Primary Care in Rochester and Kasson

Minority stress and LGBTQ+ family health

6/2/2022 by Cesar Gonzalez, Ph.D., L.P., and Anne Roche, Ph.D.


Common experiences among LGBTQ+ people relate to social acceptance. For example, an LGBTQ+ person may decide not to disclose a partnership with someone of the same sex. Or a same-sex household may avoid socializing with others in their neighborhood out of fear of not being accepted.

It was previously thought that only LGBTQ+ people experienced minority stress. However, recent research has found that loved ones of LGBTQ+ people also experience minority-related stress. For example, parents of an LGBTQ+ child may worry about taunting from the child's peers at school. Grandparents may privately wonder how to discuss the wedding of their LGBTQ+ grandchild with their close friends. These situations are bound by experiences of minority stress, and they negatively affect health.

Minority stress

Minority stress refers to the physical and emotional distress that is unique to LGBTQ+ and other marginalized communities. If often centers on the anticipation of being rejected, harassed or discriminated against. The consequences of the anticipation of negative outcomes often are shame, concealment and social isolation.

Because of the historically negative perceptions and sociopolitical climate about LGBTQ+ people, many LGBTQ+ people experience long-term activation of stress responses. These stress responses place people at risk for many medical conditions, such as sleep difficulties, heart disease, muscle tension, immune disorders, anxiety and depression. It is also important to note that LGBTQ+ people may hold additional marginalized identities that put them at further risk for experiencing minority stress. While research has not yet confirmed these negative effects among loved ones of LGBTQ+ people, it is likely that they are similarly affected

Countering minority stress through family health

Did you know that family relationships may contribute to over 25% of your health? Many believe that the health of the family is not modifiable. Research suggests that family health factors can be modified to promote a sense of belonging, build confidence and promote flourishing in life. 

Consider the questions in the domains below: 

Family social and emotional health processes

  • Does your family discuss problems and feel good about the solutions?
  • Are you happy with your relationships with your family members? 
  • Do you feel safe in your family relationships? 

Family healthy lifestyle

  • Does your family help each other to avoid unhealthy habits? 
  • As a family, do you make it a point to support and follow medical recommendations?
  • Do you help each other make health changes, despite it going against what may be expected based on family norms? 

Family health resources

  • Does your family have adequate housing? 
  • Does your family have enough money at the end of the month after bills are paid? 
  • Does your family trust health care professionals for information?

Family external and LGBTQ+ social support

  • Does your family have people outside of the family to turn to when there are problems at school or work? 
  • Does your family have people outside of the family to help with advice, child care, a ride or to help with a loan? 
  • If an emergency were to occur, do you have people outside of the family who could provide a place to live? 
  • Does your family have people outside of the family to turn to who know about and supports LGBTQ+ issues? 

If you rate your family low and you have attempted to address the concerns with little change, consider reaching out to your primary care team to identify resources and help build a strong, lifelong foundation to face minority stress. For any items that you answered no, consider discussing your answer with your health care team. 

It's understood that not all people may feel safe with and supported by the people in their life traditionally defined as family members. The people and communities you define as your closest support system may be your chosen family. 

Remember, the World Health Organization describes health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." WHO goes on to say that "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition."

Cesar Gonzalez, Ph.D., L.P., is a psychologist in Mayo Clinic's Division of Integrated Behavioral Health and is clinical director of the Transgender and Intersex Specialty Care Clinic at Mayo Clinic in Rochester. 

Anne Roche, Ph.D., is a first-year clinical psychology fellow in Primary Care in Rochester and Kasson's Division of Integrated Behavioral Health at Mayo Clinic in Rochester.