Family Acceptance in Adolescence and the Health of LGBT Young Adultsjcap_246 205..213 Caitlin Ryan, PhD, ACSW, Stephen T. Russell, PhD, David Huebner, PhD, MPH, Rafael Diaz, PhD, MSW, and Jorge Sanchez, BA ISSUE: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. METHODS: A quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents’ sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N = 245). FINDINGS: Family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. CONCLUSIONS: Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities. Search terms: Gender identity, homosexuality, LGBT adolescent, protective factors, sexual orientation, transgender Caitlin Ryan, PhD, ACSW, is Director, Family Acceptance Project and Distinguished Adjunct Professor, Marian Wright Edelman Institute, San Francisco State University; Stephen T. Russell, PhD, is Fitch Nesbitt Endowed Chair and Director, Frances McClelland Institute, University of Arizona; David Huebner, PhD, MPH, is Assistant Professor of Psychology, University of Utah; Rafael Diaz, PhD, MSW, is Professor of Ethnic Studies, San Francisco State University; Jorge Sanchez, BA, is Project Coordinator, Family Acceptance Project, San Francisco State University, USA. Extensive research has focused on the nurturing and pro- tective role of families, in general, and connections to family have been shown to be protective against major health risk behaviors (e.g., Resnick et al., 1997). Although family rela- tionships are understood to be a primary context for adoles- cent development, only a small number of studies have focused on the role of parent–adolescent relationships for lesbian, gay, and bisexual (LGB) youth and young adults. Literature addressing the family relationships for transgen- der adolescents and young people is miniscule. Given the crucial role of parents in promoting adolescent well-being, it is surprising that so little attention has focused on the parent- ing of lesbian, gay, bisexual, and transgender (LGBT) adoles- cents. Most existing research has focused on negativity in the relationships between LGB youth and their parents; no known research has considered the possible developmental benefits of family acceptance and supportive behaviors for LGBT youth. One study has assessed the relationship between LGB young adults’ perceived family support (e.g., general closeness, warmth, and enjoying time together) and depression, substance use, and suicidality (Needham & Austin, 2010). The lack of literature on family support is particularly surprising because LGB youth and adults (Cochran, Sullivan, & Mays, 2003; D’Augelli, 2002; Meyer, 2003) and youth with same-gender attractions (Russell & Joyner, 2001) are known to be at risk for compromised physical and emotional health. Research over the past decade has begun to trace the origins of health disparities associated with sexual identity; these studies have focused largely on the role of victimization and negative peer relationships during adolescence and asso- ciated health risks in adolescence and young adulthood doi: 10.1111/j.1744-6171.2010.00246.x © 2010 Wiley Periodicals, Inc. Journal of Child and Adolescent Psychiatric Nursing, Volume 23, Number 4, pp. 205–213 JCAPN Volume 23, Number 4, November, 2010 205