Supporting Children Who Come Out Matters

Coming out as gay, lesbian, or bisexual may be good for young people’s health, particularly when parental support is involved.

A comprehensive new study led by Emily Rothman, a School of Public Health associate professor of community health sciences, shows that two-thirds of lesbian, gay, and bisexual adults in a representative Massachusetts sample reported receiving positive support from their parents after telling them about their sexual orientation. Their incidence of mental health and substance abuse problems was significantly lower than those who did not receive support, the authors report.

Overall, the study found that three-quarters of lesbian, gay, and bisexual adults reported having come out to their parents, typically when they were about 25 years old.

Parents’ response to their coming out led to different health outcomes, according to the researchers. Gay and bisexual males whose parents did not support them, for example, had six to seven times the odds of serious depression and binge drinking, while lesbian and bisexual females had 5 times the odds of developing serious depression, and 11 times the odds of illicit drug use.

In the study, published in the Journal of Homosexuality, Rothman and her colleagues surveyed 5,658 Massachusetts adults ages 18 to 64 using a statewide surveillance system. They explored whether coming out—and the reaction it received—was associated with better or worse adult health. The authors controlled for such factors as age, race, education level, and health insurance status, in order to focus as narrowly as possible on the association between coming out and adult health status.

Some college students who came out to their parents in their late teens said they were not surprised by the findings. Nicole Sullivan, a 22-year-old student at Bunker Hill Community College, came out as bisexual when she was 19 years old. “I struggled with mental health and drug problems during my adolescence, and I know that some of it is because I didn’t feel accepted at home,” she says. “I am really grateful that I had cousins who supported me, and it’s because of them that I was able to get healthy.”

The study’s authors found that the act of coming out (instead of remaining closeted) was generally associated with better health for lesbian and bisexual women, but that this was not similarly true for gay and bisexual men.

“It’s possible that the stress of not disclosing your sexuality to your parents affects men and women differently,” explains Rothman. “In general, gay and bisexual men may be able to conduct their sexual lives apart from their parents with less stress. On the other hand, it’s also possible that this was true only for this particular sample.”

Citing the high rates of suicide and self-harm among lesbian, gay, and bisexual (LGB) young people, and the high costs of treating mental-health and substance-abuse disorders, Rothman says that “it’s critical that we understand what we can do to promote better health for LGB kids.”

In the study, the authors propose that a low-cost but potentially far-reaching strategy to improve LGB youth health would be for national academies of pediatric medicine to develop and disseminate guidelines or recommendations that would encourage pediatricians to provide all parents of adolescents with tips for supporting their children if they come out as lesbian, gay, or bisexual.

“The way that parents treat their LGB children when they come out is an important public health topic that has received too little attention to date,” Rothman says. “Our message is that parents should take note: the way we treat our LGB children, even from before the time they disclose their sexual orientation status, may have a long-term, significant impact on their health and ability to handle life’s challenges.”

Other researchers on the study were Ulrike Boehmer, an SPH associate professor of community health sciences, and Mairead Sullivan (SSW’07) of Emory University.

The research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism.

The full study is available here.

Lisa Chedekel can be reached at chedekel@bu.edu.