Traditionally, lesbian, gay, transgender and other non-normative sexual orientations or gender identities have been discriminated and subjected to multiple hostile attitudes and behaviours.

Until 1973, homosexuality was considered a mental disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). Furthermore, it was not until 2007 that the right of any person to feel male or female was recognised in Spain, and not until 2013 «Gender Identity Disorder» was removed from the DSM (Los transexuales ya no son enfermos mentales, 2012).

Fortunately, in recent decades, Western societies have undergone an important and necessary transformation in terms of people’s sexual rights. Sexual diversity is now more present in the media, in the law and has become a more visible and common reality, especially among younger generations. However, this transformation has not been easy, nor has it been quick, nor can it be considered complete, given that heterosexual and cisgender people still maintain a privilege over other less socially accepted groups.

Mental health in LGTBIQ+ people

Numerous research studies have tried to explain the consequences of stigma towards LGTBIQ+ people, finding lower levels of well-being and a higher frequency of mental health problems in sexual minorities, such as anxiety, depression, substance abuse disorders and suicidal tendencias. More recent studies confirm that despite social progress in terms of acceptance of sexual plurality, these minorities continue to suffer more psychological disorders, clearly not as a result of their sexual orientation or gender identity per se (Trevor, 2020).

To understand this mental health disparity compared to the heterosexual and cisgender population, it has been argued that young people who belong to sexual minorities, or are perceived as such, experience elevated levels of stress throughout their psychosocial development. This stress generally goes hand in hand with an internalisation of widespread homophobic and transphobic attitudes in society, as well as concealment of sexual minority status (Katz-Wise, et al, 2016).

The main source of stress experienced by sexual minorities comes from their immediate social context, so that poorer mental health among sexual minorities is often the result of a hostile or stressful social environment. Some life experiences, such as peer victimisation in educational institutions, a phenomenon better known as bullying, have been largely associated with the psychological distress of these young people. However, there is one social factor that has received less attention in psychological studies that can have an enormous impact on the mental health of these individuals: family acceptance and support.

Importance of family support

Family is a central source of support in adolescence, and appropriate family dynamics are essential for young people’s well-being and development. Moreover, adolescence and emerging adulthood often mark the time when individuals become aware of and manifest their sexual orientation and gender identity, and the family has a very important place during this process (Rosario and Schrimshaw, 2014). Furthermore, the experience of disclosure of sexual orientation or gender identity is a potentially stressful event for LGTBIQ+ youth, as family rejection can become a major threat to their psychological well-being (Newcomb et al., 2019).

Unfortunately, these young people are more likely to experience parental rejection because of their sexual minority status. Because of the stigma attached to this population, some parents find it difficult to understand and accept their children’s sexual orientation or gender identity, and may adopt rejecting or overprotective attitudes. Sometimes parents interpret their children’s sexual orientation as a «phase», transmitting parental denial or ambivalence to their children.These behaviours and attitudes within the family can have a very detrimental effect on the psychosocial development of adolescents.

However, one study shows that if an LGTBIQ+ adolescent receives adequate family support, the protective effect on their mental health can be reflected both directly and indirectly. Directly, by influencing their self-acceptance, self-esteem and sense of self-confidence. Indirectly, by being able to educate them in appropriate ways to deal with homophobia or transphobia, as well as to prevent or deal with incidents of bullying outside the family context. In this sense, the family can be a key element in protecting sexual minorities from internalising the effects of victimisation or other societal attacks (Sidiropoulou et al., 2019).

How can we work with these families in therapy?

From the previous paragraphs it can be concluded that working with the families of LGTBIQ+ young people can be of great importance in preserving their mental health. Through psychological therapy, it is possible to help families to recognise and modify their false beliefs about the group, their stigma and to foster attitudes and behaviours of acceptance and support towards their children.

It is equally important to address the psychological stress experienced by LGTBIQ+ people, as well as the possible mental health problems linked to it. This therapeutic work should be carried out by professionals trained to work with sexual and gender diversity. It is particularly important to pay attention to issues of parental acceptance and rejection, and to work together with parents, with the aim of helping young people develop a healthy sense of self in terms of their sexual orientation.

At the same time, individual therapeutic work should focus on the appropriate handling of homophobia and transphobia in the individual’s different social contexts, as well as the psychological effects of possible experiences of discrimination. This requires a modification of false self-beliefs and a strengthening of self-esteem on cognitive and emotional levels, as well as learning behavioural strategies to cope with potentially stressful situations, e.g. social skills.


  • Alfageme, A. (2012, 5 diciembre). Los transexuales ya no son enfermos mentales. El Paí­s. Recuperado de
  • Katz-Wise, S., Rosario, M., y Tsappis, M. (2016). LGBT Youth and family acceptance. Pediatric Clinics of North America, 63(6), 1011-1025.
  • Newcomb, M., LaSala, M., Bouris, A., Mustanski, B., Prado, G., Schrager, S., y Huebner, D. (2019). The influence of families on LGBTQ youth health: A call to action for innovation in eesearch and intervention development. LGBT Health, 6(4), 139-145,
  • Rosario, M., y Schrimshaw, E. W. (2014). Theories and etiologies of sexual orientation. En D. L. Tolman, L. M. Diamond, J. A. Bauermeister, W. H. George, J. G. Pfaus, y L. M. Ward (Eds.), APA handbooks in psychology. APA handbook of sexuality and psychology, Vol. 1. Person-based approaches (p. 555–596). American Psychological Association.
  • The Trevor Project. (2020). 2020 National Survey on LGBTQ Youth Mental Health. The Trevor Project.
  • Sidiropouloul, K., Drydakis, N., Harvey, B., y Paraskevopoulou, A. (2019). Family support, school-age and workplace bullying for LGB people. International Journal of Manpower.
Division of Psychology, Psychotherapy and Coaching
Emma Chancellor Díez
Adults and adolescents
Languages: English and Spanish
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