Family Rejection Research Articles

Supplemental Material for Impact of Family Rejection and Racism on Sexual and Gender Minority Stress Among LGBTQ Young People of Color During COVID-19

Supplemental Material for Impact of Family Rejection and Racism on Sexual and Gender Minority Stress Among LGBTQ Young People of Color During COVID-19

Nepalese Nurses Experiences of Workplace Violence During COVID-19 Pandemic

Introduction: Work-Place Violence (WPV) against the nurses is frequent and is often accepted as a part of their job. These front line healthcare workers were more vulnerable to WPV during the corona virus pandemic (COVID-19). The present study aims to explore WPV experience of the Nepalese nurses during the first wave of COVID-19 pandemic. Methods: A cross sectional qualitative study was conducted between June and December, 2020 among the nurses working at Bir Hospital after getting institutional ethical approval. A phenomenological approach was used to explore the experiences of the nurses. Purposive sampling was done to recruit the participants from COVID ICU, COVID Isolation and COVID wards. Data were collected using In-depth Interview (IDI) guidelines from nine participants. Each interview took about 20-40 minutes. The interviews were recorded using a recorder and note taking was also done. Themes were generated from the transcripts of the interviews by the researchers. Results: Nepalese nurses experienced varied forms of violence during the first wave of COVID-19. Experiences of the nurses were expressed mainly under five main themes; tolerance towards the aggressive patient, anxious to attend patient and visitors, family rejection, stigmatized by society and disrespect towards nurses. Conclusions: Nurses faced different forms of WPV from the patient, society and the government during the first wave of COVID-19. Proper safety and security guidelines for the nurses during such pandemic should be developed to minimize such risks in the future as well as recognigation should be given for their contribution during such health emergencies.

Beyond the (family) binary: Family environment heterogeneity among transgender adults

AbstractObjectiveTo identify latent profiles of family environments among transgender adults and to examine the relationships between these profiles and mental and physical health.BackgroundHow a family‐of‐origin responds to a transgender family member has significant implications for that individual's mental and physical health. However, the extant research on the health of transgender people has largely relied on a binary conceptualization of family environments that has been critiqued as simplistic, reductionistic, and misrepresentative. To date, no known quantitative studies have assessed transgender family environments beyond this ostensibly antiquated conceptualization.MethodData were collected in 2018 from transgender adults via Amazon's MTurk (N = 873). Participants completed questionnaires about their family environment, experiences of minority stress, mental and physical health, and quality of life.ResultsLatent profile analysis yielded five profiles of transgender family environments: disengaged; accepting and affirming; repudiating; moderate family ambiguity; and high family ambiguity. Over half of respondents were assigned membership to one of the two ambiguity profiles (56.4%). Distal regression models demonstrated that, relative to embracing and affirming, membership in each of the other four profiles was negatively associated with both mental and physical health. Participants assigned to the ambiguity profiles did not statistically differ on health outcomes when compared to those in the repudiating profile.ConclusionAmbiguity is prevalent in transgender people's families‐of‐origin. It also appears equally detrimental as family rejection is to the mental and physical health of transgender adults.

Understanding polyamory as a form of concurrency to enhance HIV programmes in South Africa: The need to re-conceptualize the partner reduction policy

A conceptual framework derived from three inter-related theories of social cognitive theory, constructivism and the meaning-making model, was used to investigate the group of relations between polyamorous relationships, safer sex practices and HIV. Using purposive sampling seven participants who were in polyamorist relationships in three provinces in South Africa: Gauteng, Cape Town and Northern Cape were interviewed to collect data. Interpretative phenomenological analysis was employed as the data analysis method. The findings of this study revealed that many of the participants who were involved in polyamorous relationships were concerned about their health and well-being. Therefore, in most of these relationships, the participants required of their secondary partners to disclose their HIV status and also test for STDs. Also, in all of the participants’ polyamorous relationships there were sexual rules and agreements that were set up in order to limit exposure to HIV. Furthermore, high level of communication strategies was employed to improve honesty and trust among all of the partners involved. The coping strategies that were adopted by all of these participants in order to deal with familial and societal rejection of their involvement in concurrency included forming psycho-social support networks. These findings show that there is a need to re-conceptualize the partner reduction policy in order to accommodate the perspectives and needs of people who are involved in concurrent partnerships. Further, social work is called upon to be aware and sensitive to polyamorous relationship in both education and practice.

Three Major Interrelated Factors Contributing to Homelessness Issue among Former Prisoners in Malaysia

Homelessness issue among former prisoners in Malaysia upon their release is of great concern. Hence, this study aimed to identify the predominant factors influencing homelessness issue among former prisoners in Malaysia. Imprisonment is usually assumed to be a negative life event and can act as a hindrance for the former prisoner to successfully integrate after being freed from prison. Imprisonment and past criminal records are the biggest contributors to becoming homeless. This is a fact because imprisonment causes the former prisoners to lose his source of income, personal belongings, ability to seek shelter and personal relationships due to family rejection, addiction and unemployment. This study was based on the Ecological Model of Homeless by Nooe and Patterson. The selection of this model was considered appropriate and aligned with the objectives of the study which aimed to identify the factors that lead to the life of the homeless among former prisoners. In this study, nineteen former prisoners, regardless of the type of offence committed, were selected using the snowball sampling method and were interviewed. The findings revealed that family denial, unemployment, and drug addiction were the three major interrelated factors that contribute to the homelessness issue among the former prisoners during their reintegration process. Housing security is a risk factor of homelessness.

The impact of stigma on HIV testing decisions for gay, bisexual, queer and other men who have sex with men: a qualitative study

BackgroundStigmatization may prompt gay, bisexual, queer and other men who have sex with men (GBQMSM) to avoid or delay HIV testing. There has been little attention to GBQMSMs’ perspectives about how stigma may influence their decisions about whether, where, and how often to get tested for HIV.MethodsWe conducted nine focus groups with 64 adult GBQMSM in Metropolitan Detroit, including HIV-negative men and people living with HIV (PLWH). Data were thematically analyzed deductively and inductively in three rounds.ResultsThree themes emerged regarding whether to get tested: (1) Perceived promiscuity, risk perceptions and HIV testing; (2) Fearing sexual rejection; and (3) Fearing friend and family member distancing and rejection. Themes concerning where to get tested included: (4) Conflating HIV testing and diagnosis; and (5) Seeking privacy and safety at specialized services. As for how often to get tested, themes included: (6) Reducing contact with healthcare providers due to intersectional stigma; (7) Responsibility and regular testing; and (8) HIV stigma and testing as routine care. Black participants articulated themes (3), (4), and (6) with greater frequency than other participants. Framing HIV testing as a personal responsibility may have created a “new stigma,” with unintended consequences not observed with “routine healthcare” messaging.ConclusionsGBQMSMs’ perspectives indicate the potential for new foci for HIV testing promotion interventions based on stigma-related issues that they deem important. There is a need for interventions to challenge the “promiscuity” stereotype, and to reduce the sexual stigmatization of GBQMSM living with HIV/AIDS—especially online. Provider stigma requires both intervention and continued availability of specialized services. Future stigma-reduction interventions for Black GBQMSM could focus on building family support/acceptance, awareness of multiple testing options, and integrating LGBTQ-related issues into initiatives for racial justice in health care.

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients

“Am I really alive?”: Understanding the role of homophobia, biphobia and transphobia in young LGBT+ people's suicidal distress

Suicide is the fourth leading cause of death amongst young people aged 15–29 globally and amongst this young population, lesbian, gay, bisexual and trans (LGBT+) young people have higher rates of suicidal thoughts and attempts than their cisgender (non-trans), heterosexual peers. However, despite well-established knowledge on the existence of this health inequality, in the UK there has been a paucity of research exploring why this disparity exists, and this is particularly the case in Scotland. This paper aims to address this gap, reporting on the first study specifically seeking to understand LGBT+ young people's suicidal thoughts and attempts in Scotland. We used a qualitative methodology to explore how young people with lived experience of suicidal distress make sense of the relationship between homophobia, biphobia and transphobia, and suicidal thoughts and attempts. We undertook in-depth, narrative interviews with twenty-four LGBT+ people aged 16–24, and analysed them using reflexive thematic analysis. Drawing on this analysis, we argue that suicide can be understood as a response to stigma, discrimination and harassment, made possible by a cultural climate that positions LGBT+ people as different or other, reinforcing norms regarding gender conformity and sexuality. We suggest in turn, that this cultural climate provides fertile ground from which more explicit acts of homophobia, biphobia and transphobia, such as bullying and family rejection are able to grow. In response to this, LGBT+ young people could begin to experience senses of entrapment, rejection and isolation, to which suicidal thoughts and attempts can be understood as responses. Consequently, we propose that these stigma experiences must be taken seriously and tackled directly in order to reduce LGBT + suicide in the future.

Complex Outness Patterns Among Sexual Minority Youth: A Latent Class Analysis.

Prior scholarship has documented health-relevant consequences of sexual minority youth (SMY) sexual identity disclosure (i.e., "outness"), yet most of the extant work focuses on one social context at a time and/or measures outness as dichotomous: out or not out. However, SMY are out in some contexts (e.g., family, friends) and not in others, and to varying degrees (e.g., to some friends, but not to all). Using a national sample of 8884 SMY ages 13-17 (45% cisgender female, 67% White, 38% gay/lesbian and 34% bisexual, and 36% from the U.S. South), this study used latent class analysis to identify complex patterns of outness among SMY, as well differences in class membership by demographics, depression, family rejection, and bullying. The results indicated six distinct classes: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ peers (n = 1707), out to LGBTQ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). The findings reveal significant differences in class membership by age, sexual identity, gender identity, race and ethnicity, geography, and well-being outcomes. Moreover, these findings underscore the complex role of outness across social contexts in shaping health and well-being.

Rafiki

Rafiki

“It kinda breaks my heart”: LGBTQ young adults' responses to family rejection

AbstractObjectiveThis study examines the realities of LGBTQ young adults experiencing family rejection, specifically illuminating forms of heterosexist and cisgenderist family rejection and their impact on LGBTQ young adults.BackgroundExtant research indicates family rejection is a driving factor in the overrepresentation of LGBTQ young adults among young adults experiencing homelessness.MethodThis study analyzed two waves of interviews with 15 LGBTQ young adults. It addressed two research questions: (a) What kinds of heterosexist and cisgenderist rejection do LGBTQ young adults experience from their parents or guardians? and (b) How do LGBTQ young adults react to and experience that rejection?ResultsParticipants reported multiple forms of heterosexist and cisgenderist rejection from their families, including increased heterosexism and cisgenderism in the home after coming out, increased arguments and conflict after coming out, abuse and neglect, silence and avoidance, control and isolation, and revoking young people's access to housing. Participants' responses to these forms of rejection included pain, disconnection from their families, feeling stifled in the home, and the desire to resist.ConclusionThese findings illuminate specific forms and manifestations of heterosexist and cisgenderist family rejection and their impact on LGBTQ young adults.ImplicationsImplications for research include further exploration of how family rejection manifests in the families of LGBTQ young adults. Implications for clinical practice include developing tailored outreach and services for young adults experiencing family rejection and housing instability.

Telecarers improve osteoporosis treatment and compliance rates in secondary osteoporosis prevention for elderly hip fracture patients.

A significant treatment gap has been observed in patients with osteoporosis. Our previous audit found a 31.5% rate of anti-osteoporosis medication initiation after fragility fractures at one year. We piloted the use of telecarers to monitor osteoporosis treatment and compliance. From January 2017 to January 2018, all hip fracture patients at Changi General Hospital, Singapore, were automatically enrolled into the Health Management Unit valued care hip fracture programme. Telecarer calls were scheduled at discharge, 3, 6 and 12 months. We assessed the acceptability, completion and treatment rates of patients enrolled in this programme. A total of 537 patients with a hip fracture were enrolled in the telecarer programme over one year. Their average age was 79.8 ± 8.23 years, and 63.1% of them were female. A total of 341 patients completed 12 months of follow-up, of which 251 (73.6%) patients were on treatment at 12 months. The most common cause of lack of initiation of secondary osteoporosis treatment was patient or family rejection (34.4%), followed by physician failure to prescribe (24.4%) and renal impairment (24.4%). 16.7% of patients were deemed to have advanced dementia with a life-limiting illness and were, thus, deemed unsuitable for treatment. Telecarers may be a useful adjunct in the monitoring of osteoporosis treatment after hip fractures in an elderly population. The main limitations are patient or family rejection and physician inertia. Further studies should focus on a combination of interventions for both patients and physicians to increase awareness of secondary fracture prevention.

Minority stressors and their associations with severe psychological distress among gender-diverse people.

People whose gender does not align with assigned sex often experience negative mental health outcomes related to cisnormative societal expectations and oppression, including familial rejection, threat of harm, and identity invalidation (e.g., misgendering). This study merged two cross-sectional data sets of trans and gender-diverse people (N = 363; Mage = 22.02) investigating how various types of distal minority stress experiences impact psychological distress. We tested the associations between three minority stressors (i.e., family rejection, threat of harm, and identity invalidation) and psychological distress using unadjusted and adjusted regression models, including gender-stratified models. In the overall unadjusted model, all three stressors were significantly, positively associated with psychological distress, with identity invalidation having the highest standardized β value. In the adjusted overall model, only identity invalidation was significantly associated with distress. Results varied in gender-stratified models. Additionally, participants who experienced any of the three stressors had predicted mean distress scores at or above the cutoff for severe psychological distress, while those who did not fell below that cutoff. Results highlight the differential impact of minority stress experiences on gender-diverse young adults and provide directions for clinical competency, interventions, and future research toward understanding mental health disparities for trans people. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sleep problems among sexual minorities: a longitudinal study on the influence of the family of origin and chosen family

BackgroundThere is growing evidence that lesbian, gay, and bisexual (LGB) adults experience more sleep problems than the general population. As LGB individuals experience a significantly greater risk of family rejection and low family support, our study investigates the role of family support as a potential determinant of LGB sleep problems over a prolonged period, and whether friend support (i.e. chosen family) can mitigate the effect of low family support. Given the importance of sleep on mental and physical health, study results may help shed light on persistent health disparities across sexual orientations.MethodsOur sample included 1703 LGB individuals from the UK Household Longitudinal Study (UKHLS). Mixed-effect logistic regressions were used to estimate the effect of family and friend support on the development of sleep problems after 24 months while controlling for potential confounders. A modified Pittsburgh Sleep Quality Index was used to measure 1) presence of any sleep problems, 2) short sleep duration, and 3) poor sleep quality.ResultsFamily support at baseline was independently associated with all sleep problems in our study after 24-months: 1 SD increase in family support was associated with a 0.94 times lower risk of sleep problems (95% C.I = 0.90-0.98), a 0.88 times lower risk of short sleep duration (95% C.I = 0.81-0.95), and a 0.92 times lower risk of sleep quality (95% C.I = 0.93-0.98). Support from one’s chosen family (proxied by friend support) did not mitigate the effects of low family support on sleep problems.ConclusionsOur study found a consistent effect of family support across all sleep outcomes along with evidence of a persistent effect after 24 months. Our findings point to the importance of targeting family support in designing interventions aimed at reducing LGB sleep problems.

Latent Classes of Bidirectional Face-to-Face and Cyber Intimate Partner Violence Among Lesbian, Gay, and Bisexual Emerging Adults: The Role of Minority Stressors.

The rates of intimate partner violence have been found to be higher among lesbian, gay, and bisexual (LGB) individuals when compared with heterosexual populations. However, lesser is known about the impact of specific minority stressors experienced by LGB populations on their face-to-face intimate partner violence (IPV) and cyber IPV experiences. Using a three-step latent class approach, the present study investigated (i) the latent classes of self-reported types of face-to-face IPV and cyber IPV perpetration and victimization and (ii) their associations with LGB distal and proximal minority stressors (i.e., vicarious trauma, discrimination, family rejection, and LGB-identity disclosure). Participants were 288 LGB emerging adults in the age range of 18-29years (bisexual: n = 168, gay: n = 72, and lesbian: n = 48). Findings showed the presence of four latent classes, namely, face-to-face IPV (n = 32; 37.5% gay, 18.8% lesbian, and 43.8% bisexual individuals), cyber IPV (n = 66; 33.3% gay, 12.1% lesbian, and 54.5% bisexual individuals), psychological and stalking cyber IPV (n = 89; 15.7% gay, 15.7% lesbian, and 68.5% bisexual individuals), and low IPV (n = 101; 23.8% gay, 19.8% lesbian, and 56.4% bisexual individuals). Furthermore, multinomial logistic regressions indicated that greater exposure to the minority stressors such as exposure to heterosexism, namely, discrimination and harassment, rejection from one's family of origin, and exposure to vicarious trauma, as well as a lower degree of LGB-identity disclosure, largely predicted latent classes with greater probabilities of IPV exposure, namely, cyber IPV, face-to-face IPV classes, and psychological and stalking cyber IPV. Findings suggest the importance of addressing the role of minority stressors in IPV interventions and the creation of competent LGB-related services and training modules for clinicians.

Intersecting racism and homonegativism among sexual minority men of color: Latent class analysis of multidimensional stigma with subgroup differences in health and sociostructural burdens

RationaleApplying an intersectional framework to quantitative public health research among Black and Latino sexual minority men requires analysis that considers interlocking, multidimensional systems of racist and homonegative oppression that fundamentally subvert health. In this study, person-centered methods reflected the complexity of intersecting stigma and how subgroups experience that intersection differently. MethodsData were from a cohort of 435 Black and Latino sexual minority young men (mean age = 22.3 years) in the Healthy Young Men's Cohort Study in Los Angeles, United States. Participants provided data semiannually on five occasions spanning 24 months from 2016 to 2019. The marginal approach to longitudinal latent class analysis was used to identify latent classes indicated by multidimensional experiences of racism (e.g., police harassment, workplace discrimination, sexual objectification) and homonegativism (e.g., violence, family rejection, identity concealment) during the transition to adulthood. Associations between sociostructural burdens (e.g., socioeconomic status, food insecurity, unstable housing) and class incidents were investigated. Prevalence of mental health care needs, chronic health conditions, and overall self-reported health were compared among classes. ResultsFive latent classes were identified: Minimal Stigma (26% of person records), Select Social Stigma (22%), Homonegativism (17%), Multiform Racism (24%), and Compound Stigma (11%). Sociostructural burdens were generally associated with 1.69–3.75 times higher odds of Select Social Stigma, Homonegativism, Multiform Racism, and Compound Stigma class incidents relative to Minimal Stigma. The Compound Stigma class had the greatest sociostructural burden, highest mental health care needs, and highest odds of sleep and gastrointestinal disorders, but classes did not differ in overall self-reported health. ConclusionThese results exemplify how sociostructural burdens are interconnected with intersectional stigma experiences that together erode the health of Black and Latino sexual minority young men.

Enhancing Interpersonal Intimacy in Colombian Gay Men Using Functional Analytic Psychotherapy: An Experimental Nonconcurrent Multiple Baseline Design

A growing body of research suggests that rejection sensitivity, a form of interpersonal guardedness associated with familial rejection and societal bias, is a transdiagnostic risk factor for anxiety and mood disorders in gay men. From a behavioral perspective, rejection sensitivity is conceptualized as avoidance of intimacy as the result of systematic social punishment of vulnerable behaviors. Despite the implications of rejection sensitivity for psychological well-being, clinical psychology lacks specific behavioral interventions for emotional intimacy at the level of the individual. Functional Analytic Psychotherapy (FAP) is a therapeutic approach developed to enhance interpersonal behaviors that promote intimacy and closeness through identification of, and contingent responding to, clinically relevant behaviors.A nonconcurrent between-participants design examined the effectiveness of 4 to 8 sessions of FAP on reducing intimacy-avoiding behaviors and increasing intimacy-promoting behaviors in three Colombian gay men.FAP implementation yielded significant increases in intimacy promoting behaviors (β = 65.65, S.E. = 11.48, p = .0004) with a large effect size calculated by the between-case standardized mean difference (BC-SMD (17.01) = 1.66, CI [0.69–2.73]). The increase in intimacy-promoting behaviors occurred without evidence for reduction or elimination of intimacy-avoiding behaviors.Recommendations for future research include (1) the implementation of longitudinal intensive studies to capture participants' out-of-session behavioral changes and (2) further research to determine FAP’s effectiveness for increasing intimacy-promoting behaviors among other sexual or gender minority individuals.

The interplay of familial warmth and LGBTQ+ specific family rejection on LGBTQ+ adolescents’ self-esteem

IntroductionOur study sought to assess the interplay of family dynamics, namely familial warmth and LGBTQ+ specific rejection, and its association to self-esteem in a non-probabilistic sample of LGBTQ+ adolescents in the United States. MethodsStratified by (1) cisgender and (2) transgender and non-binary LGBTQ+ adolescents (N = 8774), we tested multivariable regression analyses to assess the association between familial warmth and LGBTQ+ specific family rejection, adjusted for sociodemographic characteristics. We then conducted a sub-analysis with LGBTQ+ adolescents who reported being out to any family member about their LGBTQ+ identity; specifically, we tested a series of multivariable regression models to assess whether levels of LGBTQ+ specific family rejection attenuated the association between familial warmth and self-esteem. ResultsFull sample models indicated a positive association between familial warmth and self-esteem. Findings from our sub-analysis indicated that familial warmth remained positively linked to self-esteem and family rejection was negatively associated with self-esteem. Family rejection was a statistically significant moderator, attenuating the association between familial warmth and self-esteem. With respect to being out about one's sexual orientation, these findings were robust across gender stratification groups. ConclusionsFamilies of origin serve as sources of stress and resilience for LGBTQ+ adolescents. Our findings contribute support to arguments that familial warmth and LGBTQ+ specific rejection are not mutually-exclusive experiences among LGBTQ+ adolescents. We provide recommendations for multilevel interventions to leverage activities that support positive family dynamics and self-esteem among LGBTQ+ adolescents.

Victimization Typologies Among a Large National Sample of Sexual and Gender Minority Adolescents.

Purpose: The overall objective of this study was to examine the hypothesis that victimization exposure among sexual and gender minority (SGM) youth would result in different latent classes and that victimization exposure class membership would relate to demographic, SGM-specific risk and protective factors, and health variables. Methods: Between April 2017 and December 2017, SGM youth (N = 17,112) aged 13-17 years completed self-report online surveys as part of the LGBTQ National Teen Survey. Data were analyzed between August 2020 and November 2020. Results: Three classes emerged: (1) no victimization exposure, (2) sexual harassment and bullying, and (3) poly-victimization (sexual victimization, sexual harassment, SGM-based bullying, and non-SGM bullying). The results demonstrated that victimization experiences co-occur disproportionately in vulnerable subpopulations of SGM youth, including those who identify as transgender or other gender minority, who are experiencing stigma-related stress and family rejection, and who had disclosed their sexual orientation to family members/parents. SGM youth who reported a diversity of strengths seemed to be protected against victimization. Finally, SGM youth in the sexual harassment and bullying class and the poly-victimization class were more likely to report depressive symptoms, self-perceived stress, and substance use than were SGM youth in the no victimization class, regardless of sex assigned at birth. Conclusion: These findings underscore the urgency with which affirmative prevention and intervention initiatives are needed for SGM youth to reduce risk factors for and correlates of victimization experiences. The data also underscore the importance of addressing SGM-specific risk and protective factors as part of comprehensive violence-related initiatives.

Minority Stress & Mental Health for Sexual Minority Adults from Religious Families: the Role of Religious Coping

ABSTRACT Background A majority of sexual minority (SM; lesbian, gay, bisexual, queer) adults identify as religious and use religious copingstrategies for dealing with life’s stressors. SM people report experiencingunique minority stressors of interpersonal rejection in family and religioussettings as a product of religious doctrine that rejects same-sex relationshipsand attraction; however, the usefulness of religious coping strategies forhandling minority stressors for improving the mental health of SM people isstill unknown given mixed findings in previous studies. In addition, locatingparticular measures of religiously based minority stress may aid in identifyingkey factors affecting mental health. Method This study utilized quantitative data from a web-based survey to explore the relationships between religious coping,interpersonal religious discontent, minority stressors of family rejection andinternalized stigma, and depressive symptoms of SM adults from religiousfamilies (n = 384). Results Moderation analysis demonstrated the significant interaction of religious coping and interpersonal religious discontent withminority stress factors for exacerbating the influence of greater minoritystress on greater depressive symptoms when religious coping and interpersonalreligious discontent were higher. In addition, those who left their religiousaffiliations experienced decreased minority stress and used less religiouscoping strategies. Conclusions Implications for family psychotherapy and future research are addressed.