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

Written 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.

Chris’ blog – June 2021

Pastoral Care Specialist for The Generalist

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by Chris Waddle, Director of Leadership and Spiritual Life


June 2021 – In one of his lectures, Family Systems therapist, Rabbi Edwin Friedman recites an overwhelmingly long list of all of the ways psychotherapists can specialize:

“It is possible today to become expert in thousands of emotional problems that range from: agoraphobia to xenophobia, living with preschoolers to living with aging parents, coping with single parenting to coping with stepchildren, personality disorder to schizophrenia, impotence to promiscuity, abuse of substances to child abuse, creativity to catatonia. . . “

His list keeps growing as he began to detail the various specializations and subspecialties of study. At one point the list becomes so nuanced and obscure that his audience begins laughing. His point was not to dismiss specialization, but to remind his audience of just how much there is to learn and know and how one person cannot possibly learn it all.

In a world that seems to be more and more specialized, clergy are largely expected to be generalists. Clergy are expected to be competent in public speaking, fundraising, teaching, management, public relations, theology, philosophy, history, politics, comparative religion, popular culture, entrepreneurship, layout and design, communications, computers, music, marriage, family dynamics, death and dying, social justice, public policy, sound systems, air conditioning, and plumbing!

If I ever need a reminder of how unrealistic the role of clergy can feel, I just go to my own denomination’s Book of Discipline and read “Responsibilities and Duties of Elders and Local Pastors.” I always chuckle as it is clear that no one pastor can do all of these things at exceptional levels at any one time. I often imagined some parishioner, miffed at something I said or failed to do, looking at the list and gleefully exclaiming “I’ve got him now!” I also knew, that but for grace, they would be correct. At any one time, yes, I could be doing more and doing it better.

One of the duties on nearly all clergy “job descriptions” is “pastoral care.” It can feel overwhelming for clergy. There is always someone in the congregation or the community who could use support. It is nearly weekly that someone will say, “You really should call on _________. They are having a tough time.” This is often followed by, “Please don’t tell them I told you.” Any clergy in any kind of congregation, Jewish, Muslim, Protestant, Catholic, Hindu. . . any clergy, could spend 100% of their time in some form of “pastoral care” alone and still not meet all the pastoral needs in the community.

On top of this, often clergy feel ill equipped for pastoral care. Despite what most people assume, most clergy do not get a great deal of formal training in pastoral care. This became clear to me when I was in college and thinking about my own major.

I knew that after graduation, I was going to seminary to study to become a United Methodist Minister. So, I began to ask different clergy, “what is it that you did not get in seminary that you wish you knew more about now?” Nearly every one of them said “pastoral care and counseling.”

With that knowledge, I changed my major from Biblical Studies to a basic degree in counseling called Social and Rehabilitation Services. It was an excellent decision for me. While it did not make me a therapist, it did give me the basic knowledge and skills that helped me have confidence in my pastoral conversations with others. It also helped me to know when and how to refer people to others, when their needs were greater than my time or skills could meet. Many times, my understanding of the therapeutic process helped me encourage others to take their first step to talking to a trained counselor.

The good new is that if you are congregational leader, lay or clergy, and you want to grow in your pastoral care skills, you do not need to get a counseling degree. I encourage you to explore Pastoral Care Specialist program at the Des Moines Pastoral Counseling Center. In this two-year, three-hour-a-month course, you will learn from clinicians, educators, and partners of the Center with special knowledge and experience on the subjects of:

  • Forgiveness
  • Whole-hearted Listening
  • Memory loss and cognitive decline
  • Suicide awareness and prevention in faith communities
  • Living with illness and chronic pain
  • The spirituality of children
  • Caring for the anxious: Being a non-anxious presence in an anxious world
  • Evil in every day life
  • Ministry with LGBTQ individuals
  • Mindful ministry
  • And more!

Class size is limited, and classes begin in September, so do not delay.

If you have questions, feel free to email me at

Your partner in hope and healing.


For more information about the Pastoral Care Specialist program see:

For more blog posts by Chris:

How To Choose a Therapist

Billie Wade, writer

Finding the right therapist can seem daunting, and with good reason. When you entrust the essence of your life to another human being, you step into uncertainty and vulnerability. Making the decision and following through requires bravery and courage. Your perceptions about what therapists and counselors do, or previous experiences, may trigger intimidation, fear of judgment, hesitation about how friends and family members will perceive you and place expectations on you when you enter therapy, and a host of other fears. There are ways to ease the angst and enhance your search for the right therapist.

The therapeutic relationship is among the most powerful you may ever experience. Therapy/counseling is a reciprocal, synergistic relationship between two or more people in which the sole purpose is to promote the client(s) on their path of hope and healing from difficult emotional experiences. Therapy can be rewarding and empowering. It also can, at times, be perplexing, uncomfortable, exhausting, and frustrating. It helps open the channels of discovery that lead to insights and epiphanies. You may feel you are making little or no progress. Sometimes you are so close to your experience that your progress is not evident to you. Some issues require the peeling of many layers of emotional distress. Some concerns cannot be resolved or cured, only made less intense with focused attention to healing, a process rather than a destination. The process involves a constant exchange between you and the therapist. You both listen and interpret what the other is saying, or not, voice inflection, and body language, then reflect what is heard or seen, and share your assessment.

Therapy is a gift to me. It has been an integral part of my life since my mid-twenties. My experience with the gift of therapy includes my time as a client as well as seven years as an advanced certified substance abuse treatment counselor (ACADC). I believe in the power of talking through problems with someone who is trained to hear what I am not saying, read my body language, and reflect her or his assessment back to me, thus helping me sift through my feelings and reframe my experiences. For more information about the counseling process, see my article of July 2017, The Gift of Counseling

Depending on their areas of interest and training, therapists work under a license or certification or both. Psychologists. Social workers. Counselors. Clergy. Spiritual Directors. Most psychiatrists provide medication management and only minimal therapy. Many therapists are members of accountability and professional development organizations. Therapists may be trained in several treatment protocols and specialize in one or more. They also may have a client focus, e.g., men and boys; women and girls; families; children; teens; parents; LGBTQ+; retirees, and others. The therapists at Des Moines Pastoral Counseling Center all have a diverse focus, recognizing how the complexities of life impact the whole client. No client walks in the door with only one issue, although a main issue may be the catalyst for seeking help.

Our list of therapists supporting adults

Our list of therapists supporting children and adolescents

Your role is to tell the therapist, as fully as possible, your story as you understand it. Honesty and openness strengthen the interactions. You may not always hear what you want or were expecting, and some reflection may be uncomfortable. Between sessions, you are responsible for working on any assignments, checking suggested resources, and reflecting on important points. You always know more than your therapist as you are living the experience and, therefore, have information the therapist does not have. Only you know your story and the reason(s) you are there. Your therapist cannot help you with what you do not tell her or him. The therapist knows, and therefore attempts to interpret, only what you reveal.

You and your therapist form a delicate bond of trust necessary to encourage honesty, exploration, challenge, guidance, and healing. The therapist’s role is to assess and interpret your words and body language and offer reflection, validation, compassion, empathy, support, encouragement, and direction. Despite the gravity of our discussions, my therapist and I always encounter something that triggers laughter or a smile—that is right, every session. While issues are usually serious, there can be room for joy and lightheartedness and celebration. This requires an ever-strengthening bond between therapist and client. With all these elements in place, the client advances along the path of healing through hard work and the gradual opening of the golden doors of trust. I praised my therapist for walking with me through difficult times to which he nodded toward me and said, “The one sitting in that chair is doing most of the work.”

Effective therapy requires an attentive, intuitive, well-educated, and experienced clinician and an honest, introspective, reflective, open, trusting client. Two other key components in effective mental health therapy is the therapist’s mental agility and adaptability. Every client is different, and every session is different. I commend therapists for their unconditional positive regard for their clients. While they are not mind readers, they must continually interpret the messages—verbal, subverbal, and nonverbal—of every client at every session.

When selecting a therapist, you need someone to whom you can entrust your story. All of it. Finding a compatible therapist is often a process of seek and find and seek and find and seek and find. I experienced a lot of therapists over the years who did not meet my needs. I did not know how to find a therapist. Friends or my primary care doctor referred me to certain therapists. For my last two therapists, particularly with the one I have at the Center, I conducted a methodical search which follows.

I sought out my therapist at the Center by visiting the website and reading the bios of each of the clinicians, paying attention to area of interest or expertise, treatment protocols used, area of study or license, and other facts about the person. The bio of my therapist seemed to jump out at me. I called the Center to set up an appointment and asked to be placed on his schedule. During my first session, I shared a little bit of my story and asked him questions. At the end of the session, he requested that I give him six sessions before making up my mind. That was seven and a half years ago. On April 9, 2020, we celebrated our 165th session. One of the surprises about my therapist, a mutual discovery that arose organically over several months, is his interest and expertise in working with Black people. Never had I been able to discuss race relations with a therapist. You may need only a few sessions or long-term as in my case. It takes as long as it takes and is totally dependent on the therapist’s and client’s perspective of the healing or progress made.

Here are some tips to find a therapist that meets your needs:

  • Consider your reason(s) for seeking therapy.
  • Think about your end-goal for therapy, although you may not be able to pinpoint the reason at first. Usually, the client’s initial goal is relief from distress.
  • What are your preferences in a therapist: race, gender, sexual orientation and gender identity, religious or spiritual background, age, treatment modalities, race relations? Other parameters may be important to you.
  • Write out what you want, then narrow the list to three to five most critical points for you.
  • Read the bios on the Center’s website for clinicians who specialize in adults; children, adolescents, and teens; or spiritual enrichment.
  • When you find a therapist whose bio most fits your criteria, fill out our online intake form.
  • Have a list of questions ready to ask at your first session, such as “What is your experience working with…?”. Take notes.
  • Pay attention to the answers to your questions and comment on points that impress you as well as on those for which you need clarification or further exploration.
  • What are the therapist’s mannerisms and voice inflections?
  • Be aware of your comfort level during the session.
  • Do not be afraid to tell a therapist your initial thoughts and even your decision if you know what it is. It is far better to decline a therapist than to enter a relationship with one you know will most likely be a poor fit. That said, there can be surprises as I discovered with my therapist that reveal themselves over time.
  • You may want to interview several therapists before making your decision. Try not to worry about offending a therapist if you think she or he is not a good fit. Therapy is for your benefit, not the therapist’s.
  • Try to relax.

The decision to seek mental health therapy is a significant step to improve your life. Choosing a therapist that closely matches your need is vital for your maximum therapeutic experience. A methodical, well-planned search can save hours of unproductive sessions and frustration and hundreds of dollars.

How you select a therapist and how you show up and participate in your healing can make the difference between a therapeutic relationship that empowers you on your healing path and one that leaves you feeling unheard. To schedule an appointment with a therapist at the Center, click here.

May your trek on your healing path be illuminating, fruitful, rewarding, and empowering.

For more of Billie’s Blogs, click HERE.

LGBTQAI+ Affirming Counseling Class for Clinicians and Clinical Students

This course is for clinicians and pastoral counselors who seek to more effectively assess the mental health treatment needs of and provide therapy and counseling to child, adolescent and adult clients who identify as lesbian, gay, bisexual, transgender, queer, questioning, asexual, agender, intersex, and/or identify with other gender nonconforming and sexual minority identities (LGBTQAI+). It will help care providers better understand the critical concepts, current research, and key clinical issues with regard to this population. This course is offered in person at the Center (8553 Urbandale Ave, Urbandale, IA; in-person class size is limited to 20.) or online, via the Zoom platform.

This course is offered in person at the Center (8553 Urbandale Ave, Urbandale, IA. In-person class size is limited to 20.) or online, via the Zoom platform.

Objectives: Understanding key clinical issues and the most appropriate, effective assessment and counseling approaches with gender nonconforming and sexual minority clients, including lesbian, gay, bisexual, transgender, queer, questioning, asexual, agender, and intersex (LGBTQAI+) clients.

Dates: Fridays, January 3 – March 27, 2020, twelve weeks, (No class on March 20-spring break)
Time: 8:15 – 9:45 AM
Cost: $300 ($150 for clinical students, enter discount code: STUDENT)
CEUs: 18 (Certificates of attendance provided)

Register online now  (deadline to register: January 2, 2020)

Participants in this in-depth, twelve-week, 18-hour course will:

  1. gain a better understanding of the research and evolving conceptualizations of gender identity, sexual orientation, and assigned sex to better ground their work with LGBTQAI+ populations.
  2. increase their awareness and understanding of the key factors for effective assessment and treatment planning.
  3. Learn to identify and begin to confront the common biases and assumptions that often limit understanding and effectiveness in this clinical work.
  4. learn how to create a more welcoming and safe therapeutic environment for these client populations.

Participants will also learn how to address the unique challenges LGBTQAI+ clients may be confronting, including:

  • heterosexist and cisgender bias, homphobia/transphobia, and internalized homophobia/transphobia
  • impact of minority stress and trauma
  • impact of spiritual violence
  • the coming out process
  • navigating and creating intimate relationships & supportive communities
  • risks and challenges faced at different life stages (e.g., youth, elders)
  • the integrative process of identity development for LGBTQ+ people, its challenges, and resolutions.

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Douglas Aupperle, Ph.D.

Doug Aupperle is a licensed psychologist. He received his B.A. in psychology from Creighton University in Omaha, and his M.A. and Ph.D. in clinical child psychology from DePaul University in Chicago.  Doug provides psychotherapy and psychological assessment/testing to children and adolescents. He has special interests in the areas of anxiety, attention disorders, Bowen Family Systems therapy, child sexual abuse, E.M.D.R. (eye movement desensitization and reprocessing), working with LGBT youth and parents, stress and coping in children, and trauma. He is a member of the EMDR International Association