June 2022 Pride Month Focus

The powerful impacts of accepting versus rejecting parent behavior on their LGBTQ+ children’s health & well-being

by Doug Aupperle, licensed psychologist

Doug Aupperle, Ph.D. Click to read Doug’s bio

It’s probably no surprise to anyone that parents have a profound impact on how their children develop, grow, and function in the world. However, research on the LGBTQ+ population has traditionally been scarce, and research related to the youngest members of that population and their families has been even more so. The Family Acceptance Project (FAP) of San Francisco State University began to shed some light on that, though, with some groundbreaking research over a decade ago. Their findings show just how powerfully parent and caregiver responses to their LGBTQ+ children really do impact their children’s mental and physical health and well-being now and into adulthood.

The researchers have conducted interviews with hundreds of families over the years and identified more than 100 types behaviors exhibited in response to their LGBTQ+ children’s identities. They found that about half of these behaviors could be categorized as accepting and the other half as rejecting. Then they evaluated the effects of these behaviors to see how they impact their LGBTQ+ children, and what they found was striking.

The study found that often the parents who were engaging in responses categorized as rejecting were actually motivated by care and concern for their children. These parents often reported being afraid for their LGBTQ+ child’s safety and concerned that their child’s identity would result in a more difficult life. In other cases, how closely the parents’ identities were tied to their children’s drove parental rejecting behavior. Parents with high levels of such identification felt personal shame and embarrassment regarding their children’s LGBTQ+ identities. They also felt intolerable distress over how it challenged the parents’ views and beliefs.

Regardless of the parental motivations for engaging in the rejecting behaviors, though, the resulting impact on their children was still the same. Compared to LGBTQ+ children whose parents are highly accepting, the research showed that those whose parents are highly rejecting are:

  • 8 times as likely to attempt suicide;
  • 6 times as likely to report high levels of depression;
  • 3 times as likely to use illegal drugs;
  • 3 times as likely to be at high risk for HIV and STDs.

When parental rejecting responses decrease even somewhat to more mixed/moderately rejecting levels, the risks, though still serious, also decrease. Compared to those with highly accepting parents, LGBTQ+ children experiencing mixed/moderately rejecting parental responses are:

  • 2 times as likely to attempt suicide;
  • 3 times as likely to report high levels of depression;
  • 1.5 times as likely to use illegal drugs;
  • 1.5 times as likely to be at high risk for HIV and STDs.

Parent responses also profoundly shape their children’s hopes and dreams for their lives. Nearly all LGBTQ+ children in the study with extremely accepting parents believed they could live happy, productive lives as adults, while only about a third of those did whose parents were not at all accepting.

The bottom line is that for parents who want to know how to best support their LGBTQ+ children, seeking out the educational resources and community support to help them best do so may be a truly life-giving and life-saving gift to their children. For those parents who are conflicted and struggling, taking steps to be even a little less rejecting and a little more supportive can still significantly reduce the risks for their children. As the saying goes, every journey begins with a single step.

Some Family Behaviors that Increase Your LGBTQ+ Child’s Risk for Health and Mental Health Problems BEHAVIORS TO AVOID

  • Hitting, slapping or physically hurting your child because of their LGBTQ+ identity
  • Verbal harassment or name-calling because of your child’s LGBTQ+ identity
  • Excluding LGBTQ+ youth from family events and family activities
  • Blocking access to LGBTQ+ friends, events, and resources
  • Blaming your child when they are discriminated against because of their LGBTQ+ identity
  • Pressuring your child to be more (or less) masculine or feminine
  • Telling your child that God will punish them because they are LGBTQ+
  • Telling your child that you are ashamed of them or that how they look or act will shame the family
  • Making your child keep their LGBTQ+ identity a secret in the family and not letting them talk about their identity with others

© Caitlin Ryan, Family Acceptance Project, 2009.

Some Family Behaviors that Reduce Your LGBTQ+ Child’s Risk for Health and Mental Health Problems & Help Promote Their Well-Being BEHAVIORS THAT HELP

  • Talk with your child or foster child about their LGBTQ+ identity.
  • Express affection when your child tells you or when you learn that your child is LGBTQ+.
  • Support your child’s LGBTQ+ identity even though you may feel uncomfortable.
  • Advocate for your child when he or she is mistreated because of their LGBTQ+ identity.
  • Require that other family members respect your LGBTQ+ child.
  • Bring your child to LGBTQ+ organizations or events.
  • Connect your child with an LGBTQ+ adult role model to show them options for the future.
  • Work to make your congregation supportive of LGBTQ+ members, or find a supportive faith community that welcomes your family and LGBTQ+ child.
  • Welcome your child’s LGBTQ+ friends & partner to your home and to family events and activities.
  • Support your child’s gender expression.
  • Believe your child can have a happy future as an LGBTQ+ adult.

© Caitlin Ryan, Family Acceptance Project, 2009.


Ryan, C. (2009). Helping Families Support Their Lesbian, Gay, Bisexual, and Transgender (LGBT) Children. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.

Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay and bisexual young adults. Pediatrics, 123(1), 346-352.

Thank you to the Viking Foundation of Lincoln

“Young people are the world’s greatest resource.”

Thank you to the Viking Foundation of Lincoln for providing generous, critical support for the children and adolescents who need high quality mental health services and are served through the Des Moines Pastoral Counseling Center’s C.O.O.L. clinic (Children Overcoming the Obstacles in Life).

The Viking Foundation is guided by a set of core values including “Young people are the world’s greatest resource.” We see that value come alive with the resources made available to help children heal from abuse and trauma, and learn to manage their depression, anxiety and other life challenges.

Since 2012 the Viking Foundation has supported the C.O.O.L. clinic with grants totaling $16,000 — providing critical support to thousands of young people plus their families. Funds have helped C.O.O.L. clinicians to build a premier treatment approach for children in Central Iowa to find hope and healing. Over the years, the Viking Foundation has provided art supplies, therapeutic toys, outdoor play equipment, children’s psychological testing materials, medical technology, clinical training and other accessories needed for COOL’s innovative, experiential approach to treating children and teens.

For more information on the Center’s C.O.O.L. clinic: www.dmpcc.org/COOL.


Carlos’ story

To demonstrate the power of counseling, we share the story of Carlos. We have changed the name and identifying details to preserve privacy.

“Sometimes it feels like my life is a roller coaster and counseling is my seat belt.” ~ Carlos

Carlos has experienced great hardship in his young life. He came to the United States five years ago at age three. He came with his mother, who migrated from Mexico to search for a job and security. But it hasn’t been easy for Carlos or his mother. Sadly, there has been much heartbreak. Carlos experienced abuse by another adult, and he witnessed violence upon his mother. Trauma has long-lasting effects on people, especially when it happens in childhood.

Carlos’ mother did not know where to turn for help. She works the nightshift at a low-wage job and has very little household resources, yet she found her way to a bilingual children’s counselor, Alicia Krpan, at the Center’s through it’s specialized services for children and adolescents, C.O.O.L. (Children Overcoming the Obstacles in Life). COOL is an experienctial approach to therapy, integrating art, play, food, sports, nature and music into the counseling process. Alicia provides services at the Center’s home facility and also at a satellite center in the Drake neighborhood. Both locations provide the a safe, welcoming place for children like Carlos to find hope and healing.

Alicia Krpan, t.L.M.H.C., bilingual counselor

“It has been such a privilege to help Carlos to know that the trauma he and his mother experienced was not his fault,” said his counselor Alicia. “He now knows that he did nothing wrong. In his counseling sessions I can remind him he is brave and beautiful and awesome.”

Alicia employed the use of a therapeutic sand table (more info here) to help Carlos communicate his concerns, and to help Carlos to understand that he can heal and become whole again.

Carlos and his counselor Alicia communicate in English, but his mother only speaks Spanish. It is scary for a parent to sign up their child for a service in a language they don’t understand. It could put the child in an awkward position of translating their own counseling sessions for their parents. However, counselor Alicia is able to speak with Carlos’ mother in Spanish and help her to understand the process. Carlos only needs to think about his own healing, and not how to explain it to his mother. Carlos can stay focused on being a child.

Sand Therapy

Sand therapy is a powerful therapeutic technique used by counselors at the Center to help clients process their trauma. It is especially useful to help children to find ways to communicate their experiences. Clients choose small objects that describe, say, their family or home. The skilled clinician will help the child explore their fears and experiences by asking questions about their choices of objects. The counselors helps the child to learn that healing is possible. (See last photo.)

Children learn that it is possible to heal. Sand objects in this photo represent a broken heart, a repaired heart and a patched heart.

For more information about C.O.O.L. (Children Overcoming the Obstacles of Life) www.dmpcc.org/COOL

The Work of Play

by Grace Sherer

What is play? It is spontaneous, fun, free – a means with no end. A seemingly purposeless process from which springs joy. It is the creative expression of Self through every age and stage that says “I am alive!”

Play is about accessing that which is vital – the life spark. Play is not productive in a quantitative sense and it is not about rules. Play is not about winning and losing, but rather about presence and experience. Play is enormously significant for both children and adults.

There is growing evidence that the learning of emotional control, social competency, personal resiliency and continuing curiosity are accomplished largely through developmentally appropriate play experiences.

Play is the occupation of childhood. Play provides a space for the “greening” or development of the young Self. It is the mirror where the child first glimpses its Self as fun, beautiful, and worthy of the time and energy of another. It is where life experience is assimilated. It is where life experience is mastered. It is where life experience is communicated.

Play begins at a very young age. Babies play with their primary caregivers and vice versa. When a parent is smiling at an infant and the baby laughs spontaneously, it is the baby’s first experience of the joy found in relationship through play. These early play experiences transmit messages such as “you are very special” and “it is fun to be with you” and “it’s okay for you to change the rules or create something new.” Play is the activity that allows children to explore and master their world without fear of judgment.

Play is a presence that does not mete out rewards and punishments contingent upon performance. What is deemed “good” is just being together and celebrating whatever happens. There is little room for cautionary statements, admonishments, or limitations. Play becomes the medium for conversation and relationship.

Sometimes the conversation is issue specific as when a child recreates a divorce scene with toy animals in a sand tray. Sometimes the “conversation” is more abstract as when a child creates a shield with pictures cut out from magazines of things about herself that “protect” her in the world. Sometimes play relates to specific coping skills (e.g., tolerating frustration) and sometimes it is just about BEING in relationship (e.g., constructing an airport out of masking tape on the office floor).

This is what play is at C.O.O.L. (Children Overcoming the Obstacles of Life), the Des Moines Pastoral Counseling Center’s child and adolescent program. It is the fort made from two chairs, a prayer shawl, a couple of bean bag chairs, and a construction paper sign. It is the child hiding under the bean bag chairs in the waiting room and a therapist who gingerly sits on top lamenting the “absence” of the child. It is a child stacking bean bag chairs on top of a therapist to build a volcanic mountain that erupts when the child climbs on top. It is the “Topsy Turvey Rule” that says, “If you win, you lose and if you lose, you win” that a child can invoke anytime during any game. Play in this context is not structured in a traditional sense but is free-form where rules are mutable and even able to be totally eliminated. Thus, a regular checkers game can become “give away checkers” where the goal of the game is to lose all your pieces rather than capture all the opponent’s pieces.

Many children come to C.O.O.L. fearful about being judged, fearful about being “less than,” fearful about losing and losing out. We live in a highly competitive world that tends to promote these kinds of fears. In play, children are often exposed to games that are only about winning and losing where the messages they seem to have learned are that you are only worthwhile
if you win, get an “A,” are first in line, etc. At C.O.O.L. we try to change that up. Games are over before there is a conclusion just to take out the competitive aspect.

“Rules” are changed over and over just because it might be fun or interesting to do so. What is immutable is the caring, spontaneously fun relationship between the child and therapist. At C.O.O.L. we have great belief in our kids. We believe that if we provide a safe and nurturing space for them and materials for them, that they will discover their true and beautiful Selves through creativity and play and relationship. We play structured games but play with the rules. We build forts and bridges and obstacle courses that are metaphors for self protection,  communication, and challenges in life. We foster play in relationship and we foster relationship through play.

It is not uncommon to see a therapist with a puppet in hand hiding behind the waiting room door and having the puppet greet the child.

Grace Sherer is a licensed pediatric psychologist, a former therapist at the Center, and founder of the Center’s C.O.O.L. clinical approach. Grace holds a master of arts degree in behavior analysis from Drake University. This timeless post was originally printed in the Center’s newsletter, November-December 2019 edition.