Institute at SF State and lead author of the paper. "The new body of research we are generating will help develop resources, tools and interventions to strengthen families, prevent homelessness, reduce the proportion of youth in foster care and significantly improve the lives of LGBT young people and their families."

Major Research Findings:

  • Higher rates of family rejection during adolescence were significantly associated with poorer health outcomes for LGB young adults.

  • LGB young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse, compared with peers from families that reported no or low levels of family rejection.

  • Latino males reported the highest number of negative family reactions to their sexual orientation in adolescence.

"This study clearly shows the tremendous harm of family rejection, even if parents think they are well-intentioned, following deeply held beliefs or even protecting their children," said Dr. Sten Vermund, a pediatrician and Amos Christie Chair of Global Health at Vanderbilt University.

"In today's often hostile climate for LGBT youth, it is especially important to note that both mental health issues like depression and suicide and HIV risk behaviors were greatly increased by rejection. Given the ongoing HIV epidemic in America, in which half of all new cases of HIV are found in men who have sex with men and there is growing concern about prevention messages reaching young people, it is vital that we share these findings with parents and service providers who work with youth in every way" Vermund continued.

"When put to practical, day-to-day use and shared with families and those who serve LGBT youth, these findings will lead to healthier, more supportive family dynamics and better lives for LGBT young people," Vermund concluded.

The prevailing approach by pediatricians, nurses, social workers, school counselors, peer advocates and community providers has focused almost exclusively on directly serving LGBT youth, and does not consider the impact of family reactions on the adolescent's health and well-being.

Subsequent work with ethnically diverse families by the Family Acceptance Project indicates that parents and caregivers can modify rejecting behavior once they understand the serious impact of their words and actions on their LGBT children's health. In addition, even a little change in parental behavior appears to have a clear impact on decreasing LGBT young people's risk. This new family-related approach to working with LGBT youth being developed by the Family Acceptance Project engages families as allies in decreasing the adolescent's risk and increasing their well-being while respecting the family's deeply held values.

"The new family-related behavioral approach to care being developed by the Family Acceptance Project offers great promise to change the future for LGBT youth and their families by helping parents and caregivers learn how to support their LGBT children and to prevent these extremely high levels of risk related to family rejection," said Erica Monasterio, MN, FNP, in the Division of Adolescent Medicine and Family Health Care Nursing at UCSF. "Rather than seeing families as part of the problem, this approach engages them as an essential resource in promoting healthy outcomes for their LGBT children."

"We are using our research to develop a new model of family-related care to decrease the high levels of risk for LGBT young people that restrict life chances and full participation in society," said Dr. Ryan.

"Our easy-to-use behavioral approach will help families increase supportive behaviors and modify behaviors their LGBT children experience as rejecting that significantly increase their children's risk. However, redirecting practice and professional training - from not asking about family reactions to a young person's LGBT identity to engaging families in promoting their LGBT children's well-being -requires a substantial shift on the part of both mainstream and LGBT providers, health systems and community programs."

"Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay and Bisexual Young Adults" is the first of many research papers on outcomes related to family acceptance and rejection of LGBT adolescents, supporting positive LGBT youth development and providing family-related care to be released by the Family Acceptance Project.


The Family Acceptance Project uses a participatory research approach. The research sample included 224 LGB young non-Latino white and Latino adults, ages 21-25, who were open about their sexual orientation to at least one parent or primary caregiver during adolescence. These youth were recruited within California from 249 LGBT-related venues. Family rejection measures in the survey were developed based on a prior in-depth qualitative study of LGBT adolescents and families throughout California from 2002-2004.

About the Family Acceptance Project

The Family Acceptance Project is a community research, intervention and education initiative that studies the impact of family acceptance and rejection on the health, mental health and well being of lesbian, gay, bisexual and transgender (LGBT) youth. Results are being used to help families provide support for LGBT youth; to improve their health and mental health outcomes; to strengthen families and help maintain LGBT youth in their homes; to develop appropriate programs and policies; and train providers to improve the quality of services and care these youth receive in a wide range of settings.

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I just want to echo Cathy's support for Caitlin, her team, and the work they are doing. It is a major advancement in thinking on these issues and is getting attention from a lot of the right people. Please do what you can to get this information circulated in your local media (of all varieties).

Oh, wow. What an awesome program... is it national, or just in California? We don't really have much by the way of youth LGBT resources around here, something like this could be really handy.

We never needed a study to prove this, b /c as I'm reading it I'm thinking "Right on!" But it's great to have and needs to get attention.

Actually we do need a study - without science and data you will not be able to convince many of the true dangers of homophobia, especially in the medical and mental health professions and other institutions. in fact, how many of our opponents use that very argument of "we don't need a study, we KNOW this" to justify their bias and hate....

until our community starts investing more in research and work like this we will continue to make slower progress
my hope is that this research changes the way our youth organizations and others engage families - too many of us are alienated from our families of origin unnesessarily with great damage

Is anyone working with Congress and the new administration to get NIH funding for translational research so this information can be put to use in the field?

Marla R. Stevens Marla R. Stevens | December 30, 2008 1:48 PM

I second that plea not to stop with the social service uses of this, please. As Cathy well knows, public health advocacy includes public policy advocacy (which encompasses anti-violence work as well). Please ensure that the appropriate people in local and state health departments get this material, too, along with analyses of how it intersects with regulatory and statutory policy in your area. This would be a good project for a major donor/foundation to underwrite nationally, with national groups coordinating with state- and local-level advocates to see that this is given proper review and analysis as to its potential. Imagine if, for instance, a state health department and that state's medical and social science associations (including AMA branch, pediatric, psychiatric, psychological, sociology, and family medicine groups) issued a joint recommendation for a change in practice by individual practitioners, youth service organizations, education infrastructure, and the state and its local governments reflecting this "new" knowledge. The statement alone could prove life-saving.

Could it be more simple? No. Do some folks still need a reminder? Hell yes. :(

Rick Elliott | January 4, 2009 2:00 AM

Not long ago I attended a lecture by one of the chief researchers at University of Texas Medical School. Based on broad spectrum research over thirty, they came to the conclusion that one's homosexuality is determined in the 6-12th week of gestation in the womb. Males who did not absorb or didn't absorb enough of the testosterone produced by their mothers became homosexual males. Females who did take in testosterone became Lesbian. They determined without a doubt tat homosexuality i a choice, nor can it be changed except when genetic reshaping can done earlier.

Caitlin's work is crucial. My husband and I have now taken in over 100 lgbt youth who have endurred rejection and sometimes violence within their homes and or communities with no support at home.

Most of the children had either attempted suicide or admitted to strong feelings toward suicide. I learned to determine each child's potential for this on the first day. We have been very fortunate in that we could locate homes for most and to our knowledge all are well.

We sued the state of Arkansas in 1999 to overturn a ban on foster parenting by gay adults and parents of lgbt people. Theory was if you can "hatch" one of your own you could brainwash other children to be gay. Now, the same nut jobs in our state got the voters to pass another ban calling it Act 1. We have aged and loss of health prohibits us from working as we did but bless ACLU, they have once again sued the state to overturn this. It hurts all children, especially lgbt children.

Caitlin's study would have been a very helpful tool for us a decade ago but now it is here for all of us to get busy making this a safer and better place for those to follow.

Make no mistake however, suicide remains a risk even when the parents/home is safe and accepting. The world our children face when they leave home to attend school, church, sports, etc. remains hostile and ugly.

At the website I will list below one can find and download a booklet specifically for parents/guardians of lgbt youth. It was composed by many of us who learned our child was lgbt when they were 12-15. Many of us have endured hate crimes, loss due to suicide, hostile schools/communities and hatemongers.

Thank you Caitlin for your fabulous work all these years and to you too Cathy! I cannot have fathomed the work we have done without Cathy in years past.

Carolyn Wagner