While there has been extensive research on parenting risk and protective factors for the general population, knowledge of parenting specific to queer youth—those who identify as lesbian, gay, bisexual, pansexual, queer, or other sexual minority identities—remains very limited. Recognizing this gap, two Faculty Fellows at the UNC Frank Porter Graham Child Development Institute (FPG) joined with colleagues from Carolina and the University of Wisconsin at Madison to examine previous research. The findings, “Parenting and Queer Youth Mental Health and Substance Use: A Systematic Review and Meta‐analysis,” were published earlier this year in Adolescent Research Review.

The research grew out of conversations among FPG Faculty Fellow Melissa Lippold PhD, an associate professor in the School of Social Work, FPG Faculty Fellow Roger Mills-Koonce, PhD, professor in the School of Education, and Will Hall, PhD, associate professor in the School of Social Work. The three colleagues were interested in bringing together their knowledge and research to create a parent-based intervention that focuses on supporting queer teens. In discussing the process to develop such an intervention, they realized that they first had to do basic research to outline and understand the specifics of what parents can do to promote the well-being of these children.

The systematic review and meta-analysis addressed three questions:

1. What parenting factors are risk factors for mental health or substance use outcomes among queer youth?
2. What parenting factors are protective factors for mental health or substance use outcomes among queer youth?
3. What is the magnitude and direction of parenting factors associated with mental health and substance use outcomes among queer youth?

The researchers note that queer youth experience higher rates of mental health challenges such as depression, anxiety, suicidality and substance use than their heterosexual peers. Lippold, whose research focuses on parent-child relationships during adolescence, says that while parenting plays an important role in the lives of all teens, it may be particularly important for queer teens who bear a disproportionately high risk of mental health issues. She says that there is strong evidence that parental support can reduce the risk for these mental health challenges.

Lippold says that parenting of queer teens is surprisingly understudied. While the team found research on this topic, it had been more than 10 years since the last systematic review of the effects of parenting for queer youth had been conducted. In their systematic review, the researchers reviewed studies specific to queer youth, rather than studies that compare queer teens to their heterosexual counterparts. The research examined the most recent empirical literature, between 2011 and 2021, with the idea that this information would be relevant to contemporary queer youth and their parents. The age range of the studied subjects spanned 12 to 25 years old.

“We want to better understand and define the positive things that parents can do to support their child’s identity because the focus has been more on parental rejection and other negative actions by parents,” says Lippold, “There are a lot of parents who love their child and want guidance about what they can do to support their teen. We hope that some of the research that we are doing can help answer those questions.”

For the systematic review and meta-analysis, the team used standards from PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses), which provides guidance for the reporting of systematic reviews evaluating the effects of interventions. They identified 24 studies for review, 15 of which were included in a meta-analysis on the effects of parental support and rejection.

One of the study’s key findings is that there is a lack of clear measures of parental support specific to queer youth. “We want to better understand and define the positive things that parents can do to support their child’s identity because the focus has been more on parental rejection and other negative actions by parents,” says Lippold, “There are a lot of parents who love their child and want guidance about what they can do to support their teen. We hope that some of the research that we are doing can help answer those questions.”

The study also found that greater parental support and less parental rejection were both associated with fewer internalized problems and substance use among queer teens. The meta-analysis found that the effects of parental rejection on youth mental health were stronger than those of support. Both parental rejection and support remain important as predictors of queer youth depression, anxiety, suicidal behaviors and/or ideation, and substance use. The researchers suggest that next steps should include expanded conceptual models and measures that capture the nuanced ways that parents may affirm queer youth identity and promote queer youth well-being.

“Parents really matter for the mental health of queer teens,” says Lippold. “Positive and supportive behaviors can reduce the risk of mental health challenges.”

The research team is now working on a qualitative study to understand positive parenting behaviors. Lippold hopes that this collaboration will continue and lead to definitions of affirmative parenting of queer teens that could result in the creation of family-based interventions.

“Parents really matter for the mental health of queer teens,” she says. “Positive and supportive behaviors can reduce the risk of mental health challenges.”