Parents’ attitudes and behaviors toward their gay, lesbian, and bisexual offspring are key determinants of their children’s risks of suicide, subtance abuse and depression, according to a new study published in the journal Pediatrics.  Findings from the study were featured in a story by National Public Radio (NPR) health reporter Joe Shapiro on December 29th, 2008.

The findings dovetail with a period of raging social debate on gay rights, and suggest the large economic, social, and personal costs associated with ingrained stigma and discrimination.

As a group, gay, lesbian and bisexual teens and young adults have
higher rates of suicide and substance abuse problems than their
heterosexual peers.  The study in Pediatrics, conducted by a team of researchers led by Caitlin Ryan, director of Adolescent
Health Initiatives at the Cesar Chavez Institute at San Francisco State
University, found that rejection by one or both parents and efforts to change sexual orientation were significantly associated with higher risks of suicide and poorer health outcomes among this population.

Findings were based on an analysis of in-depth interviews and surveys conducted with 224 white and Latino
self-identified lesbian, gay, and bisexual young adults, ages 21 to
25.  Interviews were coupled with quantitative methods
to measure the type and frequency of parental and caregiver reactions
to a lesbian, gay, or bisexual sexual orientation, retrospectively during adolescence. 
The researchers also included measures of 9 negative health indicators,
including mental health, substance abuse, and sexual risk.  According to the researchers:

This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults.

Lesbian, gay, and bisexual 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.

Cultural norms also clearly played a major role: The researchers found that Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence.

Researchers gauged levels of rejection by examining behaviors such as whether parents
tried to get their child to change their sexual orientation or tried
to stop them from being with other gay kids.  Conversely, those whose parents remained neutral or were supportive fared far better.  This shows, Ryan told NPR, that:

A little bit of change in rejecting behavior [by parents],
and [having parents who are] a little bit more accepting, can make a
significant difference in the child’s health and mental health.

Parents’ perceptions of their own behavior and actions did not reflect an understanding of the effects such rejections have on their children. Ryan told NPR that:

Parents thought that by trying to change them that would make them
happy, but instead it put their children at great risk. When we shared that with parents, they were shocked.

Reflecting these findings, the researchers called for educational, counseling and training support for parents and caregivers of gay, lesbian and bisexual youth.

Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.

Similar findings have been found by other researchers.  Effie Malley, a senior prevention specialist at the federally-funded Suicide Prevention Research Center in Newton, Mass, has done her own research according to NPR and released another study this month that shows gay teens have very high rates of suicide attempts. She says parents matter — and so do peers, teachers and society.

What I’d like to see down the road is that parents and people who work with families counseling them would really take to heart Ryan and her co-authors’ research about not trying to change who the parents are or their beliefs, but just to help them to recognize the words they use and the actions that are harmful to their kids and to stop using those behaviors.

These findings underscore two further points.  The first is that sexual and reproductive health education and services that include unbiased, factual and non-stigmatizing information on sexual orientation are critical aspects of basic preventive health care–whether provided in schools, in community settings, or through other means–and must be addressed as part of the discussion on the kind of health care system we want–in the broadest sense–so that we can both prevent and mitigate the effects of stigma and discrimination on public health. 

The National Institutes of Mental Health reports that the costs of untreated depression alone in the U.S. population are astronomical.  In a 2006 analysis, Drs. Phillip Wang and Ronald Kessler of Harvard University note that:

Depression exacts economic costs totaling tens of billions of dollars
annually in the United States, mostly from lost work productivity.

To the extent that factual sexual and family life education programs remain contested and we delay implementation of effective programs, gay, lesbian, and bisexual teens will be disproportionately affected and the personal and medical costs for them, and the social and economic costs for the United States, will be that much higher.

The second is that these findings could not be more relevant to the current public debate around religious fundamentalisms and evidence-based approaches to sexual health and rights.  Religious and political leaders who continue to treat sexual identities other than heterosexuality as "outside the norm" contribute to a climate in which shame, marginalization and discrimination persist in many quarters. This climate in turn raises the costs in individual lives and for the public writ large in terms of higher rates of isolation, depression, substance abuse and suicide among vulnerable children, youth, and young adults.