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. 2025 Jun 27;20(6):e0327370.
doi: 10.1371/journal.pone.0327370. eCollection 2025.

The relationship between family environments growing up and behavioral health among LGBTQ+ adults: The mediating role of internalized homonegativity

Pin-Chen Chiang  1 , Yinuo Xu  1   2 , Denise Yookong Williams  3 , Ankur Srivastava  1 , Jake A Leite  1 , Adam R Englert  1 , William J Hall  1
Affiliations

The relationship between family environments growing up and behavioral health among LGBTQ+ adults: The mediating role of internalized homonegativity

Pin-Chen Chiang et al. PLoS One. .

Abstract

Purpose: Disparities in the behavioral health outcomes for lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) adults-such as depression, anxiety, and alcohol use-are often attributed to experiences of discrimination, victimization, and lack of supportive environments, including hetero- and cis-normative family settings. Yet, how family environments in childhood influence LGBTQ+ adults' behavioral health and internalized homonegativity has not been extensively examined.

Methods: This study utilized a U.S. national dataset of LGBTQ+ adults (N = 499). Data were collected in November 2020 using an online survey. A series of multivariate ordinary least squares regression models and Sobel tests were performed.

Results: Results showed that as homophobic messages from family increased, levels of depression (β = .19, p < .001), anxiety (β = .17, p < .001), and internalized homonegativity (β = .13, p < .01) increased. As the conservatism level in families increased, levels of alcohol use (β = .11, p < .05), and internalized homonegativity (β = .15, p < .01) increased. In the mediation analysis, internalized homonegativity was found to partially mediate the relationship between homophobic messages from family and depression (z = 3.35, p < .001), homophobic messages and anxiety (z = 3.09, p < .01), and conservatism in family and alcohol use (z = 2.80, p < 0.01). Internalized homonegativity also fully mediated the relationship between homophobic messages and alcohol use (z = 2.66, p < 0.01), conservatism in family and depression (z = 3.76, p < 0.001), and conservatism in family and anxiety (z = 3.45, p < 0.001).

Conclusion: Study findings underscore the importance of inclusive climates within a family and internalized homonegativity as a mediator for LGBTQ+ individuals' behavioral health. Implications for intervention and future research are discussed.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Conceptual model.
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