Patterns of Parental Relationships With LGBTQ+ Youth Aged Out of Out‐Of‐Home Care

ABSTRACT

The study's purpose was to explore the relationships between parents and LGBTQ+ youth who left their homes and went to residential out‐of‐home care. This study sheds light on different patterns of family relationships, offering insights into the changes that may occur at three points in time: before, during, and after leaving out‐of‐home care. Employing constructivist grounded theory methodology, 31 in‐depth semi‐structured interviews were conducted with LGBTQ+ youth aged 16 to 32 (average 21.6) who had aged out of out‐of‐home care services for homeless LGBTQ+ youth in Israel. The analysis indicated four patterns of relationships: (a) improvement pattern, reflecting a gradual increase in parental acceptance levels over time; (b) partial acceptance pattern, showing a middle situation between conditional acceptance and rejection; (c) from rejection to acceptance pattern, demonstrating rejection before and during out‐of‐home care, which rapidly progressed to acceptance after leaving out‐of‐home care; and (d) persistent disconnection pattern, indicating permanent rejection. The discussion highlights the need to train family therapists to recognize distinct relational patterns between LGBTQ+ youth and their families and to tailor interventions accordingly. Policy efforts should include funding for family support centers and the assignment of dedicated LGBTQ+ caseworkers within local social service departments to promote parental acceptance and reduce the risk of youth homelessness.

1. Introduction

The literature is replete with studies on family's reactions following the disclosure of their child's sexual orientation and gender identity. Various reactions and emotions have been documented, including relief and happiness, which signify acceptance, as well as shame, anger, disappointment, and sadness (Gottlieb 2000; Lasala 2010). A few studies have examined parents' well‐being and noted their depression, anxiety, and dissatisfaction after learning of their child's transgender identity (Kane 2006; Lenning and Buist 2013; Veldorale‐Griffin 2014). Studies focusing on youth perspectives have highlighted family conflicts post‐disclosure, noting increased arguments and conflicts, instances of abuse and neglect, silence and avoidance, control and isolation, as well as limited access for young people to out‐of‐home care (DeChants et al. 2022). The decision to disclose a non‐heterosexual orientation to parents is often influenced by four interconnected factors: sexual identity development and integration, family dynamics, messages about non‐heterosexuality, and expectations that the outcome of the disclosure will affect the psychological stress experienced by the youth (Grafsky 2018).

The reactions of family members, particularly parents, to a youth's disclosure of their sexual and/or gender identity have the most significant impact on the well‐being of LGBTQ+ youth (Katz‐Wise et al. 2016; Malpas 2011; Ryan et al. 2009). While family acceptance is associated with high levels of well‐being (Malpas 2011; Shilo et al. 2015), family rejection has been associated with increased symptoms of depression, suicide attempts, substance use, and commercial sexual exploitation (Klein and Golub 2016; Mazursky and Nadan 2024; Ryan et al. 2010; Shenkman et al. 2020). Furthermore, family rejection has often been found to lead to LGBTQ+ youth experiencing homelessness and entering out‐of‐home care (Choi et al. 2015).

Recently, literature has begun to shed light on the experiences of LGBTQ+ youth in out‐of‐home care (Álvarez et al. 2022; Kaasbøll et al. 2022; Mazursky 2024). In Israel, the majority of children and youth are placed in residential care (Kosher 2023), while foster care is a more common form of out‐of‐home care in countries like the U.S. Studies in the U.S. have concluded that LGBTQ+ youth are overrepresented in foster care (Baams et al. 2019; Dettlaff et al. 2018; Fish et al. 2019; Kahn et al. 2018) and were 2.5 times more likely to experience out‐of‐home placements (Fish et al. 2019; Wilson et al. 2014). Compared to heterosexual and cisgender youth in foster care, LGBTQ+ youth have reported receiving fewer health and mental health services (Mallon et al. 2002). Similarly, they are significantly more likely to have poorer health, mental health, and well‐being outcomes than heterosexual and cisgender youth (Damian et al. 2023; Dettlaff et al. 2018; Marshal et al. 2011). In addition, LGBTQ+ youth in out‐of‐home placements are often exposed to negative experiences, such as violence, discrimination, and abuse from their peers and care professionals (Capous‐Desyllas and Mountz 2019; Mallon et al. 2022; McCormick 2018).

The current study is led by three theoretical frameworks. The first is the minority stress model, which emphasizes that living in a heterosexist society leads to chronic stress related to experiences of stigmatization (Meyer 1995). Second, the intersectionality framework broadens this understanding by shedding light on the interconnected power systems at the macro‐social‐structural levels. These systems encompass existing welfare policies, legal and educational frameworks, traditional gender norms, and a conservative political climate (Crenshaw 1989). Additionally, the study is led by the standpoint theory (Hartsock 1983). The core tenet of standpoint theory is that oppressed members of society may experience the world differently due to their social positioning. Therefore, the standpoints of oppressed groups should inform knowledge production and the construction of social reality (Hooks 2000).

This study is situated within the Israeli context. In Israel, the life experiences of LGBTQ+ youth continue to be challenging. They often encounter inequality regarding their rights, and the political recognition necessary to assist LGBTQ+ youth with their unique challenges is only beginning. Furthermore, some religious groups in Israel have low levels of acceptance for LGBTQ+ individuals, which is associated with high levels of internalized homophobia (Shilo and Savaya 2012). According to the annual report of the Association for LGBTQ+ Equality in Israel (2022), 444 LGBTQ+ youth left their homes and entered out‐of‐home care due to homelessness in 2021. In Israel, parents remain highly involved in their children's lives well into adulthood, with many young adults living at home and relying on parental support into their twenties (Donath 2015; Goldscheider 2019; Lahad et al. 2018; Lavee and Katz 2003). A recent study conducted on the experiences of Israeli parents of transgender young adults indicated that parents' vulnerability in facing their child's identity was influenced by being part of a minority group and their socio‐political environment. Simultaneously, their resilience increased according to their ability to cope through meaning‐making, social support, and activism (Tsfati and Nadan 2022).

While the literature has explored parents' diverse reactions toward their children's LGBTQ+ identity, it has typically focused on their response at the time of their child's coming out. The current research aims to understand parents' reactions over time, viewing these changes through the perspectives of LGBTQ+ youth. This study specifically examined the experiences of LGBTQ+ young people who have resided in out‐of‐home settings due to parental rejection. In this study, out‐of‐home care refers to residential services for LGBTQ+ youth who have experienced family rejection and homelessness. The research question was: What are the perceptions and experiences of LGBTQ+ youth who have stayed in out‐of‐home care regarding their relationships with their parents (a) before entering care, (b) during their stay, and (c) after leaving?

2. Method

This qualitative study employed a grounded theory approach (Charmaz 2014). Grounded theory methods provide systematic yet flexible guidelines for collecting and analyzing qualitative data to construct theories directly rooted in the data. According to this approach, data collection and analysis occur simultaneously, with continuous interaction between the two processes (Charmaz 2014; Strauss and Corbin 1994). Furthermore, there is a constant interaction between the researcher and the data, enabling processes of reflection and recognition of the various contexts in which the research takes place (Charmaz 2014).

2.1. Participants

The inclusion criteria to participate in this study were to be a youth who aged out of one or more of the residential facilities operated by the Otot organization for homeless LGBTQ+ youth (i.e., Beit Dror, The Pink Roof, Avney Derech, and Transitional Apartment). Convenience sampling and snowball sampling were used in the data collection phase (Glaser and Strauss 1967; Patton 2015). The participants were recruited through ads posted in WhatsApp groups for LGBTQ+ out‐of‐home care alums and by asking participants to refer other community members. The final sample consisted of 31 LGBTQ+ youth between the ages of 16 and 32 (M = 21.6, SD = 3.9) who had aged out of the out‐of‐home residential facilities for homeless LGBTQ+ youth.

All of the participants experienced forms of heterosexist and cisgenderist parental rejection, which led them to leave their homes and enter out‐of‐home care. The participants were also asked to identify themselves along the sexual orientation and gender continuums. The sexual orientation continuum reflects the diversity of sexual attractions, ranging from exclusive heterosexuality to exclusive homosexuality, with various identities and experiences in between (e.g., bisexual, polysexual; Kinsey et al. 1953). The gender continuum is a spectrum that acknowledges a range of gender identities and expressions beyond the binary of male and female, recognizing gender as fluid and diverse (e.g., transgender, nonbinary, genderqueer; Butler 1990). Approximately one‐third of the participants identified as cisgender and on the sexual orientation continuum (i.e., other than exclusively heterosexual); 58% identified themselves on the gender continuum (i.e., other than exclusively cisgender); and nearly 10% defined themselves as being both on the gender and sexual orientation continuums. Regarding socio‐cultural background, 20 participants were Jewish, six were Muslim, three were Christian, and two did not identify themselves culturally. Most were born in Israel, and three immigrated to Israel in early childhood.

In‐depth semi‐structured interviews were conducted in locations suggested by the participants and lasted from 1.5 to 3.5 h. The interview guide (see Data S1) focused on their personal background (e.g., “Tell me about yourself.”); childhood (e.g., “Describe the atmosphere at home when you were younger”); leaving home (e.g., “Describe the reasons that led you to leave your home”); and stay in the LGBTQ+ out‐of‐home care facility (e.g., “How was your relationship with your parents during your stay in the LGBTQ+ out‐of‐home care?”). All interviews were conducted, recorded, and transcribed verbatim in Hebrew and analyzed using MAXQDA 2020, a qualitative data analysis program. Illustrative quotes selected by the author were translated into English by a professional translator.

2.2. Data Analysis

In the grounded theory approach, the data is analyzed in four stages (Charmaz 2014). In the first stage, I familiarized myself with the data by listening to the interview recordings, transcribing them, and reading them several times. In the second stage, I began coding the text to identify basic meaning units (codes). The codes identified reflected the participants' perceptions while maintaining the original meaning and content, for example, “experiencing being thrown out of home” and “experiencing disconnection from family until today.” In the third stage, I made connections between and within the codes (subcategories) using axial coding (Strauss and Corbin 1994). This step entailed grouping meaning units into identical content worlds to create higher‐level categories addressing the same subject. For example, the codes “experiencing being thrown out of home” and “ran away from home” were grouped under the category “parental rejection,” while the codes “experiencing disconnection from family until today” and “experiencing disconnection from family during the stay in out‐of‐home care” were grouped under the category “persistent disconnection.” The fourth step was to present the results and build a theoretical model based on the data to explain the phenomenon being studied.

2.3. Trustworthiness

Trustworthiness in qualitative research points to methodological integrity, which consists of two main concepts: fidelity and utility (Levitt et al. 2018). Fidelity relates to adhering to the phenomenon being studied. Utility is the process by which the researcher chooses an effective method to answer the research questions and meet the goals. The present study demonstrated fidelity through the qualitative method chosen to address the research questions for the specific population and data collection process. For example, in each interview, I followed the interview guide, asking all participants the same questions, and accurately recorded the data. Utility is reflected in how the findings are presented and in the numerous quotations that allow the reader to gain a broad picture and reflect on the answers to the research questions.

Additionally, as a cisgender, heterosexual female social work researcher with experience working with LGBTQ+ individuals in mental health services, I approached this study with an awareness of my own perspectives and potential biases. My values of openness and non‐judgment guided the way I listened to the participants' narratives and approached the analysis. This sensitivity, along with ongoing reflection to identify potential biases, led me to maintain a detailed field log of personal reflections throughout the study. For example, I noted the need for additional sensitivity during interviews, particularly when discussing family relationships. A sense of differentness has been acknowledged as an origin of knowledge construction (Enosh et al. 2008). Therefore, as an outsider, I paid particular attention to implicit rather than self‐evident or given knowledge. The discovery of incongruities and contradictions led me to treat them as sources of new knowledge (Enosh and Ben‐Ari 2016). One example was when I asked for explanations during the interviews regarding the slang and terminology common among LGBTQ+ community members. A peer review was also conducted among a group of doctoral students who provided feedback on the findings. For example, my peers encouraged the identification of additional patterns and gave feedback that ensured a clearer distinction between each pattern to enhance the analysis.

2.4. Ethical Considerations

The study was approved by the Ethics Committee of the Hebrew University of Jerusalem. The research was conducted according to the committee's guidelines. Before each interview, the participant signed an informed consent form. Confidentiality was guaranteed throughout all stages of the study, including using pseudonyms and omitting all identifying information. After completing the interview, each participant was given 100 NIS (~US$25).

3. Results

The analysis presented various patterns of relationships between LGBTQ+ youth who aged out of out‐of‐home care for homeless LGBTQ+ youth in Israel and their parents. The four patterns were: (a) improvement (n = 6), (b) partial acceptance (n = 13), (c) from rejection to acceptance (n = 6), and (d) persistent disconnection (n = 11). These patterns were observed over three points in time: before entering, during their stay, and after leaving out‐of‐home care. Some families had multiple patterns of reactions. For instance, one parent may have exhibited one pattern, while another exhibited a different one. The patterns identified in the study are based on the experiences of all participants. Figure 1 presents the four relationship patterns and their location between the axes of time and level of parental acceptance of the youths' LGBTQ+ identity.

FIGURE 1.

Patterns of the parental relationship.

3.1. Improvement Pattern

One relationship pattern was characterized by a gradual increase in parental acceptance levels. From the participants' point of view, their stay in out‐of‐home care and the resulting distance from their parents helped improve the relationship. They shared that the acceptance process began while staying in out‐of‐home care and continued in a positive trend. The youth who experienced this pattern usually returned to their parents' homes after their stay in out‐of‐home care. Maurice (16 years old, nonbinary, and queer) left home after many fights with their parents following their coming out. They described:

I got there [out‐of‐home care] because I had a fight with my parents […] I just had a really big fight with my parents and I felt like my father wanted to control my life, so I just couldn't be at home, so I ran away.

Maurice said that during their stay, the relationship with their parents began to improve:

The relationship still remains, they also wanted me to come to them every weekend for the whole weekend. I didn't have the strength to go to them for the whole weekend. I also didn't feel right to do it, like I was ready for it… so usually I just went for Friday dinner and then I came back.

At the end of the interview, Maurice said that they returned to their parent's house after leaving care and described a now‐close relationship with them:

I have a little more communication with my parents than before… which is also something I try to focus on with the social worker and with my parents in general… I had a conversation with my father and I'm really happy about it… we had a parent‐teacher conference, and the children were invited, and on the way, I told my father that if they spoke to me it would probably be by [new name] and by “they,” because I came out of the closet there… and he was like okay fine […] and when we came back, I had a long talk with my dad… we talked about just random things… it's just something that didn't happen for a long time… yes, and I gave him a hug… it also didn't happen for a long time. And that night I cried, because I missed it so much… and I told my mom a few days ago, and she said that my dad told her the same thing too… and she hugged me, it didn't happen for so long.

Maurice felt an improvement in their relationship with their parents over time. At first, the relationship was fraught with fighting, which led to Maurice leaving home. Then, during their stay in out‐of‐home care, it seemed that a desire for contact arose, but mainly on the part of their parents. After leaving care and returning home, the relationship continued to improve. Thus, a bond was built in which the desire to be in the relationship was mutual, leading both parties to make an effort to connect and even engage in comforting physical contact.

The participants indicated that the intervention of a professional served as a mediator in the relationship, helping shape and maintain family relationships over time. Most of the participants noted that, during their stay in out‐of‐home care, a professional maintained contact with their family or attempted to establish such contact. Pinchas (16 years old, cisgender, and gay) explained the process he underwent with social workers during his stay in out‐of‐home care:

I had daily conversations with the social worker there [in the residential facility] and the family social worker […] At first, it was a bit complex and challenging […] during my first conversation with my father, he upset me immensely. I became really angry because he had extremely homophobic reactions, which infuriated me, as he never believed anything I said, was never really there for me, and never tried to understand me […] The family social worker knew exactly how to handle the situation at that time; she helped me calm down, and the conversations with my mother were much more relaxed.

Pinchas described a therapeutic intervention that helped him by introducing a third party into the dyadic dynamic. This third party created space between his parents and himself, providing a psychological environment in which both sides could process their experiences and attempt to reconnect. In Pinchas's case, as in other cases described by the interviewees, the intervention of a professional helped the family become closer and improved the parents' acceptance of their child over time. In addition, there were differences in the relationship between Pinchas's mother and father, which indicates a case of the multiple patterns that may coexist within the same family.

3.2. Partial Acceptance Pattern

In the next pattern, only partial parental acceptance was achieved. Before entering out‐of‐home care, the youth was rejected because of their LGBTQ+ identity. Upon entering care and during their stay, there was a slight improvement in their relationship with their parents. After the stay, the relationship remained in a “middle” state, whereby the parents did not fully accept, nor did they reject, their child. In this pattern, there were various forms of contact, such as discontinuous contact, contact with economic stipulations, silence and silencing regarding marital and family issues, hiding their child's sexual orientation or gender identity from those outside the nuclear family, and more. Meir (20 years old, cisgender, and gay) was kicked out of his parents' house because of his sexual orientation. He described the slight improvement in his relationship with his parents during his stay in out‐of‐home care:

There were periods… at the Pink Roof [an out‐of‐home‐care residential facility] there was almost no contact [with the parents]… It was, like, from time to time I would talk to them on the phone here, on the phone there… yes… but at Avney Derech [an out‐of‐home‐care residential facility]—even Avney Derech helped me a lot… so slowly, slowly, I really restored contact with the family… I started going to them on weekends from time to time, so yes, the contact returned in this period during the stay at Avney Derech… because they already missed me. They knew it wasn't worth them… They went through a process with themselves during this period, they also knew that having their son was better for them than [caring about] the people's words… a gay son is better than not having a son. They went through this process with themselves.

Later, Meir spoke about his relationship with his parents today and described it as an average relationship, halfway between acceptance and rejection:

We're in a pretty good relationship. If I need anything, I can just pick up the phone and that's fine… and they also… we have at least two calls a day, like… they support me less financially because their condition is to return home… they still keep this condition of going back home and living a heteronormative life… they still think… they still have some hope that it will change somewhere in my life… that I will suddenly get tired of it and I will go back… so this is the condition: you do not receive any financial assistance until you straighten up… and I can't straighten up… I'm only getting worse for them. I just moved [to live] with a partner, it's even worse for them […] They're still going through the process with themselves… They seem to love me, they don't want to talk about it, prefer not to talk about it too much… not to see, not to hear, not to know.

Meir shared that, while in out‐of‐home care, his parents went through a process made possible by their physical distance and disconnection in communication. Meir then received a message from his parents that he was loved, that his presence in their lives was missing, and that he was more important to them than his sexual orientation. This meaningful message and recognition of his existence legitimized his sexual orientation, even if not explicitly stated, and opened a window for mutual reconciliation. However, his parents imposed a condition to provide Meir financial support, that he live a heterosexual life. It seems that their support for Meir depended on his sexual orientation, with the hope that their son would return home and “straighten up,” obscuring the reality of Meir's identity. Thus, the relationship and parental positioning were situated between acceptance and rejection.

Another form of the partial acceptance pattern can be seen in the case of Hila (26 years old, transfeminine, and heterosexual). Hila explained that she ran away from home after experiencing physical and sexual violence, homophobia, and transphobia, among other reasons. She described that while staying in out‐of‐home care: “My mother would talk to me once every four months. Sometimes yes, sometimes no.” Later, Hila said that, now, “My mother knows… she accepts, doesn't accept… let's say in the middle.” Hila added:

She is afraid of people, what they will say about me and what they will say […] [about] my mother and my sister [in relation to me]. Just not always, once in a while… sometimes once in a while… they call me, or I call them. Not always… sometimes we talk as a daughter [she/her pronouns], sometimes not, sometimes they tell me it's forbidden and… you know, sometimes not.

Hila described her relationship with her parents as “in the middle.” It was evident that her parents did not act consistently, both in terms of maintaining their relationship with Hila and in accepting her gender identity and using her identified pronouns. This inconsistency expressed a parental relationship that was not complete acceptance, on the one hand, and was not complete rejection, on the other hand.

Furthermore, some participants claimed that their gender identity posed a greater challenge to their families' acceptance than sexual orientation. Pnina (18 years old, transfeminine, and heterosexual) spoke about the transgender community and stated: “I think that transgender individuals are at a higher risk than gay, lesbian, and bisexual people […] because society accepts them less, fewer parents accept them. There are fewer things we can do, in addition to the dysphoria.” It is evident that, in such cases, the rejection these youth experienced was more intense, and the family needed a longer period to process and understand their child's identity.

3.3. From Rejection to Acceptance Pattern

This pattern represented parental relationships that were previously in a state of rejection at two points in time: before entering out‐of‐home care and during their stay there. However, after the youth's stay in out‐of‐home care ended, the relationship improved, and acceptance began. This pattern was less common among the participants. Yoel (20 years old, cisgender, and gay) left home after a big fight with his parents about his sexual orientation. He described a relationship of rejection and disconnection during his stay in out‐of‐home care:

Relations with the family at that time in Beit Dror [an out‐of‐home care residential facility] were not good. Quite tragic… not tragic, as if traumatic, like that… my mother went into depression… the whole time I was at Beit Dror she was depressed, didn't get out of bed… couldn't do anything… there was a period of graduation parties, proms… I went to nothing… I was cut off from my whole world… My mother was very, very sad… My father tried to threaten… My mother kept wanting me to come home… My father, many times, he sent me shocking messages on WhatsApp… really very difficult messages… the main content of these messages is that he doesn't know me anymore… just very, very rude and crude words, and, basically, it was my choice whether to go home or actually continue life without my parents.

Later in the interview, Yoel described the situation with his parents as better after he left out‐of‐home care, as he spoke about his parents' acceptance and their relationship:

When I came home, my parents kind of missed me very, very, very much. My mother was very happy to see me, my father was very happy to see me… simply… I can tell you that perhaps the most stable time in my life was with my family now… I don't know why. Maybe it's because I'm less at home, or we moved past all these dramas already. But … a period of stability.

Yoel described that, before and during his out‐of‐home care stay, his relationship with his parents was not good, and even traumatic for him. It was evident that his sexual orientation agitated his parents, and they reacted with strong emotions—his mother with sadness and his father with anger. These feelings were so intense that they left no room for his parents to get closer to and accept him. It might be that his stay in care served as a vivid reminder that they loved their son, who chose to leave home because of how they reacted to his sexual orientation. Only upon leaving care and returning home did it become possible to approach and progress toward acceptance.

3.4. Persistent Disconnection Pattern

In this pattern, the parental relationship remained disconnected and unchanged over time. Beginning with the parent's rejection and the youth's departure from home, the disconnection continued during the youth's stay in out‐of‐home care and after. Usually, this disconnection was complete and mutual, with neither party knowing what was happening in the other's life. Adele (22 years old, transfeminine, and heterosexual) left home to be true to herself and fulfill her gender identity, severing contact with her family as soon as she left home due to a physical threat from them. She shared her experience when her family tried to contact her:

They tried to contact me several times… This created a habit of me answering the phone, like, when I see a number I don't recognize, then I first answer and wait to hear who it is… so that's usually what I do, and when I hear it's someone I know from my biological family, I hang up… It happened to me once, just once, that they called me and I didn't really realize it was someone from the family… until they said my deadname, so I didn't realize it was them, and then suddenly, also, I recognized the voice… the thing is, he didn't recognize my voice, he didn't know it was me… and it was like I hung up as soon as I realized… so it really, really stressed me out, I was very, very scared when it happened… after I hung up, I started crying and I started to get stressed, because I was afraid that they would find me and that they would kidnap me, that they would do something to me.

In Adele's words, it appeared that she had adopted a strategy to maintain distance from her family. She expressed fear that they would locate her, believing that if they did, her life would be in danger. While it seems that the decision to sever ties primarily originated from Adele, her statements indicated that her family sought a relationship with her only to harm her due to her gender identity, which is not accepted in their community. Therefore, she felt cutting ties was necessary for her protection.

In another example, Sima (27 years old, transfeminine, and heterosexual) described how the disconnection from her parents, prompted by their mental threats, propelled her forward in her personal life:

I came to the conclusion that I should cut them [the parents] off. They are just harmful to me and not useful to me. From the moment I disconnected from them, it became easier for me, the need for blurring decreased… suddenly I didn't feel like I needed to be the nice guy; suddenly I felt like I didn't want and didn't need to. I also stopped the Cipralex automatically without any side effects, not even anything. I mean, everything showed me that the sacrifice and what I gave up, the price I paid, personal and even health and mental, was only because of them.

Sima cut herself off from her parents because of their emotional abuse. Her parents rejected her because of her gender identity. Indeed, it was evident that Sima was interested in having a relationship with them and had already sacrificed a lot to maintain this relationship. As a result, it seemed that emotionally, the separation pained her, but rationally, Sima understood that this was good for her. Thus, she described how she was able to move forward in her life and stop taking the anti‐depressant and anti‐anxiety medication, thanks to the separation from her parents.

4. Discussion

This research aimed to understand the different patterns of relationships between parents and LGBTQ+ youth who aged out of out‐of‐home care. The findings indicated four patterns of parental relationships over time. The improvement pattern reflected a gradual improvement from rejection to acceptance. The partial acceptance pattern presented a relationship in the middle between acceptance and rejection. However, the level of acceptance was partial and depended on certain conditions. The from rejection to acceptance pattern demonstrated rejection before and during the youth's stay in out‐of‐home care, but with a rapid improvement after the youth left out‐of‐home care. Finally, the persistent disconnection pattern showed permanent rejection without any change over time. These patterns have the power to help family therapists understand and connect with their clients who are parents of LGBTQ+ youth to assist them in the process of accepting their children's gender and sexual identities.

McCubbin and Patterson (1983) developed a family crisis framework emphasizing the importance of adaptation and balance in achieving optimal functioning, promoting family cohesion and individual growth. Families must attain a functional alignment between their challenges and resources, individual and systemic priorities, and various dimensions of family life. This framework helps explain the diverse patterns and changes observed in the current findings in the context of family relationships after the disclosure of the sexual orientation and/or gender identity of a youth in the family. In addition, the four patterns are consistent with family resilience theory (Walsh 1996). According to family resilience theory, the concept of family resilience provides a flexible framework that can accommodate multiple variables, encompassing both similarities and differences and allowing for continuity and change over time. Furthermore, the differences between the patterns can be explained according to the various factors that may influence the relationships between the parents and the LGBTQ+ youth from the lens of the intersectionality approach and the minority stress model, such as LGBTQ+ subgroup identity, cultural background, and family intervention.

Parental rejection based on LGBTQ+ identity varies among the different identities. While some sexual stereotypes may allow women to discuss their sexual orientations more openly, men may find it more challenging to disclose their non‐heterosexual orientation within their families (D'Augelli et al. 1998; Savin‐Williams and Ream 2003; Shenkman and Shmotkin 2011). Moreover, individuals who identify as bisexual often face hostile and invalidating behaviors and attitudes from their families. Consequently, bisexual individuals may choose to remain closeted or seek relationships with other‐sex individuals to avoid negativity from their family members (Todd et al. 2016). Additionally, transgender individuals experiencing homelessness may face even greater challenges in various spaces and encounters (Mazursky 2025) and, in particular, greater rejection from their families compared to their cisgender, LGB homeless peers (Choi et al. 2015). These different forms of heterosexist and cisgenderist family rejection toward different subgroups within the LGBTQ+ community may explain the differences between and within each pattern.

Additionally, cultural background could be an explanatory factor for the presence of one pattern over another. The existing literature focusing on non‐Western regions has highlighted how prejudiced contexts can affect LGBTQ+ individuals within their families. A study conducted in the United States with Hispanic youth, who are minorities in this context, illustrated the intrapersonal challenges experienced by the youth when disclosing their LGBTQ+ identity to their families (Lozano et al. 2021). This could be explained by Hispanic cultural constructs that may dissuade youth from revealing their sexual and gender orientation, particularly to fathers and/or grandparents, as they prioritize family harmony over their own needs (Przeworski and Piedra 2020).

In the Israeli context, part of the population follows Islam, which can result in discrimination, harassment, and stigma (Needham 2012). For many imams and Muslim communities, homosexuality is viewed as a sin against God, faith, and the family. Consequently, LGBTQ+ individuals within Israeli Islamic communities may face significant parental rejection. Additionally, families belonging to other types of conservative religious communities in Israel, such as the Jewish ultra‐Orthodox, may reject secular LGBTQ+ individuals, as religion has often been employed to justify stigmatization, discrimination, and persecution (Acosta 2020).

Another critical dimension that could influence the differences between the patterns is family intervention. Family interventions by professionals have the potential to promote healthy young adult‐parent attachment. Diamond and Shpigel (2014) proposed an attachment‐based family therapy model for working with families when the parents have ongoing difficulties accepting their lesbian and gay young adult children. Moreover, it has been found that interventions targeting families of LGBTQ+ youth in out‐of‐home care are essential for creating relationships, developing family resilience, and returning youth to their homes, specifically for families in conflict that reject their children due to their gender identity and/or sexual orientation (Nimrodi‐First et al. 2022).

The practice implications arising from the current findings highlight the importance of training family therapists to understand LGBTQ+ youth and their dynamics with their families more deeply. At the micro level, therapists should validate the family's situation and pay close attention to the differences between the patterns found in this study, identifying the specific pattern that relates to the family at that moment. It is crucial to recognize that family dynamics can change from one pattern to another over time. Family therapists should adopt a variety of techniques when working with families with an LGBTQ+ child, ensuring extra sensitivity during different phases of the family's journey. They should also be aware of the fragility that may arise at different stages in relation to family structure and development. Furthermore, therapists should provide information about support groups for LGBTQ+ youth and their parents, encouraging their participation to foster acceptance. At the macro level, it is crucial to advocate for continued funding for family care centers and to assign workers dedicated to the LGBTQ+ community in all social departments in the local authorities. This approach may help reach parents and further promote acceptance of their child's sexual orientation and/or gender identity, potentially preventing family crises and youth homelessness and increasing societal acceptance and recognition.

The current study has three main limitations. First, it was challenging to explore each pattern within specific cultural backgrounds. Further research should focus on specific cultural groups and attempt to understand the nuances within each group that contribute to the manifestation of specific patterns. Secondly, examining the links between subgroups in the LGBTQ+ community and the different patterns was difficult. Third, member checking was not conducted due to the sensitive nature of the participants' experiences and the potential challenges in maintaining contact with them. Instead, the author ensured the trustworthiness of the findings through the steps outlined in the trustworthiness section. It is recommended that future studies identify the unique family dynamics of each subgroup within the LGBTQ+ community. These challenges were due to the broad range of participants; therefore, the representation of each culture and subgroup was limited. Another recommendation for future studies is to focus on each pattern and examine the specific factors that lead to changes over time and across different levels of rejection and acceptance.

In conclusion, the present study contributes to the understanding of the different patterns in relationships between parents and LGBTQ+ youth who have aged out of out‐of‐home care, showing varying levels of acceptance and rejection across three points in time. In this way, it adds to the theoretical understanding of the various patterns of relationships within families, particularly those marked by severe rejection, leading LGBTQ+ youth to arrive at out‐of‐home care. The study also discusses the different factors that could shape the changes between and within these patterns through the lens of the intersectionality approach and the minority stress model. Thus, the study expands the body of knowledge regarding relationships between parents and their LGBTQ+ children as a contextual and dynamic phenomenon influenced by various factors.

Conflicts of Interest

The author declares no conflicts of interest.

Supporting information

Data S1: famp70066‐sup‐0001‐Supinfo.docx.

Mazursky, N. 2025. “Patterns of Parental Relationships With LGBTQ+ Youth Aged Out of Out‐Of‐Home Care.” Family Process 64, no. 3: e70066. 10.1111/famp.70066.

Data Availability Statement

The data that has been used is confidential.