1124957

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JARXXX10.1177/07435584221124957Journal of Adolescent ResearchBosse et al.

Article
Journal of Adolescent Research

Sexual and Gender

1­–31
© The Author(s) 2022
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DOI: 10.1177/07435584221124957
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that are Supportive and

Unsupportive of Sexual
Orientation and Gender
Identities

Jordon D. Bosse1,2 , Sabra L. Katz-Wise3,4,

and Lisa M. Chiodo5,6

Abstract
To explore specific responses that sexual and gender diverse young adults
(SGD YA) perceive to be supportive and unsupportive of sexual orientation
and gender identity by caregivers and other adults following identity disclosure.
SGD YA (N = 101), ages 18 to 25 years (M = 21.2) were predominantly
White (83.1%), non-Hispanic (89.1%), assigned female at birth (82.2%). The
majority (97.8%) were sexually diverse (e.g., queer, pansexual, lesbian, gay,
asexual, bisexual) and half (50%) were gender diverse (e.g. transgender,
agender, genderqueer, nonbinary). Participants completed an online survey.
This analysis is focused on participants’ responses to open-ended questions

1
Northeastern University, Boston, MA, USA
2
Massachusetts General Hospital, Boston, USA
3
Boston Children’s Hospital, MA, USA
4
Harvard Medical School, Boston, MA, USA
5
University of Massachusetts, Amherst, USA
6
Wayne State University, Detroit, MI, USA

Corresponding Author:
Jordon D. Bosse, School of Nursing, Northeastern University, 360 Huntington Ave., 106 K
Robinson Hall, Boston, MA 02115, USA.
Email: j.bosse@northeastern.edu
2 Journal of Adolescent Research 00(0)

regarding responses they perceived to be supportive and unsupportive

of their SGD identity/identities. Content analysis of participants’ open-
ended survey responses was conducted using a combination of inductive
and deductive coding. Six themes emerged for both supportive responses
(communication, actions, acceptance, open-mindedness, unconditional love,
and advocacy) and unsupportive responses (distancing, hostility, minimizing,
controlling, blaming, and bumbling). For some themes, different sub-themes
emerged based on identity. Parents/caregivers as well as other adults in the
lives of SGD YA can implement specific responses to demonstrate support
for sexual orientation and gender identity with the potential to improve the
mental health of SGD YA.

Keywords
sexual orientation, gender identity, LGBT issues, early/emerging adulthood,
young adults, parent-child relations, social support

Sexual and gender diverse young adults (SGD YA; e.g., those who identify
as lesbian, gay, bisexual, transgender, nonbinary, queer, and other identities)
have several known disparate physical and mental health outcomes and risk-
taking behaviors that can be influenced by parental support or lack of sup-
port for their sexual orientation and/or gender identity following identity
disclosure (Bockting et al., 2013; Haas et al., 2014; Rosario et al., 2004;
Ryan et al., 2009; Teasdale & Bradley-Engen, 2010). Disclosing one’s sex-
ual orientation and/or gender identity (“coming out”) to others is a process
that is crucial to identity formation and integration (Cass, 1979; Devor,
2004; Troiden, 1979). Rather than a discrete point in time, coming out is an
ongoing process, often beginning with close, trusted individuals (e.g., close
friend or immediate family member), then expanding to others in one’s life
(Herek, 1996; Rust, 1993). Whether because of changing contexts, fluidity
in one’s identity, or evolution of how an individual understands their gender
identity or sexual orientation, identity disclosure to the same person may
occur more than once (e.g., first as bisexual, and then as gay or lesbian; first
as gay and then as transgender) across the lifespan (Katz-Wise & Hyde,
2015; Katz-Wise et al., 2017; Rosario et al., 2006; Rowniak & Chesla,
2013). Coming out to a particular person, especially for the first time, can be
a stressful event for SGD YA, particularly when one is unsure how the other
person will respond, has already received negative responses from others,
Bosse et al. 3

has a high level of internalized stigma, or anticipates rejection (Charbonnier

& Graziani, 2016; Grafsky et al., 2018; Pistella et al., 2016).
Parents may have a range of responses to SGD identity disclosure that
have been categorized as neutral, positive, negative, and mixed (Chrisler,
2017). Previous research on parental responses to gender identity disclosure
has identified responses ranging from explicit rejection to unconditional
acceptance (e.g., Koken et al., 2009), with the potential for responding in
ways that demonstrate both acceptance and rejection (Catalpa & McGuire,
2018; Pariseau et al., 2019). Parental acceptance and/or rejection of sexual
orientation and/or gender identity can either improve or exacerbate health
outcomes among SGD YA (Zimmerman et al., 2015). A recent systematic
review on risk and resilience factors for gender diverse youth’s (GDY) men-
tal health identified that parent and family connectedness and parental sup-
port for gender identity are negatively associated with adverse mental health
outcomes (e.g., depression, suicidality, non-suicidal self-injury, despair, and
posttraumatic symptoms), and positively associated with life-satisfaction,
self-esteem, and resilience (Tankersley et al., 2021). Similar results have
been found among sexually diverse youth (SDY) (Newcomb et al., 2019). A
critical review that was focused on family strengths (appreciation and affec-
tion, commitment, coping ability, positive communication) and health/well-
being factors among GDY demonstrated similar associations (Brown et al.,
2020). Parental support for sexual orientation and gender identity can also
improve health-seeking behaviors and reduce risk-taking behaviors such as
substance use/abuse, unprotected intercourse, and self-harm (Haas et al.,
2014; Newcomb et al., 2019; Tankersley et al., 2021).
Support for SGD YA can take many different forms. Social support is a
broad construct that has been defined in terms of the specific function or
categories of supportive behaviors, and commonly includes tangible support
and emotional support (Barrera, 1986; Pierce et al., 1996; Rueger et al.,
2016). Tangible support is the provision of “task-focusing and pragmatic
assistance” (Weine & Siddiqui, 2009, p. 426). Tangible support may also be
described as “received” support (Glanz et al., 2008) and may include specific
behaviors (e.g., provision of money, information, praise, or assistance)
(Haber et al., 2007). Tangible or received support is often situational and
given in response to a specific event during a specific time frame (Barrera,
2000; Thoits, 1986; Uchino, 2009). Tangible support for SGD YA could
include connecting the young adult with community resources, educating
others about SGD identities, advocating on their behalf, and using the young
adult’s chosen name and pronouns (Chrisler, 2017; Hale et al., 2021; Roe,
4 Journal of Adolescent Research 00(0)

2017; van Bergen et al., 2021). Emotional support, which occurs when some-
one “shows and expresses concern, care, and reassurance” (Weine & Siddiqui,
2009, p. 426), is less tangible than other types of support, but equally benefi-
cial. Emotional support for SDG YA may include expressing approval of
SGD identities, affection, and unconditional love, being emotionally avail-
able for conversations about sexual orientation and/or gender identity and
envisioning a positive future for the young person (Chrisler, 2017; Hale et al.,
2021; Le et al., 2016; Roe, 2017; van Bergen et al., 2021).
Though social support is often driven by good intentions (Glanz et al.,
2008), it is not always perceived as beneficial by the recipient, particularly
under stressful or uncomfortable circumstances (Ingram et al., 2001).
Research in the context of other stressful circumstances has identified four
themes consistent with unsupportive interactions following a stressful life
event: distancing, bumbling, minimizing, and blaming (Ingram et al., 2001).
A person may create physical or emotional distancing from the person expe-
riencing stress by avoiding the topic, changing the subject, and refusing
requests for help (Ingram et al., 2001). Bumbling interactions are those in
which the individual who has been disclosed to subsequently behaves awk-
wardly toward or displays discomfort interacting with the disclosing indi-
vidual (Ingram et al., 2001). Bumbling actions may include trying to fix
uncomfortable feelings (e.g., forcing optimism); engaging in unwanted phys-
ical touch (e.g., hugging); or coming across as not knowing what to say to
provide support, being afraid to say the “wrong” thing, or asking intrusive
questions (Ingram et al., 2001). A person might also minimize the individual’s
experience of stress by invalidating their experience, such as saying they are
overreacting or telling them to forget about the experience (Ingram et al.,
2001). Finally, one might blame the individual, making them feel responsible
for the stressful circumstances they find themselves in (Ingram et al., 2001).
Prior research with SGD YA has demonstrated that many experience physi-
cal, social, and emotional distancing from parents (e.g., being kicked out,
having financial support withdrawn, refusing to discuss sexual orientation
and/or gender identity); bumbling (e.g., asking inappropriate questions) due
to lack of information about sexual orientation and/or gender identity; mini-
mizing (e.g., telling them “it’s just a phase”) and blaming the SGD YA behav-
ior (e.g., disclosing their identity, gender nonconformity) for negative
interactions (Catalpa & McGuire, 2018; Chrisler, 2017; Graham et al., 2014).
Regardless of intent, responses such as these can negatively impact SGD YA
mental health.
Doty et al. (2010) found sexuality specific support and the provision of
advice, guidance, or comfort in responses to sexual-orientation related stress-
ors, contributed to decreased emotional distress in sexually diverse youth
Bosse et al. 5

(SDY). However, SDY were less likely to get sexual orientation-specific sup-
port from family members compared to receiving support from friends (Doty
et al., 2010). Gender diverse people may also receive less overall support
from family members (Factor & Rothblum, 2007). Transgender women
report less family support than gay and bisexual cisgender men (authors) and
cisgender women (Davey et al., 2014). Lack of primary parent support com-
pared to support from other adults has been associated with increased psy-
chological distress among GDY (Le et al., 2016). It is possible that family
members may not understand SGD-related stressors or know how to provide
guidance (Doty et al., 2010). For social support to be effective, the type of
support provided must match the demands of the stressor on the receiving
individual (Cutrona & Russell, 1990). It is possible that there is a “mis-
match” between what SGD YA perceive as needed support regarding their
sexual orientation and/or gender identity and the types of support that their
parents/caregivers may be providing. Thus, the aim of this project is to better
understand the specific responses that SGD YA perceive to be supportive and
unsupportive of sexual orientation and gender identity by caregivers and
other adults following SGD identity disclosure.

Method
Participants
One hundred one participants (of the original sample, previously described in
Bosse & Chiodo, 2016) responded to the open-ended questions. Participants’
mean age was 21.1 years (SD =2.1, range: 18–25). The majority (n = 98,
97.0%) reported diverse sexual orientation identities, with nearly half identi-
fying as pansexual or queer. GD participants (N = 50, 50.0%) identified as
transgender, nonbinary, agender, genderqueer, or a gender different than their
sex assigned at birth. Participants were predominantly White (83.1%), non-
Hispanic (89.1%), and assigned female at birth (82.2%). About a third of the
sample were living with a parent at the time of the survey. The characteristics
of participants in the sample are provided in Table 1.

Data Collection
Data were collected between November 2014 and March 2015, as part of a
larger cross-sectional study examining potential predictors of SGD YA per-
ception of parental acceptance-rejection. Printed flyers and wallet-sized cards
with a QR code to access the study materials online were sent to community
6 Journal of Adolescent Research 00(0)

Table 1.  Sample Demographics (N = 101).

M SD

Age (years) 21.2 2.2

  n %
Sexual orientation identity
 Queer 24 23.8
 Pansexual 19 18.8
 Lesbian 16 15.8
 Gay 12 11.9
 Asexual 11 10.9
 Bisexual 11 10.9
 Heterosexuala 3 2.9
  Another identity 5 4.9
Gender identity
 Woman 39 38.6
 Manb 19 18.8
 Transman/transmasculine 13 12.9
 Genderqueer/non-binary 13 12.9
 Agender 5 4.9
 Transgender 3 2.9
  Wrote in multiple 4 3.9
 Questioning/unsure 3 2.9
  Another identity 2 1.9
Sex assigned at birth
 Male 17 16.8
 Female 83 82.2
 Intersex 1 1.0
Race
 White 84 83.3
  More than one race 7 6.9
  Black/African American 3 2.9
  Another racial identityc 3 2.9
  Not reported 4 3.9
Ethnicity
 Hispanic 11 10.9
  Not Hispanic 90 89.9
Live at home/with parent(s) 32 31.68
a
Transgender-identified respondents; bIncludes individuals who were assigned female at birth
and whose gender identity is man; cIncludes American Indian (n = 1), Asian (n = 1), Pacific
Islander (n = 1).
Bosse et al. 7

organizations around the US that serve SGD YA. Some community organiza-
tions shared study information via Facebook posts in addition to printed
materials. Participants were also recruited online via posts in Facebook
groups geared toward SGD YA with permission from group administrators;
study information was either shared by the group administrator or posted by
the first author (in groups in which he was a member). Participants completed
an online survey hosted by Survey Monkey. All study procedures were
approved by The University of Massachusetts.

Measures
Sex assigned at birth.  Participants were asked whether they were assigned the
sex male, female, or intersex.

Gender identity. Participants selected a single response from the following

gender identity options: man, woman, transman/transmasculine/female-to-
male, transwoman/transfeminine/male-to-female, genderqueer, and some-
thing else (please describe). Participants who reported a sex at birth that was
different than their gender identity (e.g., female at birth, identifies as a man)
were also categorized as transgender and asked about gender identity sup-
portive responses as outlined below.

Sexual orientation.  Participants were asked how they define their sexual ori-
entation by selecting a single response from the following options: asexual,
bisexual, don’t know, gay, heterosexual/attracted to another gender, lesbian,
pansexual, queer, something else (please describe).

Supportive responses.  The focus of this analysis was the open-text responses
to questions in which participants were asked to specify the “top three”
behaviors demonstrating support and lack of support for sexual orientation
and gender identity. The instructions read: “[B]ecause ‘support’ means differ-
ent things to different people, I would like to know what behaviors1 you think
show support. Please list 3 things below that show how parents and other
adults can be most supportive of your sexual orientation. These can either be
things people have actually done, or things you think they could do to support
LGBTQ young people.” This question was followed by: “What are three
things that parents and other adults have done that have demonstrated that
they are NOT supportive of your sexual orientation?” Then, for participants
who indicated a transgender or genderqueer identity, the questions were
repeated replacing sexual orientation with gender identity. The questions
8 Journal of Adolescent Research 00(0)

about supportive and non-supportive behaviors were asked separately regard-

ing sexual orientation and gender identity, allowing participants to provide
information about either sexual orientation or gender identity, or both sexual
orientation and gender identity. Not all participants listed three responses for
each question.

Data Analysis
Each response was copied to a separate index card, and the cards were first
divided into supportive and unsupportive responses. Then they were further
divided by sexual orientation and gender identity, resulting in four sets of
data: responses supportive of sexual orientation, responses unsupportive of
sexual orientation, responses supportive of gender identity, and responses
unsupportive of gender identity. Individual responses (n =12) that were not
about a parental adult’s responses (e.g., “My wife doesn’t police my gender”)
or that did not provide enough contextual information to be categorized (e.g.,
“remembering”) were excluded from analysis, which left 849 responses for
coding.
Data were coded by hand by the first author and a research assistant inde-
pendently and analyzed using a general content analysis with both inductive
and deductive approaches (Miles & Huberman, 1994). For supportive
responses, words and phrases within each response were coded inductively.
Coded items were then grouped into categories and then higher order themes.
For unsupportive responses, theoretical codes distancing, bumbling, mini-
mizing, and blaming were applied to the data. Responses that did not fit into
any of the theoretical categories were coded inductively, grouping similar
items, and organizing them into additional themes. Finally, any data that had
not yet been categorized by theme, sub-theme or code was examined to deter-
mine if any similarities exist.
There was minimal overlap between responses regarding sexual orienta-
tion and gender identity. Five participants who answered both items about
sexual orientation and gender identity wrote identical responses for at least
one support item (n = 6 items total). Similarly, seven participants wrote the
exact same answer for lack of sexual orientation and gender identity support
for at least one item (n = 9 items total). Finally, one person wrote in “same as
before” for all gender identity responses (supportive and unsupportive) after
entering sexual orientation support responses; because we were unable to
know what the prior responses were, these were excluded from gender iden-
tity-related analyses.
For every set of data, the first author and research assistant met after each
step to compare findings and discuss discrepancies; once categories and
Bosse et al. 9

themes were created, they were sent to the last author for review. After final
themes were agreed upon, the individual responses were independently
reviewed to make sure they were consistent with the final themes and sub-
themes. Discrepancies in coding were resolved through multiple strategies
(collective reflection, open dialog, and considering rival explanations and
alternative conclusions), which enhanced the credibility and confirmability
of the findings, until a consensus was reached on all responses (Cohen &
Crabtree, 2008). The coded data were re-entered into the computer in an
Excel spreadsheet to facilitate frequency counts of categories (sub-themes)
and themes. Any categorical responses that made up less than 1% of the over-
all responses (n < 3) or responses that mirrored the overarching theme (e.g.,
“support me”) were counted under the theme but are not listed as specific
sub-themes.

Researchers
All of the authors are White, non-Hispanic individuals with diverse sexual
orientations and/or gender identities; one author is also the parent of a SD
YA. Researchers’ training includes developmental psychology, adolescent
health, gender and women’s studies, and nursing. All authors were employed
in academic settings when the data were collected. Two authors had experi-
ence conducting research with SGD YA and their parents/caregivers. The first
author, who was responsible for recruiting participants, had shared identities
with some potential participants, which was known by his membership in
specific Facebook groups. Having shared identities may have influenced
whether some SGD YA responded to the study materials.
Primary assumptions relevant to these analyses are the beliefs that SGD
YA are the experts of their own lives and experiences and that it is important
to affirm the gender of transgender and nonbinary young adults. Assumptions
about parents/caregivers included that they may have a sense of the young
person’s identity even before identity disclosure, and that they may respond
in ways that are both supportive/unsupportive, including having mixed feel-
ings. As such, the researchers anticipated a mix of supportive and unsupport-
ive behaviors being reported. Interpretations of supportive and unsupportive
behaviors could be influenced by the researchers’ own experiences of dis-
closing their SGD identities or responding to the disclosure of a child’s SGD
identity. The two coders kept reflexive notes as codes and themes were
emerging to document their own thoughts, feelings, and experiences related
to the data. The notes were used during code comparison meetings to discuss
the ways in which personal reactions may have biased interpretation.
10 Journal of Adolescent Research 00(0)

Results
Sample
Most sexually diverse youth (SDY) (82.0%) had disclosed their sexual orien-
tation to at least one parent, on average, at 17 years old (SD = 2.6). About half
of GDY (52.9%) had disclosed their gender identity to at least one parent, on
average at 19 years old (SD = 2.3). Among those who had disclosed their sex-
ual orientation and/or gender identity, nearly half (47.9%) ranked a parent in
their “top three biggest supporters” for sexual orientation and about a fifth
(20.8%) as top supporters of their gender identity.
Nearly the entire sample provided at least one response that was support-
ive of sexual orientation (n =98; 97.0%) or unsupportive of sexual orientation
(n =100, 99.0%); 43 (42.5%) responded to at least one question about sexual
orientation and gender identity, and 3 (2.9%) responded only about gender
identity. In all, participants provided 417 supportive responses (219 for sex-
ual orientation and 118 for gender identity) and 422 unsupportive responses
(296 for sexual orientation, 126 for gender identity).

Themes
Supportive responses. From the responses regarding supportive behaviors,
participants described responses that fell into six themes: (1) communication,
(2) responses, (3) acceptance, (4) open-mindedness, (5) unconditional love,
and (6) advocacy. The frequency with which each theme and sub-theme was
reported overall and by sexual orientation or gender identity is provided in
Table 2.

Theme 1: Communication. Responses regarding communication made

up 29.7% of the total responses regarding perceived supportive responses.
There were four sub-themes within communication; (1) use identity and gen-
der appropriate language, (2) ask questions, (3) keep lines of communica-
tion open, and (4) use active listening. Use identity and gender-appropriate
language accounted for 43% of communication responses. For example,
“When they ask if I have a romantic love interest, they use gender neutral
language like ‘significant other’ or ‘love interest’ to show I’m not attracted
to one gender” (pansexual cisgender man). Among GDY, “Using my name
and pronouns” was the main response. Participants also encouraged the par-
ent or adult to ask questions “. . .but in a curious and polite way and without
pressing” (bisexual genderqueer person), keep lines of communication open
(e.g., “Make themselves available if I ever want to talk” (pansexual agender
Bosse et al. 11

Table 2.  Supportive Responses by Theme and Sub-Theme for Overall Sample and
by Disclosure Type.
Number of responses*

All SO GI
Theme Sub theme n = 427 n = 302 n = 125

Communication 7 7 —
  Use identity and gender appropriate language 55 12 43
  Ask questions 32 22 10
  Keep lines of communication open 17 14 3
  Active listening 16 14 2
  Total 127 69 58
Actions 3 2 1
  Support relationships 30 30 —
  Emotional support 29 23 6
  Acknowledge identity publicly 10 10 —
  Support gender expression 10 — 10
  Normalize 9 9 —
  Help the individual engage with SGD 8 8 —
community
  Instrumental resources (incl. medical care) 7 2 5
  Be present 4 4 —
  Total 110 88 22
Acceptance 13 10 3
  Affirm new identity 24 14 10
  Treat the individual the same 21 16 5
  Not making a big deal about it 13 12 1
  Total 71 52 19
Open-mindedness 1 1 —
  Willing to learn 33 26 7
  Make an effort to understand 11 8 3
  Open to changes in identity 8 5 3
  Total 53 40 13
Unconditional love 34 29 5
Advocacy 4 2 2
  Stand up against hate 13 9 4
  Discuss the issues with others 8 7 1
  Show political support of SGD issues 7 6 1
  Total 32 24 8

Note. GI = gender identity; SGD = sexual and gender diversity; SO = sexual orientation.
*There are more responses in the overall theme than appear in the sub-themes.
12 Journal of Adolescent Research 00(0)

person) and use active listening (e.g., “Listening to worries and hopes about
crushes and relationships” (pansexual cisgender woman). One participant
advised:

Try your hardest to keep open communication with them, and a space of
comfort. If the person would not like to talk about it, then don’t push them to
talk. But if they express that they feel comfortable talking about it, then talk!
(pansexual cisgender woman)

Communication was the most common theme for gender diverse participants;
using identity and gender appropriate language accounted for more than a
third of all supportive behavior responses.

Theme 2: Actions.  Responses that conveyed support for identity made up

about a quarter (25.7%) of the responses in the overall samples and was com-
posed of eight sub-themes: (1) support relationships, (2) provide emotional
support, (3) acknowledge identity publicly, (4) support gender expression,
(5) normalize identity, (6) help the individual engage with the SGD commu-
nity, (7) provide instrumental resources, and (8) be present. Support relation-
ships (e.g., “make it known that my significant others are welcome at home”
(lesbian cisgender woman) and provide emotional support (e.g., “console
when having trouble” (lesbian cisgender woman) combined made up more
than half (53%) of the action-based responses. Acknowledge identity publicly
(e.g., “Acknowledge my partner to their friends” (gay cisgender man)) and
support gender expression (e.g., “buying things that fit their identity or buy-
ing things they need to help them pass (e.g., binders, packers, etc.)” (hetero-
sexual transgender man) were the next most common responses. Participants
wanted their parents and other adults to normalize their identity (e.g., “point
out cute guys, girls, and gender nonconforming people to me” (pansexual
transgender man) and help the individual engage with the SGD community.
The latter included identifying resources and providing “transportation to.  .  .
youth events [for SGD YA], including queer dances, discussions, and pride
parades” (queer cisgender woman). Respondents were looking for their
parents/caregivers to provide instrumental resources, which included basic
needs like housing (e.g., “Let me live with them” (lesbian cisgender woman)
and, for GDY, access to medical care. The final sub-theme in this category
was to be present, by physically attending events and/or functions (e.g., pride
celebrations, graduations, weddings) that are important to the young person.
For example, “volunteering to chaperone field trips for the [Gay-Straight
Alliance]” (queer femme).
Bosse et al. 13

Responses that conveyed support for sexual orientation identity were the
most frequently theme reported by SDY, accounting for nearly a third (30%)
of their total responses. Five of the subthemes appeared only in responses
from SDY: supporting relationships, acknowledging identity publicly, nor-
malizing, helping individual engage with the SGD community, and being
present. One SDY noted, “My mom sometimes will point out girls with rain-
bow bracelets on, or ask about the people I’m dating, and that makes me feel
supported” (pansexual cisgender woman). Among GDY responses, support-
ing gender expression was a unique response, as was assistance accessing
medical care (under the sub-theme of instrumental resources). For example,
“telling you they like your hairstyle or complimenting your appearance”
(pansexual nonbinary person).

Theme 3: Acceptance. Acceptance of the individual’s newly disclosed

SGD identity was the next most frequent response, making up approximately
17% of the total supportive responses. Three sub-themes were identified: (1)
affirm new identity, (2) treat the same, and (3) not make a big deal. About a
third of the responses reflected a desire to be affirmed in their new identity,
which included “believe[ing],” and not “questioning,” “denying,” or “try-
ing to change” the individual. They also wanted to be treated the same as
they were pre-disclosure and treated the same as others (e.g., “Treat me like
anyone else and not. . . like some rarity to be examined” (human, pansexual
person). The remaining responses in the theme of acceptance were proposed
to not make a big deal of it; one participant suggested, “non-reaction would
be perfect” (bisexual cisgender woman).

Theme 4: Open mindedness.  The theme of being open-minded made up

12% of the total response and included three sub-themes: (1) willing to learn,
(2) make an effort to understand, and (3) be open to changes in identity.
Willingness to learn included learning specific language/terminology while
making an effort to understand included self-education (e.g., “go to PFLAG
[Parents and Friends of Lesbians and Gays]/support groups” (queer transgen-
der person). Be open to changes in identity responses included recognition
that identities may change. For example, “Recogniz[e] gender as fluid and
not fixed as society has made it to be” (pansexual genderqueer person). Two
responses included recommendations for being an ally to SGD YA. For one
young person, this included “never use offensive language and do your best
to educate others on being a good ally as well” (queer transgender man). The
other advised,
14 Journal of Adolescent Research 00(0)

Do not remain uneducated on [lesbian, gay, bisexual, transgender, and/or

queer] LGBTQ issues and stereotypes. Learn to work through your biases. I’d
also recommend that people research LGBT issues, to understand their loved
ones feelings, and complications better. I’d recommend The Trevor Project
(pansexual cisgender woman)

Theme 5: Unconditional love.  Nearly at 10th of the responses (8%) indi-

cated the need for love that is unchanging and without limitations. Some
examples included, “Say that my sexuality matters, but does not change their
opinion of me as a person” (pansexual agender person) and “Offer reassur-
ance that one’s gender has not changed the relationship” (queer agender per-
son). One participant provided guidance to parents/caregivers on how to best
demonstrate unconditional love even in the presence of mixed feelings:

Be honest and explain the reasons why you may have mixed feelings about it,
but in the end, say you support them because of who they are, not because you
need to. Tell them that you care for them, and that you love them, and that
nothing could change that. (pansexual cisgender woman)

Theme 6: Advocacy.  The remaining supportive behaviors (7.5%) partici-

pants identified were focused on advocating on behalf the SGD young adult
through action. Three subthemes were identified: (1) standing up against
hate, (2) discussing issues with others, and (3) providing political support of
SGD issues. Standing up against hate primarily referred to behaviors defend-
ing the young person’s SGD identity/identities to others, including immedi-
ate and extended family members. One participant specified that defending
could be demonstrated by person wrote, “mak[ing] an effort to correct people
who misgender me, use the wrong name, or police me in the restroom” (trans-
gender, queer, asexual person). Discussing issues with others was focused on
educating others about issues relevant to SGD populations. Lastly, providing
political support of SGD issues as advocacy included acts like “. . .voting in
favor of equal rights legislation” (gay cisgender man).

Unsupportive responses.  Participants’ descriptions of unsupportive responses

fell into six themes, which were developed from the four theoretical codes
and two emergent codes (in order of frequency: (1) distancing, (2) hostility,
(3) minimizing, (4) controlling, (5) blaming, and (6) bumbling. The two
emergent themes were hostility and controlling. The frequency with which
each theme and sub-theme of unsupportive responses was reported overall
and by sexual orientation or gender identity is presented in Table 3.
Bosse et al. 15

Table 3.  Unsupportive Responses by Theme and Subtheme- Overall and by

Disclosure Type.

Number of responses

All SO GI
Theme Sub theme n = 422 n = 296 n = 126
Distancing* 1 1 —
  Refuse to give specific help or support 39 5 34
  Deny identity’s existence 22 15 7
  Not wanting to hear about it 23 18 5
  Not acknowledging identity 20 18 2
  Does not want to learn about identity 7 5 2
  Total 112 62 50
Hostility* 12 6 6
  Hateful language/verbal abuse 51 44 7
  Disown 16 14 2
  Interrogate 6 4 2
  Physical violence 8 6 2
  Mock 7 4 3
  Yell 6 5 1
  Neglect 3 3 —
  Total 109 86 23
Minimizing  
  Not taking identity seriously 30 21 9
  Invalidate identity 28 24 4
  Total 58 45 13
Controlling* 2 1 1
  Trying to “fix it” 15 14 1
  Encouraging gender conformity 12 2 10
  Telling to keep it a secret 8 7 1
  Threats 7 4 3
  Dictate who the individual can see 5 5 —
  Bodily autonomy 4 — 4
  Total 53 33 20
Blaming* 2 1 1
  “You should be ashamed” 25 20 5
  Try to make the individual feel 22 19 3
responsible
  Total 49 40 9
(continued)
16 Journal of Adolescent Research 00(0)

Table 3.  (continued)

Number of responses

All SO GI
Theme Sub theme n = 422 n = 296 n = 126
Bumbling — —
  Reliance on stereotypes/assumptions 24 14 10
  Inappropriate questions or statements 12 11 1
  Behave differently after disclosure 5 5 —
  Total 41 30 11

Note. GI = gender identity; LGBT = lesbian, gay, bisexual, transgender, and/or queer;
SO = sexual orientation.
*There are more responses in the overall theme than appear in the sub-themes.

Theme 1: Distancing. The most common theme (26.5% of responses)

among all participants was the act of creating physical, social, or emotional
distance with the SGD young adult. This theme had five sub-themes: (1)
refusing to give specific help or support, (2) denying of identity’s existence,
(3) not wanting to hear about it, (4) not acknowledging identity, and (5) not
wanting to learn about the new identity. Refusing to give specific help or
support included physical distancing (e.g., “refus[ing] to come to my house
when I live with a same sex partner” (gay agender person) and, among GDY,
not using the individual’s chosen name and/or pronouns accounted for 97%
of their responses in this sub-theme. Denying of identity existence was indi-
cated by statements that expressed disbelief (e.g., “Not believe[ing] my ori-
entation exists (asexual cisgender woman).” Not wanting to hear about it
involved actions such as changing the subject or avoiding discussions related
to SGD identity (e.g., “Shut down conversations that have the potential to
talk about [being] queer” (queer transgender man). Not acknowledging iden-
tity was enacted by responses such as “Pretend[ing] they didn’t hear and
still ask about partners of opposite sex (lesbian genderqueer pereson)” and
statements such as “You’re still biologically _____, so that’s what you are to
me (asexual agender person).” Not wanting to learn about the new identity
included responses in which the person declines to learn about the identity
(e.g., “Stated that they didn’t understand, but didn’t want to try to” (pan-
sexual cisgender woman).

Theme 2: Hostility.  About a quarter (25.5%) of the participants described

unsupportive responses that were categorized under the theme hostility,
which consisted of seven sub-themes: (1) hateful language, (2) disown-
ment, (3) interrogation, (4) physical violence, (5) mocking, (6) yelling, and
Bosse et al. 17

(7) neglect. Hateful language included the use of derogatory comments,

slurs, and hurtful “jokes” to or about [SGD] people. Disownment included
responses such as “cutting off communication for an extended period of time
(lesbian cisgender woman)” and “kicking me out of the house” (gay cisgen-
der man). Interrogative responses were those that required the young person
to “defend” their identity or actions through “intrusive questions” in ways
that “violated privacy” (e.g., “Print[ing] excerpts from my blog, highlight
what is problematic and put it on the kitchen table to discuss as a family” (cis-
gender lesbian woman). Physical violence included hitting the young adult
with hands or throwing objects (e.g., “the Bible”) at them. Mocking included
“mocking [SGD] people” (asexual queer cisgender woman) and responses
such as “making faces” (pansexual transgender man). Yelling included rais-
ing one’s voice when talking to the youth. Neglect, a sub-theme found in
only response specific to sexual orientation included “ignoring me” (lesbian
cisgender woman) and “neglecting my life from adolescence forward (pan-
sexual transgender person).”

Theme 3: Minimizing.  Responses that were classified as minimizing (14%)

were statements that belittled the SGD young adults’ identity/identities. This
theme had two subthemes: (1) not taking them seriously (52%) and (2) invali-
dating them (48%). Not taking them seriously included asserting the young
adult was “too young.” For an asexual cisgender woman not taking her seri-
ously also included, “keep asking if I ‘have a boyfriend yet’ or ‘when’ I’m
going to get married.” Invalidating statements expressed doubt about the
young adult’s SGD identity, suggested the identity was “a phase” or “a fad”
or “failed to acknowledge the. . . bravery of coming out to them (pansexual
agender person).” Another participant was invalidated when their parents
did not “[recognize] my son my wife carried as my own (lesbian cisgender
woman).”

Theme 4: Controlling.  This subset of responses indicated that participant’s

parents/caregivers were attempting to control the person or situation, which
made up 12.5% of the total responses. This theme had six sub-themes: (1) try-
ing to “fix it,” (2) encouraging gender conformity, (3) telling the individual
to keep their identity a secret, (4) threatening, (5) dictating who the indi-
vidual can see, and (6) controlling the individual’s bodily autonomy. Trying
to “fix” the young adults’ identity included efforts attempting to change their
sexual orientation or gender identity through therapy (“to make me straight”;
cisgender gay man) or other programming (e.g., “sent me to church”; queer
nonbinary person). Behaviors encouraging gender conformity included “gen-
der policing,” “criticizing your appearance and shaming you for not [stick-
18 Journal of Adolescent Research 00(0)

ing to gender norms regarding body hair, makeup, etc.] (bisexual cisgender
woman)” and “forcing me to wear . . . clothes I’m not comfortable wearing”
(genderqueer asexual person). One respondent advised:

Do not push gender norms, even on trans people. For example, if a trans male
likes to paint his nails and get his hair did, then don’t . . . tell him he does not
line up with his gender. He should be free to express the way he wants to (queer
transgender man).

Parents and other adults also tried to control who could know the young
adult’s sexual orientation and/or gender identity by telling the individual to
keep their identity a secret from other family members or friends or telling
them to “wait to tell people” (gay cisgender man). They also threatened to
withhold financial support or emotional support (e.g., “said my family would
turn their back on me” [bisexual cisgender woman]), or suggested harm
would come to others (e.g., “told me that my father would lose his job if his
employers found out I was gay” [lesbian cisgender woman]) as a means of
minimizing identity disclosure and preventing sociomedical gender transi-
tions. Dictating who the individual can see was unique to responses regard-
ing sexual orientation and included actions such as restricting access to the
individual’s significant other and “telling me to stay away from LGBTQ
people” (bisexual genderqueer person). Restricting bodily autonomy was
unique to GDY and referred to refusal to support gender affirming medical
care and “offering me bribes to not get surgery” (bisexual transgender man).

Theme 5: Blaming.  The act of blaming the individual for their identity or
hardships related to the disclosure of their identity made up 11.6% of the total
responses. Blaming included two subthemes: (1) “you should be ashamed”
and (2) making the individual feel responsible. “You should be ashamed”
was indicated through examples such as “telling me that I’m sick or wrong”
(queer genderqueer participant). As an example of making the individual feel
responsible, one participant wrote, “said anti-nonbinary things like ‘you just
need to pick one’ and ‘stop making everything so complicated for everyone’”
(queer, asexual, transgender, and genderqueer person).

Theme 6: Bumbling. Responses that were deemed bumbling (10% of

responses) exhibited lack of information, awkwardness, and discomfort
with the sexual orientation or gender identity without being hostile. Bum-
bling included three sub-themes: (1) relying on stereotypes/assumptions,
(2) inappropriate questions/statements, and (3) behaving differently after
disclosure. Relying on assumptions/stereotypes included responses such as
Bosse et al. 19

“assum[ing] I was romantically interested in my female friends” (lesbian

cisgender woman) and young people being told they are “gay and hiding it”
(bisexual cisgender man) or “just hadn’t found the right person yet (asexual
cisgender woman).” Inappropriate questions/statements included “but you
seem so female all the time” (asexual genderqueer person) and “calling my
relationship my ‘lifestyle’” (queer cisgender man). Lastly, behaving differ-
ently after disclosure, which only arose as a sub-theme in the responses of
SDY included actions such as “being weird about sleepovers with girls”
(lesbian cisgender woman).
One person advised parents and other caregivers against multiple responses
that have been classified as unsupportive and made recommendations for an
alternate approach:

Do not try to change them or accept them in hopes that it is just a phase. Most
times it is not, and people deserve to be believed and respected. Don’t. . .guilt
them, or shame them, for they may already hold their own guilt and shame still.
If you need some time to work through it, let them know that so you don’t hurt
them in the time that it takes for you to make peace with it. (pansexual cisgender
woman)

Discussion
The goal of this analysis was to gain an understanding of what specific
responses SGD YA perceive to be supportive or unsupportive of their sexual
orientation and/or gender identity from parents/caregivers and other adults.
SGD YA identified a range of both global and specific actions demonstrating
support or lack of support for their sexual orientation and/or gender identity.

Supportive Responses
Communication was important for both groups and highlights the importance
of parents and other adults stating and demonstrating that they are interested
in hearing about the young person’s experiences by asking questions and
actively listening, which is consistent with themes found in previous research
(Manning, 2015). Communication was the focus of nearly half of the sup-
portive responses from GDY, and in prior research, positive family commu-
nication was associated with decreased depression, anxiety, and self-harm
(Katz-Wise et al., 2018). Using GDY’s chosen name and pronouns was the
most common response for ways in which parents/caregivers and other adults
can demonstrate support, which is consistent with previous research (Hale
et al., 2021).However, for parents, using the young person’s chosen name and
20 Journal of Adolescent Research 00(0)

pronouns may be one of the most difficult adjustments following the disclo-
sure of a gender diverse identity (Hale et al., 2021).Given the potential for
gender affirming communication to act as a resilience factor for mental health
(Tankersley et al., 2021), it is critical that adults who are parents/caregivers
of GDY or work with this population honor the young person’s gender
through use of the correct name and pronouns. Adults who work with GDY
can also provide support to parents, caregivers, and other family members
who may be having a difficult time adjusting to changes in name and/or
pronouns.
Actions were the second most common theme across the sample, but there
was only overlap in SDY and GDY responses in two sub-themes: emotional
support and instrumental support. Among SDY, responses that described
actions were the most common, accounting for nearly one-third of their
responses. Unique sub-themes that arose for SDY included supporting rela-
tionships, acknowledging identity publicly, normalizing SD identities, help-
ing the individual engage with the SGD community, and being present at
events that are important to SDY. These unique subthemes point toward an
interest in more public demonstrations of support for SDY and their relation-
ships. This could be because sexual orientation, specifically marriage equal-
ity, were in public conversation when these data were collected (Human
Rights Campaign, n.d.). GDY, on the other hand, primarily identified actions
that support their gender expression, which may help the GDY to express
themselves publicly. Within the sub-theme of instrumental support, helping
the GDY access gender affirming medical care and navigate the healthcare
system was unique to this group, and is consistent with another recent study
(Johnson et al., 2020). Though both SDY and GDY may experience chal-
lenges obtaining inclusive healthcare, access to gender affirming treatment
has been identified as lifesaving for GDY (Green et al., 2022; Tyler & Abetz,
2022).
SGD YA also wanted parents and other adults to advocate for them in situ-
ations that were unjust, through interpersonal (e.g., defending the youth
against another family member’s negative ideas) or more public (e.g., social
media post, bumper sticker) actions. Results from other studies with GDY
have identified parental advocacy being interpreted as supportive (Hidalgo
et al., 2017; Johnson et al., 2020). Advocacy may be especially salient today
as the rights of GDY to access gender affirming healthcare, play sports in
their affirmed gender, and use restrooms in accordance with their affirmed
gender are under attack across the US (Ronan, 2021). Parents of SGD adults
in one study understood the importance of support that extends beyond the
home environment, adding: “It also means advocating for them [in other
environments] .  .  . All daily mundane interactions add up to something larger
Bosse et al. 21

in scope and highlight parents’ effort to confront societal level bigotry and
intolerance” (Tyler & Abetz, 2022, p. 318).
SGD YA also identified demonstrating open-mindedness by being willing
to learn and make an effort to understand through self-education and interact-
ing with other parents (e.g., peer support groups) as demonstrations of sup-
port. Participants’ responses indicated that SGD YA understand that, for some
parents and other adults, acceptance can be a process that takes time (Phillips
& Ancis, 2008). This was emphasized in one respondent’s advice to let the
SGD YA know “if you need some time to work through it. ... make peace
with it.” Indeed, prior research has identified that asking questions of the
SGD YA (communication), seeking out information and support from others
(open-mindedness), and attending LGBTQ-related events (actions) are
responses that support the young adult, as well as reducing stress among par-
ents (Chrisler, 2017; Johnson et al., 2020).
For social support to be deemed helpful, it must match what the person
receiving support perceives they need in that situation (Cutrona, 1990). It is
possible that parents and SGD YA will prioritize supportive responses differ-
ently. In one study with parents and GDY, for example, parents primarily
highlighted their connecting the GDY to gender affirming services as demon-
stration of support whereas GDY more frequently mentioned the use of their
chosen name and pronouns (Hale et al., 2021). Similarly, types of support can
take on different priorities, expressions, and meanings given different socio-
cultural contexts of families; what appears to be negative behavior in one
family might be perceived as positive by members of another family
(McGolddrick et al., 2005). As such, asking SGD YA whether or not they
perceive a specific behavior to be supportive in the context of their own fam-
ily situations could be helpful.

Unsupportive Responses
Unsupportive responses from caregivers created emotional or physical dis-
tance between the SGD YA and their parent(s), minimized feelings, blamed
the young person, were violent, attempted to gain control over the young
person or their behavior, and those responses for which the young person
perceived the parent was uncomfortable with the youth’s sexual orientation
and/or gender identity.
There were three subthemes that were unique to SDY, which were
responses that reflected neglect, dictating who the individual can see, and
behaving differently after disclosure. Dictating who the individual can see
largely referenced putting limits upon when and where the individual could
be with their significant other, which participants perceived to be domineering
22 Journal of Adolescent Research 00(0)

of the caregiver. The sub themes of neglect and behaving differently after
disclosure may have only arisen in responses from SDY in this sample
because the sample was small and there were more SDY than GDY partici-
pants. Prior research suggests SGD YA report adverse childhood experiences
such as neglect more frequently than their cisgender, heterosexual counter-
parts (Craig et al., 2020). Encouraging gender conformity arose twice within
the sexual orientation responses, which indicates some potential overlap
between sexual orientation and gender identity, though these are separate
constructs. Avoiding and negative communication and responses such as
refusing to talk about or acknowledge identity, interrogating, physical vio-
lence, inappropriate questions or comments, and shaming statements, were
also similar to themes identified in previous research (Chrisler, 2017; Johnson
et al., 2020; Manning, 2015; van Bergen et al., 2021). Given the established
association between unsupportive parents and increase in risk responses (e.g.,
binge drinking, illicit substance use, sexual practices) and worse mental
health outcomes, it is critical to discourage responses communicating lack of
acceptance for sexual orientation (Rothman et al., 2012; Ryan et al., 2009,
2015).
Consistent with prior research, GDY in this study identified unsupportive
responses such as verbal abuse, physical violence, disownment, shame, and
distancing, all of which have implications for GDY mental health, self-
esteem, and ability to form relationships as adults (Johnson et al., 2020;
Koken et al., 2009). There was only one subtheme unique to GDY, which was
the parent or caregiver trying to gain control of the individual’s bodily auton-
omy. These responses suggest that individuals who disclose a gender identity
may have unique social support needs, as well as unique responses that
should be avoided. Parents’ attempt to control or alter gender expression/
related behavior, for example, by refusing to provide clothing reflective of
the youths’ gender has been identified in other research with GDY, and like
other unsupportive behaviors, may contribute to worse mental health
(Johnson et al., 2020).

Responses that May be Supportive or Unsupportive

One category of communication—asking questions—was described by par-
ticipants as both supportive and unsupportive, depending on the context.
Among questions participants deemed to be supportive were those that com-
municated genuine interest and were related to their (actual or potential)
relationship(s) or partner(s), including extended interest in getting to know
one’s partner. Recognizing that disclosure can be a stressful process, partici-
pants were also open to questions about their well-being during the process
and how others have responded to them. Seeking to clarify understanding
Bosse et al. 23

about a particular identity and what it means to the young person, rather than
making assumptions was deemed supportive. Questions about how best to
provide support were also welcomed; among GDY, this included specifically
asking about their name and pronouns. On the other hand, questions that cast
doubt on SGD YA’s identity or required them to defend their identity (e.g.,
“are you sure?”) were viewed as unsupportive. Similarly, questions viewed as
unsupportive were those that were not in line with youths’ identity (e.g., ask-
ing a SDY if they have a partner of the “opposite” gender) or that used hurtful
or outdated language (e.g., “phase” or “lifestyle”).
The idea of “asking too many” questions came up in both supportive and
unsupportive responses. How many is “too many” may vary from individual
to individual. Similarly, participants responses indicated that, while they
were willing to educate caregivers and other adults about their own identity,
they did not want to be the sole source of knowledge about SGD people;
instead, they encouraged others to seek out resources and information to edu-
cate themselves. In both cases, taking cues from the young person may be
helpful. One common point was a desire for adults to demonstrate interest in
or availability to discuss sexual orientation or gender identity-related subjects
(“keep lines of communication open”), but not to pressure or force the young
person to respond.

Strengths and Limitations

One of the strengths of this study is that the participants were diverse in terms
of sexual orientation and gender identity. This contribution fills a gap in the
current knowledge as most literature on SGD YA focuses solely on SDY or
GDY. In addition, nearly half of the GDY participants have gender identities
outside the woman/man gender binary, a population less frequently repre-
sented in existing literature. The number of open-ended responses allowed
for the identification of numerous specific responses that are perceived by
SGD YA as supportive or unsupportive, expanding on what was already
known.
There were only three participants who disclosed their gender identity that
reported a heterosexual sexual orientation identity, which may be due to
recruitment methods or limited interest in engaging with the larger
LGBTQ + community. Thus, these results may not accurately reflect the
needs or experiences of heterosexual-identified GDY. Similarly, this conve-
nience sample recruited predominantly through social media and snowball-
ing was somewhat limited with regard to sex assigned at birth, race, and
ethnicity. The survey was administered electronically so it was only available
to individuals with access to the Internet and a computer or other electronic
device. Thus, the experiences of participants in this sample may not represent
24 Journal of Adolescent Research 00(0)

the experiences of those who may have been better reached using face-to-
face methods (Reisner et al., 2014).
The survey did not include a query about the location of the participants,
so it is unclear whether the data is representative of experiences across the
US, or if it includes responses from urban, suburban, and rural participants.
Future research should include questions about location as previous research
has demonstrated that individuals’ experiences with interpersonal violence
and discrimination may be influenced by geographic location and environ-
mental contexts such as state-wide policies regarding SGD individuals (Craig
et al., 2020; Swank et al., 2013).
The brevity of some participants’ responses was a limitation in this study.
In some cases, it was difficult to identify which theme might be best as the
participants did not always provide context for their responses. A few short
responses (n = 3) without context (e.g., “remembering” as a supportive care-
giver behavior) were not able to be classified with an existing theme and were
excluded from analysis. In most cases, however, abbreviated responses
became their own code. Because these individual codes (e.g., “help”)
occurred so infrequently (<1% of responses), they are captured under the
larger themes only, and not specific sub-themes. The anonymous, online
nature of the survey may have allowed participants to feel more comfortable
providing responses to these questions (Gates, 2011; Wood & Kerr, 2006),
but it meant that the researchers could not follow up with participants to
clarify their responses.
There were a few sub-themes in the original coding that were not included
in the final list of sub-themes when they occurred fewer than three times. It is
unclear if these responses (e.g., the parental caregivers blaming themselves
for their child’s identity) were not reported more frequently because they are
not common experiences for SGD YA in general or were only uncommon
among the participants in this sample. Future research could specifically ask
SGD YA if they have experienced those parental responses to provide a better
understanding of the prevalence of such responses.

Suggestions for Future Research

It could be important to explore the association between the provision of
direct (received) and indirect (perceived) support using responses outlined by
young adults here with conditions and factors known to be related to support
(e.g., mental health, engaging in risk behaviors, self-esteem, etc.). Subsequent
research should continue to take into consideration the experiences of differ-
ent subgroups, as well as individuals with intersecting identities, such as
those who are both SGD and people of color, as this will provide
Bosse et al. 25

more information about the unique needs of SGD YA on the basis of these
identities. Knowing more about this area will allow us to develop effective
family-centered interventions that could increase resources and feelings of
support for SGD YA and their family members.

Conclusion
SGD YA who receive support for their sexual orientation and/or gender iden-
tity from parents and other adults report better mental health and quality of
life compared to SGD YA who do not receive support. Parents and other
adults, regardless of their level of support, communicate their amount of sup-
port through different responses. Words and actions meant to demonstrate
support may be misinterpreted by SGD YA if not aligned with the youth’s
perceived support needs. Parents and other adults can demonstrate support
for sexual orientation and gender identity by engaging in communication and
responding in ways that demonstrate acceptance, open-mindedness, and
unconditional love. Support can also be demonstrated through willingness to
learn about the SGD YA identity and advocating for the SGD YA inside and
outside the family. GDY find use of their chosen name and pronouns a spe-
cific means of demonstrating support for their identity and may also benefit
from support accessing and navigating the healthcare system for gender
affirming treatment.

Acknowledgments
The authors would like to thank the undergraduate honors student who assisted with
the analysis of these data as well as all the study participants who provided responses
to the additional (optional) study items that made up this analysis.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: This study was funded by a research
grant awarded to the first author by the Beta-Zeta-at-Large chapter of Sigma interna-
tional nursing honor society.

ORCID iD
Jordon D. Bosse https://orcid.org/0000-0003-3547-9077
26 Journal of Adolescent Research 00(0)

Note
1. Participants were asked about behaviors that demonstrate support or lack of sup-
port for gender identity. However, some of their answers did not indicate direct,
observable actions. As such, we have used the word “responses” to describe par-
ent/caregiver reactions more broadly when needed and “behaviors” to indicate
specific actions.

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Author Biographies
Jordon D. Bosse (he/him) is a nurse scientist whose program of research is focused
on the mental health of sexual and gender diverse young adults in the context of
minority stress and their family relationships. You can find him on Twitter: @jbossern
Sabra L. Katz-Wise (she/her) is a developmental psychologist with postdoctoral
training in social epidemiology. Her research utilizes mixed methods to investigate
sexual orientation and gender identity development, sexual fluidity (changes in sexual
orientation dimensions over time), health inequities related to sexual orientation and
gender identity in adolescents and young adults, and psychosocial functioning in fam-
ilies with transgender youth.
Lisa M. Chiodo (she/her) is a developmental psychologist and statistician with
decades of basic and clinical research focused on high-risk populations of young
adults and the impact of trauma on childhood development.