Stigma Experiences of Sexual and Gender Minority Parents and Offspring Mental Health

Importance: Nearly 40% of sexual and gender minority individuals become parents. Research has highlighted the intergenerational outcomes of parental psychopathology associated with child psychiatric symptoms, yet how stigma and parental mental health influence child outcomes in sexual and gender minority families remains unclear. Objective: To examine associations between parental stigma experiences and psychiatric symptoms and children's mental health and emotional and behavioral well-being. Design, Setting, and Participants: This survey study recruited a community-based sample of sexual and gender minority parents (aged ≥18 years) between October 12 and December 1, 2023. Parents reported stigma experiences, internalizing and externalizing psychopathology, and their children's emotional and conduct problems. Exposure: Parental stigma defined as discrimination and internalized stigma. Main Outcomes and Measures: Parental externalizing and internalizing psychopathology and child emotional and conduct problems were analyzed using structural equation modeling with bifactor measurement models. Results: The sample included 551 sexual and gender minority parents (mean [SD] age, 34.5 [8.7] years, 268 identifying as cisgender women [48.6%]). Parental psychiatric symptoms were significantly associated with children's psychiatric symptoms (β [SE], 9.35 [3.44]; 95% CI, 2.61-16.09). Parental externalizing symptoms were associated with child conduct problems (β [SE], 0.67 [0.32]; 95% CI, 0.03-1.30), while internalizing symptoms were associated with child emotional problems (β [SE], 2.05 [0.77]; 95% CI, 0.54-3.55). General stigma was associated with both child psychiatric symptoms (β [SE], 3.53 [1.20]; 95% CI, 1.18-5.89) and emotional problems (β [SE], 2.13 [0.45]; 95% CI, 1.25-3.01). Discrimination, was also significantly associated with child emotional problems (β [SE], 0.22 [0.11]; 95% CI, 0.00-0.44). Conclusions and Relevance: This survey study found that parental stigma experiences in sexual and gender minority families are associated with both parental and child psychopathology. These findings highlight the need for longitudinal, multi-informant research to guide interventions supporting sexual and gender minority family mental health.