Family support and depression in sexual and gender minority adolescents

Both articles today deal with families of sexual and gender minority youth. First, Bitran et al. (2024) published “The Effects of Family Support and Smartphone-Derived Homestay on Daily Mood and Depression Among sexual and gender minority adolescents. Journal of Psychopathology and Clinical Science. Here are the edited abstract and impact statements

Sexual and gender minority (SGM) adolescents are at elevated risk for depression. This risk is especially pronounced among adolescents whose home environment is unsupportive or nonaffirming, as these adolescents may face familial rejection due to their identity. Therefore, it is critical to better understand the mechanisms underlying this risk by probing temporally sensitive associations between negative mood and time spent in potentially hostile home environments. The current study included adolescents (N = 141; 43% SGM; 13–18 years old), oversampled for depression history, who completed clinical interviews assessing lifetime psychiatric history and depression severity as well as self-report measures of social support. Participants also installed an app on their personal smartphones, which assessed their daily mood and geolocation-determined mobility patterns over a 6-month follow-up period. Over the 6-month follow-up period, SGM adolescents reported elevated depression severity and lower daily mood relative to non-SGM youth. Interestingly, SGM adolescents who reported low family support experienced lower daily mood than non-SGM adolescents, particularly on days when they spent more time at home. Current findings reinforce evidence for disparities in depression severity among SGM adolescents and highlight family support as a key factor. Specifically, more time spent in home environments with low family support was associated with worse mood among SGM adolescents. These results underscore the need for clinical interventions to support SGM youth, particularly interventions that focus on familial relationships and social support within the home environment. 

Adolescents provided smartphone-derived geolocation and daily mood surveys for 6 months, providing an opportunity to explore associations between time spent in unsupportive homes and same-day mood. Results show that relative to their heterosexual peers, SGM adolescents with low family support reported lower mood on days when they spent more time at home, underscoring the need for digital interventions that may be accessible from within nonaffirming home environments. 

I found this study helpful in identifying some of the family stressors that may increase depression in sexual and gender minority youth. I thought it especially interesting that, when these youth are at home without family support, they experience far more depression. This isn’t surprising but offers good questions to ask when such youth seek treatment. The second study turns to symptoms in parents. Clark, Argiros, Dougherty & Pachankis (2024) published “Stigma and Anxiety and Depressive Symptoms in Parents of Sexual and Gender Minority Youth” in Journal of Family Psychology.  Here’s the edited abstract:

Parents of sexual and gender minority (SGM) youth play an important role in supporting their SGM child’s mental health in the face of stigma. Yet, parents of SGM youth may themselves experience stigma, including discrimination/rejection, and its emotional consequences, including vicarious stigma and shame. The present cross-sectional study leveraged a national sample of parents of SGM youth to investigate associations between parents’ stigma experiences and self-reported anxiety and depression symptoms. Further, we additionally explored sociodemographic and contextual correlates of parents’ stigma experiences. Participants included 264 parents (Mage = 46) who reported having at least one SGM child under age 30 (Mage = 18). The Lesbian, Gay, Bisexual-Affiliate Stigma Measure (LGB-ASM) assessed parents’ experiences of discrimination/rejection (e.g., actual and anticipated rejection experiences due to having an SGM child), vicarious stigma (e.g., worry and concern for one’s SGM child), and shame (e.g., feeling embarrassed for having an SGM child). Parents indicated their anxiety and depressive symptoms using respective Patient-Reported Outcomes Measurement Information System—short forms. Results showed that vicarious stigma and shame, but not discrimination/rejection, were uniquely associated with parents’ increased symptoms of anxiety (vicarious stigma: β = 1.59, p < .001; shame: β = 2.15, p < .001) and depression (vicarious stigma: β = 0.90, p < .01; shame: β = 2.77, p < .001). Further, parents with more accepting religious, racial, ethnic, and/or cultural communities reported lower stigma experiences. This study advances understanding of how the psychological consequences of stigma extend beyond SGM people themselves and contribute to mental health difficulties in parents of SGM youth. 

A plethora of evidence shows that LGBTQ youth face discrimination and associated negative mental health outcomes. But what about their parents? This study explores the mental health of parents of LGBTQ youth who, in addition to supporting their children, also face discrimination, rejection, and complex emotions like worry and shame. In a large national sample of parents of LGBTQ youth, this study links parents' experience of discrimination and its emotional consequences to their mental health. Findings enhance our understanding of how the psychological impact of stigma extends beyond LGBTQ individuals, affecting the mental well-being of parents of LGBTQ youth.

This is a slightly larger sample and a study of an important topic. I find it interesting that it is not discrimination and rejection but vicarious stigma and shame that impact anxiety and depression in parents of sexual and gender minority youth. It’s not at all surprising that, when parents are in more accepting communities, they, and likely their children, fare better.