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. Author manuscript; available in PMC: 2018 Aug 1.
Published in final edited form as: Arch Sex Behav. 2017 Dec 26;47(6):1825–1837. doi: 10.1007/s10508-017-1057-7

Gay and bisexual adolescent boys' perspectives on parent-adolescent relationships and parenting practices related to teen sex and dating

Brian A Feinstein 1,2, Matthew Thomann 3, Ryan Coventry 1,2, Kathryn Macapagal 1,2, Brian Mustanski 1,2, Michael E Newcomb 1,2
PMCID: PMC6019640  NIHMSID: NIHMS938433  PMID: 29280027

Abstract

Close parent-adolescent relationships and specific parenting practices (e.g., communication about sex, monitoring) are associated with reduced sexual risk behavior among heterosexual youth. Despite gay/bisexual male youth being at increased risk for HIV, little is known about parental influences on their sexual behavior. As such, the goal of the current study was to examine parent-adolescent relationships and parenting practices related to teen sex and dating from the perspective of gay/bisexual adolescent males. Online focus groups were conducted with 52 gay/bisexual male youth ages 14-17. Most gay/bisexual adolescent males felt that their sexual orientation had an influence on their relationships with their parents and discussions about sex/dating. Although some felt that their relationships improved after coming out, a larger percentage reported that it put strain on their relationships. Discussions about sex/dating generally decreased after coming out, but some youth described positive conversations with their parents. Many reported that their parents struggled with whether or not to adapt parenting practices (e.g., rules about dating) after they came out. Youth consistently noted that parent-adolescent relationships and parenting practices depended on the adolescent's level of outness. Findings have important implications for refining HIV prevention programs for gay/bisexual adolescent males, especially interventions that include parents.

Keywords: gay, bisexual, adolescent, HIV, parent

Introduction

Parents play an important role in shaping adolescent sexual behavior. Close parent-adolescent relationships and specific parenting practices (e.g., communication about sex, monitoring) are associated with reduced sexual risk behavior among heterosexual youth (Guilamo-Ramos, Jaccard, Dittus, & Bouris, 2006; Kincaid, Jones, Sterrett, & McKee, 2012; Pequegnat & Bell, 2012). As a result, many HIV prevention programs for heterosexual youth include family members, such as parents (Pequegnat & Bell, 2012). The most common goals of these programs are to increase sexual health knowledge and communication about sex (for a review, see Wight & Fullerton, 2013), while some also teach parenting skills (e.g., positive reinforcement, monitoring) (Miller et al., 2011) or focus on improving family functioning (e.g., increasing parental involvement and support) (Pantin, Schwartz, Sullivan, Prado, & Szapocznik, 2004; Prado et al., 2007). Family-based HIV prevention programs vary in how much parents are involved, with some delivered primarily or exclusively to parents and others delivered to both parents and adolescents (Wight & Fullerton, 2013). These programs have demonstrated positive effects, such as increased condom use, communication, and perceived parental monitoring (Dilorio et al., 2006; Miller et al., 2011; Prado et al., 2007; Prado et al., 2012; Sutton, Lasswell, Lanier, & Miller, 2014; Wang et al., 2014; Wight & Fullerton, 2013).

Despite gay/bisexual male youth being at increased risk for HIV (CDC, 2014), little is known about parental influences on their sexual behavior. Many gay/bisexual youth face unique challenges and stressors in their family relationships (e.g., disapproval of their sexual orientation, rejection upon coming out), which are associated with sexual risk behavior (Ryan, Huebner, Diaz, & Sanchez, 2009). As such, it cannot be assumed that parents serve the same protective role for gay/bisexual youth as they do for heterosexual youth. The extent to which parents and adolescents have mutual and sustained emotional bonds (referred to as parent-child connectedness) is an important determinant of health outcomes, including HIV (Rolleri, Bean, & Ecker, 2006). The development of parent-child connectedness requires trust, effective communication, support, and structure (Lezin, Rolleri, Bean, & Taylor, 2004), all of which influence adolescent sexual behavior (Guilamo-Ramos et al., 2006; Kincaid et al., 2012; Pequegnat & Bell, 2012). For gay/bisexual youth, parental relationships can have profound impacts on sexual identity development, the abilities to form and maintain secure relationships, and health outcomes (Cook & Calebs, 2016; Rosario, 2015). Specifically, receiving support from a reliable attachment figure can increase effective coping, promote security in relationships, and buffer against adverse health outcomes (Cook & Calebs, 2016). Given the importance of parent-child relationships and the unique challenges experienced by gay/bisexual youth, it is critical to understand if and how parents influence their sexual behavior. Doing so will inform the development of evidence-based HIV prevention programs for this high-risk population.

Effective parent-adolescent communication about sex includes discussing various topics, such as condom use, HIV/STIs, sexual decision making, and healthy relationship skills (e.g., how to ask someone on a date, the importance of consent) (Beckett et al., 2010). In samples of heterosexual youth, parent-adolescent communication about sex is associated with later sexual debut, less frequent sex, and more condom use (Hadley et al., 2009; Hutchinson, Jemmott, Jemmott, Braverman, & Fong, 2003; Kincaid et al., 2012; Markman et al., 2010), although effects tend to be small, especially for males (for a meta-analysis, see Widman, Choukas-Bradley, Noar, Nesi, & Garrett, 2016). Given that parent-adolescent relationships are often strained for gay/bisexual youth (Floyd, Stein, Harter, Allison, & Nye, 1999; Mustanski, Newcomb, & Garofalo, 2011; Ryan et al., 2009; Savin-Williams, 2003), parents of gay/bisexual youth may be less likely to talk about sex, especially if they feel unknowledgeable about or uncomfortable with same-sex sexuality. Further, most parents of gay/bisexual youth do not share the same sexual orientation with their child and it may be challenging for them to help their child navigate the domains of sex and dating if they are unaware of the unique aspects of same-sex relationships (e.g., sexual health needs, limited availability of partners).

Although limited in number, studies are beginning to find that parental influences on sexual behavior operate differently for gay/bisexual adolescent males compared to their heterosexual peers. For instance, one study found that the most common topics related to sex discussed between young men who have sex with men (YMSM) and their parents were sexual orientation and HIV/AIDS (Rose, Friedman, Annang, Spencer, & Lindley, 2014). Despite describing benefits of communication (e.g., increased connectedness and sexual health knowledge), YMSM described numerous barriers (e.g., fear, parents lacking knowledge about gay male sexual health) (Rose et al., 2014). Although most parents denied barriers, some described being uncomfortable talking about sex because of their child's sexual orientation or the gender difference between mothers and sons (Rose et al., 2014). In another study, young gay/bisexual males and their parents both described parent-adolescent closeness as protective against sexual risk behavior (LaSala, 2015) and over half of the youth indicated that family members influenced their sexual behavior. Those who denied parental influence tended to have strained relationships and reported little or no communication about sex. Consistent with Rose et al. (2014), youth and parents both described discomfort as a barrier to communication (LaSala, 2015). Thoma and Huebner (2014) also found low rates of parent-adolescent communication about sex among YMSM. They found that communication was associated with more condomless sex for YMSM who were out to their parents, speculating that this may be due to parents' difficulties communicating about sex with YMSM. These studies suggest that there can be benefits and risks to parent-adolescent communication about sex for gay/bisexual adolescent males. Although not examined in these studies, communication may be most likely to have negative consequences when parents are not accepting of their child's sexual orientation.

Finally, parental monitoring is also thought to reduce adolescent risk behavior through rule enforcement and modeling self-monitoring strategies (Dishion & McMahon, 1998; Stattin & Kerr, 2000) and it is also associated with positive sexual health outcomes (for a meta-analysis, see Dittus et al., 2015). While it is clear that parents have an influence on heterosexual youth's sexual behavior, it is unclear if findings generalize to gay/bisexual youth. Parental monitoring is less effective with youth who are involved in contexts that are unfamiliar to parents (Dishion & McMahon, 1998), making it challenging for parents to monitor gay/bisexual youth without education about how to do so (e.g., education about the contexts in which gay/bisexual youth meet partners). While parents who are more accepting of their child's sexual orientation may be more likely to monitor, even parents who are less accepting can have an interest in monitoring their child's behavior and keeping them safe. Parental monitoring has received very little attention among gay/bisexual youth, but Thoma and Huebner (2014) found that it was associated with more condomless sex for YMSM who were out to one parent and those who were uncertain if their parents knew their sexual orientation. They suggested that monitoring may not work for parents of YMSM, because the youth may be dishonest about their whereabouts, especially if they perceive their parents as not accepting their sexual orientation.

In sum, research is beginning to document how parents influence sexual risk behavior among gay/bisexual males, but there are critical gaps. Qualitative studies have focused on late adolescents and early adults who were out to their parents (LaSala, 2015; Rose et al., 2014) with limited attention to early adolescents and those who are not out to their parents. Adolescence is a critical time to understand parental influences on sexual behavior among gay/bisexual males, because self-identification as gay/bisexual tends to occur during this period (Dunlap, 2016; Martos, Nezhad, & Meyer, 2015) and adolescence involves profound psychological, social, and sexual change (Jessor, 1992; Mustanski, Kuper, & Greene, 2014). For instance, capacities that moderate risk taking (e.g., impulse control) remain underdeveloped (Steinberg, 2008), while perceived “benefits” of engaging in risk behavior often outweigh knowledge of “risks” (Parsons, Siegel, & Cousins, 1997; Siegel, Cuccaro, Parsons, Wall, & Weinberg, 1993). Further, if gay/bisexual youth are not out to their parents, then parents are likely to assume that they are heterosexual and provide inadequate sexual health education. Finally, little is known about several important aspects of parent-child relationships among gay/bisexual adolescent males, including their perceptions of whether or not their sexual orientation influences their relationships with their parents, discussions about sex/dating, and parental monitoring. To address these gaps, we conducted online focus groups with gay/bisexual adolescent males ages 14-17. We were interested in the adolescent perspective on: (1) if and how sexual orientation influences parent-adolescent relationships, communication about sex/dating, and parental monitoring; (b) what parents say to gay/bisexual adolescent males about sex/dating; and (c) how parents monitor gay/bisexual adolescent males' dating experiences.

Methods

Participants

Gay/bisexual adolescent males (ages 14-17) were recruited to participate in online focus groups. In order to participate, they had to meet the following criteria: (a) identify as cisgender males (i.e., assigned male at birth and currently identify as male); (b) be 14-17 years old; (c) identify as gay, bisexual, queer, questioning, or same-sex attracted; (d) have phone and Internet access; and (e) live in the US. Participants were recruited nationally through paid Facebook advertisements from February to April 2016. Advertisements targeted adolescent males who indicated romantic interest in males on their Facebook profile or who listed interests relevant to gay/bisexual youth (e.g., same-sex marriage, LGB-related media). Recruitment continued until the information collected during the focus groups was judged to be saturated. After each focus group, the research team discussed new information that emerged, compared it to existing information from previous focus groups, and judged whether or not additional focus groups were likely to lead to additional information. The advertisement led to an online eligibility survey and those who appeared eligible based on their responses were contacted by telephone to confirm eligibility, provide information about the study, assess understanding of study procedures and decisional capacity (Moser et al., 2002; Mustanski, 2011; UCSD Task Force on Decisional Capacity, 2003), and obtain verbal informed assent.

A total of 538 people completed the eligibility survey, 318 were eligible, and 59 enrolled. Of those 59, 52 completed at least one day of the focus group (6 enrolled, but did not complete the baseline survey, which was a prerequisite to participating in the focus group, and 1 enrolled and completed the baseline survey, but did not participate in the focus group). Demographic characteristics of the analytic sample (N = 52) are reported in Table 1.

Table 1.

Demographic characteristics of the sample (N = 52).

Demographic characteristic Mean (SD) or n (%)
Age 15.63 (1.01)
Grade
 8th 1 (1.9 %)
 9th 14 (26.9 %)
 10th 14 (26.9 %)
 11th 19 (36.5 %)
 12th 4 (7.7 %)
Sexual identity
 Gay 36 (69.2 %)
 Bisexual 16 (30.8 %)
Race/ethnicity
 White 22 (42.3 %)
 Latino 17 (32.7 %)
 Black 5 (9.6 %)
 Asian 3 (5.8 %)
 American Indian/Alaska Native 2 (3.8 %)
 Multi-racial 2 (3.8 %)
 Did not disclose 1 (1.9 %)
Out to parents
 Out to some or all parents 42 (80.8 %)
 Not out to any parents 10 (19.2 %)
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Notes. “Parents” refers to parents or guardians. Participants were able to provide demographic information for up to four parents. Most provided data on one (n = 25; 48.1 %) or two parents (n = 20; 38.5 %) and a minority of participants provided data on three (n = 4; 7.7 %) or four parents (n = 3; 5.8 %). Most (n = 48; 92.3 %) reported that at least one of the parents listed was a biological parent.

Procedures

Prior to participating in the focus groups, participants completed online questionnaires. Four online focus groups were conducted between February and May 2016. Online focus groups were used to overcome challenges related to youth participation (e.g., transportation, concerns about meeting in an unfamiliar place, concerns about publicly identifying oneself as part of a stigmatized group) (Fox, Morris, & Rumsey, 2007) and a group format was chosen to facilitate a sense of belonging and community among gay/bisexual youth (Greene, Fisher, Kuper, Andrews, & Mustanski, 2015; Ybarra, DuBois, Parsons, Prescott, & Mustanski, 2014). For each focus group, data were collected asynchronously over two consecutive days using a password-protected bulletin board website (vBulletin). Each focus group was moderated by two research team members and enrolled 9-18 participants. While it has been suggested that focus groups include up to 12 participants (Krueger, 2009), we enrolled a larger number with the expectation that there would be attrition. Consistent with our expectation, despite enrolling 9-18 participants in each focus group, there were 9-15 participants who responded to questions on at least one day of each focus group. All research team members had access to the online bulletin boards and were able to monitor the discussions, which participants accessed using a pseudonym to protect their privacy (DuBois et al., 2015).

Questions were posted each morning and participants could answer at their convenience, to accommodate challenges of engaging a diverse sample of youth across various time zones in an online discussion. Participant responses were visible for all research team members and participants to see, wherein participants could comment, reply to, or provide feedback on other participants' responses. Moderators prompted participants who did not respond and probed respondents for clarification or additional information. Participants who completed the baseline survey and responded to at least one question each day received a $30 Visa gift card. All procedures were approved by the university's Institutional Review Board. Parental permission was waived for this minimal risk study on the grounds that it was not a reasonable requirement to protect participants and appropriate protective mechanisms were in place (a decisional capacity assessment, a discussion about the privacy measures taken by the study team and that the participants could take, and a Certificate of Confidentiality from the National Institutes of Health) (Mustanski, 2011).

Measures

Demographics

Participants reported their age, sexual orientation, race/ethnicity, and level of outness (out to everyone, most people, a few people, or no one). Those who were out to at least a few people were asked if they were out to each of their self-reported parents or guardians. Consistent with previous research, participants were categorized as either out to some/all parents or not out to any parents (Macapagal, Coventry, Arbeit, Fisher, & Mustanski, 2017).

Focus group guide

Focus group questions were organized into three themes: (1) parent-adolescent relationships; (2) communication about sex and dating; and (3) parental monitoring. For parent-adolescent relationships, adolescents were asked questions such as: “How would you describe the quality of your relationship with your parents?” and “In what ways does your sexual orientation affect your relationships with your parents?” For communication about sex and dating, they were asked questions such as: “Tell us about a time when you talked with your parent(s) about sex, relationships, or HIV. How did you feel talking about this with your parents? How do you think your parents felt?;” “In what ways have your parents talked to you about sex and/or staying safe while having sex?;” “What rules or limits, if any, do your parents set related to your sexual activity?;” and “Do you think being gay/bisexual has affected how your parents talk to you about sex?” For parental monitoring, they were asked questions such as: “How do your parents keep track of whether you are dating and what you do on dates?” and “How do you think being gay/bisexual influences how your parents monitor your dating life?” Being gay/bisexual has the potential to influence how an adolescent perceives their relationships with their parents regardless of whether or not they are out to their parents. Therefore, all youth (regardless of outness) were asked the same questions.

Coding and analysis

Transcripts were imported into Dedoose mixed-methods software for analyses. Analyses focused on individual-rather than group-level transcripts in order to quantify the presence of codes in individual responses (Carey & Smith, 1994). We used deductive and inductive coding to examine patterns of interest while also allowing themes to emerge throughout the analysis. A codebook was created with codes, descriptions of codes, and example quotes (MacQueen, McLellan, Kay, & Milstein, 1998). We began with a preliminary codebook, but expanded it as themes emerged. Emergent themes/codes were generated based on the first several transcripts, reexamined, and refined using the constant comparison method (Taylor & Bogdan, 1998). Further, coder memos were compared to identify new themes that emerged consistently beyond existing codes and to identify codes that overlapped and could be collapsed. Thus, the analysis was a dynamic process, such that each transcript informed the analysis of further transcripts. Codes were applied to each transcript to identify excerpts representing each theme, with subcodes developing as examples of themes. Two team members coded the transcripts and reliability was tested on 25% of the transcripts. The coders achieved a kappa score of .81, indicating strong reliability (McHugh, 2012). Participant quotes are presented verbatim with the exception of minor edits to spelling and grammar to facilitate readability.

Results

Our analyses revealed three main themes: (1) being gay/bisexual had both positive and negative effects on parent-adolescent relationships; (2) being gay/bisexual influenced parenting practices (e.g., communication about sex, monitoring); and (3) being gay/bisexual influenced these domains regardless of whether or not youth were out to their parents, although there were some unique influences for those who were not out. Table 2 presents counts and percentages for code endorsement (percentages are based on how many youth answered questions relevant to each code).

Table 2.

Counts and percentages of codes and subcodes.

Code Subcode Count Percentage
Quality of parent-adolescent relationships (N = 50)
Good (including okay) 25 50 %
Bad 15 30 %
Different with one parent versus another 10 20 %
Impact of sexual orientation on parent-adolescent relationships (N = 39)
Positive impact 4 10 %
Negative impact 22 56 %
No impact 10 26 %
Different with one parent versus another 3 8 %
Impact of sexual orientation on parent-adolescent discussions about sex and dating (N = 45)
Did impact frequency and/or quality 34 76 %
Did not impact frequency and/or quality 11 24 %
Parental monitoring (N = 31)
Parents do monitor 16 52 %
Parents do not monitor 15 48 %
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Note. The sample included 52 individuals, but percentages are based on how many participants provided data relevant to each code; for “impact of sexual orientation…” codes, some participants described how being openly gay/bisexual impacted these domains, whereas others described how not being out to their parents impacted these domains; for “parental monitoring,” 15 participants indicated that their parents do not monitor them, but 7 of them went on to provide evidence of monitoring.

Impact of sexual orientation on parent-adolescent relationships

Half of the adolescent males in our sample reported having okay/good relationships with their parents compared to 30% who reported bad relationships and 20% who reported okay/good relationships with one parent and bad relationships with another parent. Over half (56%) reported that their sexual orientation had a negative impact on their relationships with their parents. For instance, a 17 year-old, White, gay male who was out to his parents described it as: “Me and my parents don't really do things like we used to before I came out to them and since then it's like they kind of avoid me. It's as if like they think my gay might rub off on them. My mom even said to me once that ‘I want my old son back. I don't want my gay son’” Another adolescent described the following similar situation:

I feel as though that because I am not straight, it puts a strain on my relationship with my father. Rather than being an active part of my life, he decides to only participate when he needs to…. He favors my sister more than me which makes me upset and confused. I hope that in the future I could have a relationship with my father similar to that of when I was not out. -year-old, questioning/unsure, White, out to parents

Other youth described hostile exchanges with their parents, including threats about HIV and derogatory language. One explained: “I argue with my dad a lot as well, and sometimes they are about my sexual orientation. He and I were arguing once and he called me and my ex ‘faggots' and that’s the worst I've ever been mad at him” (15 years old, White, gay, out to parents). Another adolescent described his parents' negative reaction when he came out:

…my parents are not at all supportive about my [sexual orientation]… I went ahead and told my parents I had a boyfriend. My mom like freaked the f out. My dad was just watching my mom freak out at me… They immediately told me I was going to die from HIV/AIDS if I continue to be gay. I explained the best way I could that ANYONE could get HIV. -15 years old, White, gay, out to parents

In contrast, 10% reported that their sexual orientation had a positive impact on their relationships with their parents. For example, a 16 year-old, Black, gay male described an experience with his grandmother (who was his guardian): “… since coming out I feel like things between me and my grandmother has made thing even better between us.” Another adolescent described that it was initially awkward between him and his parents after he came out, but it improved with time: “At first me being gay was a little awkward because they didn't really know how to act about it or how to ask about relationships but after I had a couple boyfriends it's pretty normal…” (17 year-old, Latino, gay, out to parents).

An additional 8% reported that their sexual orientation had a positive impact on their relationship with one parent, but a negative impact on their relationship with another parent. Adolescents typically described mothers as more supportive and fathers as unsupportive or disinterested. For example:

Me and my mom are really close. I feel as though when I came out we got closer while me and my dad only grew apart. I like how I can talk to my mom about anything… My mom is always interested in if I'm dating someone but not what we do on those dates. I think being gay makes me and my mom closer because she loves gay guys -year-old, Black, gay, out to parents

Finally, 26% reported that their sexual orientation did not impact their relationships with their parents. A 17 year-old, White, gay male said: “Me being gay does not affect my relationship with any of them since they have an open mind and said they love no matter what.” Others said that being gay/bisexual did not affect the quality of their relationships with their parents, but it affected discussions about sex/dating. For instance, a 17 year-old, White, bisexual male said: “I don't think my sexual orientation has affected my relationship with my dad. I think it just affects aspects of it, like talking about safe sex or relationship issues involving a male partner.”

For adolescents who were not out to their parents, being gay/bisexual still had an impact on their relationships with their parents and it was almost always a negative impact. These youth typically expressed concern that their relationships with their parents would change if they came out, often describing experiences where their parents made homophobic comments. For instance, one explained: “My relationship with my mother is very tense…. I think being gay made me less open with my mom since I'm aware of her homophobic beliefs” (17 years-old, Asian, gay). Similarly, another described: “My parents don't know about my sexual orientation yet. But they have talked to me about homosexuality a few times…. They said that being gay is not normal to them and should not be accepted” (16 year-old, Asian, gay, not out to parents). These adolescents also described experiences where their parents made assumptions that they were heterosexual and, in turn, asked them questions that made them uncomfortable:

My sexual orientation affects the relationship with my parents because I am not out to them yet and they tend to ask questions like “do you have a girlfriend?” Or when I have friends over that are girls, as soon as they leave they ask “is that your girlfriend?” Or “what were you and your girlfriend doing up in your room?” And it makes me feel uncomfortable because I am not attracted to girls at all. -16, White, gay, not out to parents

Although most youth who were not out to their parents expressed concern that their parents would not approve of their sexual orientation, one described that he had not come out to his parents because he just was not ready yet: “I am quite close with my parents and feel like I could really tell them anything if I needed to…. I just haven't fully come out due to the fact I just don't feel ready to say it but I know I could if I needed to…” (14 years-old, White, gay).

Impact of sexual orientation on parent-adolescent communication about sex/dating

Most adolescents (76%) reported that being gay/bisexual had an influence on conversations with their parents about sex and dating (Table 2). They typically indicated that they had talked about sex at least once, but discussions were sparse, vague, and uncomfortable. Conversations tended to focus on safety (e.g., condom use) and sometimes included uncomfortable questions. For instance, one adolescent explained: “[My father] just came to me and handed me 3 condoms and told me ‘Pinch the tip and wrap it up’ and that's all he told me about sex. It was very uncomfortable for me and I'm pretty sure my dad was just as uncomfortable” (16 years old, American Indian/Alaskan Native, gay, out to parents). Another described being asked uncomfortable questions: “… [my mom] asked very intrusive questions like if I was a top or bottom…. which irritated me a great deal…” (16 years old, Latino, gay, out to parents). Some attributed the brief and uncomfortable nature of the conversations to their parents' inexperience with gay/bisexual adolescent males. For instance, one explained: “… my parents wouldn't really know how to deal with same sex activity because they're [not] experienced or know anything about that” (17 years old, White, bisexual, out to parents). Despite describing conversations about sex as uncomfortable (for themselves and their parents), some youth expressed a desire to be closer to their parents and to be able to talk to them about sex/dating. For instance, one adolescent said that, although his parents were supportive of his sexual orientation, “being gay kinda affects our relationship because we can't talk about certain things I would like to talk about with them” (16 years old, Latino, gay, out to parents).

For youth who were out to their parents, conversations about sex/dating typically changed after coming out. They described conversations becoming less frequent and less supportive. For instance:

… before I came out my parents were basically more supportive of me being heterosexually active than homosexually active. Once I came out, don't let me even mention any guy friend let alone sex. The conversation was way different because with me being gay they never want answers to the questions they ask, but when they thought I was straight they were always encouraging me to engage with females. -years old, Latino, gay, out to parents

Some adolescents perceived their parents as being more interested in and supportive of their heterosexual siblings' dating experiences. For instance, one said:

Honestly I think because of how unsupportive my family is they really just don't even want to know about who I am dating. I believe they'd be more interested in who I was dating if I was “straight.” I wish I could tell them how I happy I would be if I was to be dating someone of the same-sex. Everything we do with each other such as dates and activities. But as you said they ARE very disinterested in my love life, whereas my sis who is dating an older boy and they are always checking up on her. -years old, White, gay, out to parents

Parental concern about HIV/STIs was central to many adolescents' narratives. Several indicated that their parents talked about HIV/STI prevention more often after they came out. Some parents referred to similar sexual health risks with male and female partners (e.g., “[My parents] told me that sex with guys are as dangerous as with a women they both may carry STDs or HIV etc.” (16 year-old, Latino, bisexual, out to parents). However, others appeared to be more concerned with the possibility of pregnancy with a female partner than the possibility of HIV/STIs. For instance, one adolescent explained:

At one point, I had a boyfriend who was a senior in high school. My mother adored him and did not bother to talk to me of the dangers of STDs and unprotected sex… But, around eighth grade, which is about two years ago, I had a girlfriend who I dated for about a year. My mother lectured me greatly and urged me to use protection due to the fact she could get pregnant. At one point she even gave me condoms and lubricant. I find it strange that my mother would not discuss the other things that come along with unprotected sex, like STDs, when I was in an intimate relationship with a male. I feel as though she thought that because neither of us could get pregnant that there was no danger. This unsettles me greatly. -year-old, White, questioning/unsure, out to parents

Although conversations tended to focus on sexual risk, some youth noted that their parents talked to them about other aspects of dating and relationships (e.g., how to cope with a break-up). For instance, one said: “As far as relationships go I've only had one which ended up on the guy cheating on me and basically my mom told me that I shouldn't let him get the best of me and that there will be another guy eventually” (17 years old, Latino, gay, out to parents).

Adolescents who were not out to their parents also said that being gay/bisexual had an impact on communication about sex. These youth were especially likely to say that discussions about sex were sparse or non-existent and that they could not talk about sex/dating with their parents because it would require them to come out. One adolescent explained that his parents do not know that he is bisexual and, as a result, “I dislike the idea that I can't tell them everything going on in my life” (15 years-old, Black, bisexual). Similarly, another described: “… one effect it [being gay] has would be the fact that I don't necessarily share everything with them (stuff like being in the gsa [Gay Straight Alliance] at school, crushes, etc” (15 years-old, American Indian/Alaska Native, gay).

Parental monitoring strategies

Over half of the youth (52%) reported that their parents monitor their behavior. The most common monitoring strategy described was asking questions about whether or not they were dating or having sex. For example, one adolescent explained: “[My parents]… only occasionally ask if I'm dating someone and if I say yes they will ask me all about that person” (15 years old, White, bisexual, out to parents). Some youth mentioned that they were not always truthful when their parents asked them questions about sex/dating, because they were concerned that it would make their parents worry more. For instance, one said:

…my parents keep track of who im dating by asking me occasionally…. but I usually do not tell them the truth when I do have a boyfriend…. Being gay has made my parents act more cautious about my relationships instead of being happy for them. For this reason, I don't tell my parents about relationships because I don't want them to be overly worried for no reason. -year-old, Black, gay, out to parents

Some adolescents also described their parents setting rules about dating (e.g., dates could not be older than a certain age, adolescents had to know someone for a certain period of time before having sex, condoms had to be used during sex). For instance, one adolescent explained: “…a condom must be used at all times. [My parents] also said not to just have sex with random people, to know someone for at least 5 months” (16 years old, Latino, bisexual, out to parents). Similarly, another said: “… my mom tells me to just wait till marriage [to have sex] or until I find ‘the guy’ and if I don't wait at least let her know so I can be safe” (17 years old, Latino, gay, out to parents). Adolescents also mentioned that their parents monitored their social media, such as checking their relationships status on Facebook to find out if they were dating anyone. Some parents would look at their sons' friends' profiles on social media to find out information about them. For example: “… my stepmother will stalk whoever I am talking to [on] Facebook, Instagram, and ask everyone she knows about him” (15 years old, White, gay, out to parents).

Adolescents also acknowledged that their parents had to drive them places, because they did not have a driver's license yet. By driving their adolescent places, parents are able to keep track of where their adolescent is going, thus constituting a monitoring strategy.

Some adolescents reported changes in parental monitoring after coming out, particularly because their parents were unsure if male friends were romantic interests. For instance:

My parents don't keep track of who I am dating or when I'm going on dates…. I think me being gay has really left my parents in the dark about who I might be dating because they aren't sure if they are meeting a guy friend or a guy I like so they just trust me more. -16 years old, Alaskan Native/American Indian, gay, out to parents

A 15 year-old, White, bisexual male who was out to his parents also expressed that his parents could not tell if he was dating someone or just friends with them, but he reported that this led them to pay more attention to his interaction: “I feel like my parents pay more close attention to interactions with my friends so they can tell if I'm secretly dating any of them or not.” Another adolescent described this as:

Being bisexual only influences my parents in an extent to where they ask if I'm going to be having sex with any boy that I'm hanging out with. They are also aware of my brother's friends being victims of my flirting (and at times successful flirting), so my mom half-jokingly caution me from “tampering” with my brother's friends. So, instead my mother moves her focus to the gay side of “tracking” my dating/sex life instead of worrying much about any heterosexual occurrences. -15 years old, White, bisexual, out to parents

Although a similar percentage of youth reported that their parents did not monitor their behavior (48%), approximately half of them (n = 7 of 15) described parenting practices that contradicted their statement. For instance, one said:

My parents don't keep track or know if I'm dating because they aren't really home they're always working. But when I go out they always ask me who and who I go with because they don't want me to go out with a guy. Then they always ask me if I'm dating one of my friends (that are girls) even though they know I'm gay. Yeah I think being gay has an influence on how my parents monitor me. -16 year-old, Latino, gay, out to parents

These responses suggest that some teens do not consider what their parents are doing as monitoring, even though their parents' behaviors indicate that they are keeping track of their behaviors and whereabouts.

Adolescents who were not out to their parents believed that their parents would treat them differently if they knew about their sexual orientation. They explained that their parents assume that nothing sexual is happening between them and their male friends, so if they knew that they were gay/bisexual, then the rules would likely change. For example:

They might not want me to close or lock my door to my room when I had a guy over and they might be checking in on me if they found out I was going out on a date -16, White, gay, not out to parents

Discussion

The goal of the current study was to describe gay/bisexual adolescent males' perspectives on their relationships with their parents, their communication about sex/dating, and their parents' monitoring of their dating activities. The majority of adolescents felt that being gay/bisexual had an influence on their relationships with their parents. Therefore, we cannot assume that research on heterosexual youth's relationships with their parents can be generalized to gay/bisexual male youth. While most of the gay/bisexual adolescents said that they had good relationships with at least one of their parents, over half also said that coming out had negative effects on their relationships. Only a small proportion felt that their relationships improved after they came out. These adolescents described their parents being supportive of their sexuality (e.g., providing educational materials about same-sex sexuality, helping with dating), providing insight into how parents can help gay/bisexual youth feel supported. Given that young gay/bisexual men describe parent-adolescent closeness as protective against sexual risk behavior (LaSala, 2015), youth who feel supported by their parents may be less likely to engage in risk behavior.

Unfortunately, over half of the adolescents felt that being gay/bisexual had a negative impact on their relationships with their parents. These youth described being treated differently than their heterosexual siblings (e.g., parents being more supportive of their heterosexual siblings' dating experiences) and, in some cases, reported explicit hostility from their parents (e.g., calling them derogatory terms). Adolescents who were not out to their parents also expressed that being gay/bisexual had a negative impact on their relationships with their parents, typically expressing concern that their relationships would change if they came out. Although discouraging, these findings point to additional ways that parents can support gay/bisexual youth. Some parents may not realize they are showing preferential interest in their heterosexual children's dating experiences. In fact, some parents may avoid asking gay/bisexual youth about their dating experiences in an attempt to avoid making them feel uncomfortable. These parents may need awareness raised to potential differences in how they treat heterosexual versus gay/bisexual children and, in some cases, training in sensitive ways to discuss same-sex sexuality.

Parent-adolescent communication about sex/dating

Most adolescents felt that being gay/bisexual also had an influence on discussions about sex/dating with their parents. Previous research has found low rates of parent-adolescent communication about sex among YMSM (Thoma & Huebner, 2014). Consistent with this, most adolescents in our sample described conversations about sex/dating as sparse to begin with and even less frequent or non-existent after coming out. Conversations tended to be brief and vague, focused primarily on HIV and condom use. This is in contrast to findings that heterosexual youth and their parents discuss a broader range of topics (e.g., physical development, sexual decision making, how to ask someone on a date, the importance of consent) (Beckett et al., 2010). Research on heterosexual adolescent males has also found that parent-adolescent communication about sex is associated with safer sexual behavior (Widman et al., 2016). Less is known about gay/bisexual youth, but many young gay/bisexual males acknowledge that their parents have an influence on their sexual behavior (LaSala, 2015) and that there are benefits of parent-adolescent communication (e.g., increased connectedness and knowledge about sexual health) (Rose et al., 2014). However, both gay/bisexual youth and their parents describe barriers to communication (e.g., fear, discomfort) (LaSala, 2015; Rose et al., 2014). Although one study found that parent-adolescent communication about sex was associated with more condomless sex for YMSM who were out to their parents (Thoma & Huebner, 2014), the authors suggested that parental difficulties communicating about sex with gay/bisexual youth may inadvertently confer risk for condomless sex. Parents of gay/bisexual adolescent males could benefit from education about the need to discuss topics other than HIV and condom use as well as skills to reduce barriers (e.g., approaching these topics in an open and non-judgmental manner). Additionally, it may be helpful for parents to learn that many gay/bisexual adolescent males believe that there are benefits to talking to their parents about sex.

Adolescents who were not out to their parents also expressed that being gay/bisexual had a negative impact on parent-adolescent communication. For instance, they described not being able to discuss sex/dating with their parents, because it would require them to come out. They also said that their parents assumed that they were heterosexual and, as a result, asked them questions that made them uncomfortable (e.g., “Do you have a girlfriend?”) Although questions like this may reflect assumptions of heterosexuality, it is also possible that some parents ask questions like this in an attempt to figure out if their child is gay/bisexual (e.g., if they suspect it). These parents may not know how to talk about sexuality in a sensitive manner and may require education on how to do so. Regardless, parents who assume that their sons are heterosexuals are unlikely to provide comprehensive sex education. Given that school-based sex education typically does not address the needs of gay/bisexual youth (Kubicek, Beyer, Weiss, Iverson, & Kipke, 2010; Santelli et al., 2006), these adolescents are unlikely to receive adequate sex education from either source.

Parental monitoring

Very little is known about parental monitoring of gay/bisexual youth. Thoma and Huebner (2014) suggested that monitoring may be less effective for YMSM, because they may be dishonest about their whereabouts, especially if their parents do not accept their sexual orientation. Half of the adolescents in our sample acknowledged that their parents monitored their dating behavior by asking questions, setting rules, and sometimes monitoring social media. A unique finding to emerge related to their sexual orientation was that their parents struggled with whether or not to adapt certain rules after they came out. For instance, adolescents said that their parents did not know how to treat their same-sex friendships, because they did not know if other boys were friends or romantic interests. Parents dealt with this by paying closer attention to their sons' interactions with other boys (to try to figure out if they were dating) and by not letting them have other boys sleep over. These findings suggest that parents of gay/bisexual adolescents may need to learn skills to have direct conversations with their sons about whether other boys are friends or romantic interests. Adolescents who were not out to their parents also expressed concern that their parents would treat them differently if they came out (e.g., they believed that their parents would monitor their same-sex friendships differently). It is important to note that parental monitoring may be different depending on whether or not parents accept their child being gay/bisexual. For parents who are not accepting, they may engage in more monitoring as a way to minimize their child's interactions with potential gay/bisexual friends or romantic partners. Alternatively, parents who are not accepting may not monitor their child's dating behavior in order to avoid facing the fact that their child is gay/bisexual.

Implications for family-based HIV prevention programs

The current findings have important implications for the development of family-based HIV prevention programs for gay/bisexual adolescent males. To date, no such programs exist, most likely because people believed it was not feasible to include gay/bisexual youth and their parents in HIV prevention programs. However, adolescents in our sample expressed a desire to be closer with their parents and to be able to talk about sex/dating. This is encouraging, as it suggests that gay/bisexual male youth may be willing to participate in family-based HIV prevention programs to learn skills to improve their relationships and to have these challenging conversations. Family-based HIV prevention programs for heterosexual youth typically focus on increasing sexual health knowledge and parent-child communication (Wight & Fullerton, 2013) and they are effective at doing so (Santa Maria, Markham, Bluethmann, & Mullen, 2015). Aspects of these interventions are likely to be beneficial for all parents (e.g., communication skills training), but adaptations may need to be made for parents of gay/bisexual adolescent males. In previous research, young gay/bisexual males have expressed that parents can facilitate conversations about sex by starting at an early age, being knowledgeable about sexual orientation and sexual health, and being non-assuming and non-judgmental (Rose et al., 2014). Our findings provide insight into additional intervention adaptations that may be required for parents of gay/bisexual male youth.

Interventions need to stress the importance of discussing a broad range of topics related to sex/dating with gay/bisexual adolescent males as opposed to focusing exclusively on HIV and condom use. Additional topics that are critical to sexual health education for gay/bisexual adolescent males include STIs other than HIV (especially rectal STIs), HIV prevention strategies other than condom use (e.g., biomedical strategies), consent (e.g., the importance of giving and ensuring that one has consent), and healthy relationship skills (e.g., how to safely find a partner, how to cope with relationship challenges). Parents may benefit from educating themselves about the specific contexts in which gay/bisexual adolescent males meet partners (e.g., online venues). Additionally, parents may need to learn how to discuss sexual behavior and health with sensitivity. In our sample, some adolescents described being asked invasive questions (e.g., whether they prefer the insertive or receptive role during sex). Parents can be taught to discuss the importance of safer sex strategies regardless of one's role in sex rather than asking about role preferences. Mothers, in particular, may benefit from interventions to help them communicate with sons about sex, because previous research has found that mothers describe the gender difference between them and their sons as a barrier (Rose et al., 2014). If possible, it may be beneficial for parents to connect gay/bisexual teens with older gay/bisexual role models to help them understand the risks and benefits associated with dating/sex.

For parents who do not approve of their son being gay/bisexual, communication skills training and sexual health education alone are unlikely to be sufficient to increase parent-child communication. For these parents, HIV prevention programs can be supplemented with interventions that provide support and information to improve attitudes and behaviors toward gay/bisexual children (e.g., the Lead with Love intervention) (Huebner, Rullo, Thoma, McGarrity, & Mackenzie, 2013). Finally, these findings also have implications for universal family-based HIV prevention programs. Parents may not know their child's sexual orientation (even if they think they do), so they could be encouraged to use gender neutral language when talking about possible partners (e.g., asking if their son is dating anyone rather than asking if they have a girlfriend). Additionally, parents could be encouraged to talk about sexual orientation and to talk about sex in a manner that does not assume their child's sexual orientation.

The current findings should be considered in light of several limitations. First, findings are based on focus groups with 52 gay/bisexual adolescent males. While appropriate for focus groups (Onwuegbuzie, Dickinson, Leech, & Zoran, 2009), findings from smaller samples are less generalizable. Because of the sample size, we were unable to test potential demographic differences in parent-child relationship experiences (e.g., age, race/ethnicity, sexual identity, geographic region, religiosity). Most adolescents in our sample identified as gay and were out to their parents, so it is remains unclear to what extent findings generalize to bisexual adolescent males and those who are not out. Although our sample was racially/ethnically diverse (only 42.3% identified as White), there may be racial/ethnic differences in parent-child relationship experiences. Parent-child relationships may also differ based on geographic region, given that certain regions offer more access to LGBT resources for parents and teens. Additionally, all participants were recruited on Facebook, thus excluding teens who do not use social media.

Additionally, some of our focus group questions used language that assumed that sexual orientation had an influence on parent-adolescent relationships (e.g., “In what ways does your sexual orientation affect your relationships with your parents?) This wording may have biased some participants to respond by indicating that their sexual orientation did have an influence on their relationships with their parents as opposed to stating that it did not have in impact. That said, a substantial proportion of participants indicated that their sexual orientation did not affect their relationships with their parents, indicating that responses represented diverse perspectives. Finally, parents may have different perspectives on the extent to which their adolescents' sexual orientation affects their relationships and parenting practices. It will be important for future research to examine the influence of parent-adolescent communication about sex and parental monitoring on sexual risk behavior among gay/bisexual adolescents using diverse methodologies (e.g., surveys of parents-adolescent dyads, behavioral coding of parent-adolescent interactions). Despite limitations, the current findings provide insight into gay/bisexual adolescent males' perspectives on how their sexual orientation influences their relationships with their parents, discussions about sex and dating, and their parents' monitoring of their behavior. Findings point to several potential targets for HIV prevention programs for gay/bisexual youth that include parents, which will be important to test in future intervention studies.

Acknowledgments

Funding was provided by the National Institute on Minority Health and Health Disparities (Grant No. R01MD009561; PIs: Fisher and Mustanski) and the Third Coast Center for AIDS Research (PI: Newcomb). Brian A. Feinstein's time was supported by a grant from the National Institute on Drug Abuse (Grant No. F32DA042708). The content of this article is solely the responsibility of the authors and does not necessarily reflect the view of the funding agencies.

Footnotes

Conflict of interest: The authors declare that they have no conflict of interest.

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent: Informed consent was obtained from all individual participants included in the study.

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