Methods: An online survey, conducted between April and June 2015, included 942 SGMA (14 to 19-years-old) who were enrolled in middle or high school and had disclosed their sexual minority and/or gender minority identity to at least one family member. The LGBTQ Microaggressions and Microaffirmations in Families Scale was used for the development of latent classes. Subscales included: interpersonal microaggressions (9-items; range: 0-36; α=.90); environmental microaggressions (7-items; range: 0-28; α=.90); interpersonal microaffirmations (7-items; range: 0-28; α=.82); environmental microaffirmations (6-items; range: 0-24; α=.89). Familial classes were produced using latent class analysis. Standard OLS and logistic regressions were produced to understand the relative relationship between family class and mental health outcomes controlling for demographics, overt victimization, and family factors (e.g., outness to parents). Mental health variables included: The Center for Epidemiological Studies Depression Scale for depression symptoms (10-items; range: 0-30; α=.87), the DSM-IV Short Screening Scale (range: 0-9) for posttraumatic stress symptoms, the General Emotional Dysregulation measure (6-items; range: 6-30; α=.86) for dysregulated affect, and one item assessing past-year suicide attemps (never  to 6 or more times ).
Results: Five classes emerged with differences in the frequency of familial microaggressions and microaffirmations. Adolescents reporting low levels of both microaggressions and microaffirmations reported the lowest levels of depression, posttraumatic stress, and suicide attempts. Adolescents reporting the highest levels of familial microaggressions with the lowest levels of microaffirmations reported the highest levels of mental health outcomes. Adolescents reporting the lowest level of microaggressions and the highest level of microaffirmations reported relatively high rates of depression and posttraumatic stress and were the only class likely to report suicide attempts when controlling for adolescent and family characteristics.
Conclusion and Implications: Our findings respond to a call to action for research addressing family influence on SGMA health and contribute to an emerging body of literature examining microaffirming and microaggressing family environments. Consistent with the extant literature, higher levels of microaggressions predicted greater mental health problems. Unexpectedly, however, greater microaffirmations were not consistently associated with fewer mental health problems. Researchers, practitioners, and policy makers need to consider microaggressions and microaffirmations in conjunction. Simply reducing microaggressions or increasing microaffirmations may not improve mental health outcomes without other support and/or clinical interventions.