Keywords

Latinx LGBTQ people face unprecedented physical and emotional health disparities compared to their White, non-Latinx counterparts (e.g., HIV, substance abuse, mental health disorders) as a result of intersecting oppressive experiences such as racism, xenophobia, cissexism, and heterosexism (e.g., Bostwick et al., 2014; Kann et al., 2018; Ocasio et al., 2016). The COVID-19 pandemic has exacerbated and created new challenges for Latinx people and their families, leading to decreased access to mental health services and increased mental health concerns (Abreu et al., 2023a; Cortés-García et al., 2022; D′ Costa et al., 2021; Harkness et al., 2020; Penner et al., 2021). Moreover, as a result of quarantine and social distancing measures during the COVID-19 pandemic, Latinx families have had to learn new roles in order to support their Latinx LGBTQ loved ones (e.g., providing LGBTQ-specific support), exacerbating potential ruptures within the family unit due to disagreements and misunderstanding about sexuality and gender identity (Abreu et al., 2023a). Taking on such roles is incredibly taxing for Latinx parents and family members who are already facing multiple stressors such as financial and language barriers (Manzano-Sanchez et al., 2019; Victor et al., 2020).

Studies have uncovered the importance of family support in the well-being of LGBTQ people (e.g., Abreu et al., 2022; Needham & Austin, 2010; Ryan et al., 2010; Saewyc et al., 2009). Specific to Latinx LGBTQ people and their families, researchers have observed the importance of specific Latinx cultural values, beliefs, and traditions when working with this community. Specifically, cultural values, beliefs, and traditions directly influence the relationship among Latinx LGBTQ people and their families. Unfortunately, the literature has been slow to provide culturally appropriate clinical implications for working with Latinx parents and families and their LGBTQ family members. To address these gaps in the literature, using an intersectional approach to understand the experiences of Latinx LGBTQ people and their families, in this chapter we aim to: (a) provide a discussion about different Latinx cultural values, beliefs, and traditions and theoretical frameworks that might be useful in understanding the intersectional experiences of Latinx LGBTQ people and their families, (b) provide a review of the available research about the experiences of Latinx LGBTQ people and their families, and (c) provide recommendations for clinicians working with Latinx LGBTQ people and their families.

4.1 Latinx Cultural Values, Beliefs, and Traditions

Latinx cultural values, beliefs, and traditions are of utmost importance when understanding how Latinx families operate within systems. From a systems view, through the cultural value of familismo, or the need to put family members and the collective’s needs above that of the individual (Arredondo et al., 2014; Marin & Marin, 1991), one can visualize how for Latinx families caring for one another is of vast importance. For instance, familismo guides the understanding that parents need to make decisions that they believe most benefit their child and go to any length to protect their child. Familismo helps us know that at the core of parent behavior, there is a desire to do what is best for their child given their understanding of the world, their context, and information that is available to them. Through this lens, one understands that there are cultural strengths to take into consideration when working with Latinx LGBTQ people and their families that are useful in moving family members towards accepting their LGBTQ members.

Gender norms such as machismo, or the belief that men within the family unit must present as hypermasculine, removed from emotions, and reject feminine behaviors, and marianismo, the belief that Latina women must self-sacrifice for the family’s well-being (Gil & Vazquez, 1996; Mayo, 1997; Saez et al., 2010), are both important cultural norms that play out in family relations. From a systems perspective, a Latinx family has specific roles within their subsystems that are believed to serve the functioning of the entire system. Adherence to gender norms could be challenging for Latinx LGBTQ people, as the intersection of their sexual and gender identity and racial and ethnic identity often defy the strict gender norms of machismo and marianismo. The role of gender norms is critical in understanding the relationship between Latinx LGBTQ people and their parents. Providers working with Latinx LGBTQ people and their families must work collaboratively to find collective goals and discuss flexible strategies to meet such goals within their unique family system. For instance, allowing Latinx parents to reflect on how gender norms influence how they parent their child may open the conversation about parenting practices that are more affirming for LGBTQ children.

Religion and spirituality are additional foundational core values in the functioning of Latinx family systems that guide interpersonal relationships (e.g., Adames & Chavez-Duenas, 2016; Arredondo et al., 2014). For Latinx families, faith is an essential factor in building resilience and, therefore, crucial in the understanding of family relations. For instance, fatalismo, or the belief across Latinx culture that certain sickness and health conditions are God’s will, and personalismo, or the emphasis on warmth, closeness, and empathy toward others (Campesino & Schwartz, 2006), are crucial in understanding the relationship between Latinx LGBTQ people and their families. The concept of accepting unplanned situations as God’s will and having warmth, closeness, and empathy required to feel connected to spiritual guidance can move family members to accept and celebrate their LGBTQ family members. For instance, therapists can prompt families to consider times when unplanned events happened and the family was able to move forward through their faith in God and their connection to the family. Collectively, the understanding of Latinx family systems lies in understanding how cultural values, beliefs, and traditions guide their functioning.

4.2 Theoretical Frameworks

Because Latinx LGBTQ people’s identities are multilayered, a single framework does not fully explain their experiences within the different systems that they navigate. We posit that Intersectionality Framework (Collins, 2000; Crenshaw, 1989), Latinx critical theory (LatCrit) (Valdez, 2005), and the minority stress model (Meyer, 2003, 2015) offer unique frameworks from which to holistically understand the experiences of Latinx LGBTQ people within the context of their Latinx families and communities. Through an Intersectionality Framework, this chapter considers the intersection of unique identities of Latinx LGBTQ people that cannot be explained from a singular perspective. Through this framework, we understand that Latinx LGBTQ people face both support and oppression within their family unit as a result of the interaction between their multilayered identities (e.g., Latinx, immigrants, LGBTQ) and Latinx culture’s understanding of these intersecting identities. In addition, LatCrit calls for a critical understanding of how laws and policies are inherently designed to oppress and erase Latinx people in the United States. An understanding of this framework allows us to better make sense of how Latinx families grapple with the different systems that oppress them individually and collectively, and what this means for the experiences of their LGBTQ members within their family unit. Furthermore, the minority stress model suggests that LGBTQ people experience stressors that lead to negative mental health outcomes. This framework allows us to best conceptualize the individual and collective experiences of oppression that Latinx LGBTQ people experience within their family unit.

4.2.1 Intersectionality Framework

Through the lens of Intersectionality Framework (Crenshaw, 1989), we can understand some of the external complexities that impact the functioning of Latinx LGBTQ people and their families. Intersectionality Framework was developed to note the unique experiences of people based on the multiple identities they hold (Collins, 2000; Crenshaw, 1989). Specifically, intersectionality was developed to accurately understand discrimination toward Black women navigating the legal systems in the United States. According to Crenshaw (1989), oppressive systems look at particular identities while ignoring others, taking away from people’s holistic and authentic experiences within different systems of oppression. Latinx LGBTQ people and their families hold multiple identities that place them at the intersection of racism, xenophobia, heterosexism, and cissexism. From an intersectionality perspective, Latinx families can be instrumental in helping their LGBTQ family members confront and cope with the different systems of oppression they navigate. For instance, family support can provide a sense of belonging that Latinx LGBTQ people need to feel empowered in the face of negative experiences within other settings (e.g., facing racism and xenophobia). Given the power of family relationships in the face of oppression and discrimination, it is critical for those who serve Latinx LGBTQ people and their families to be equipped to provide comprehensive, culturally appropriate services that both honors Latinx cultural values, beliefs, and traditions, and affirms Latinx LGBTQ people’s sexual and gender identity not as separate from each other but as part of a collective experience.

4.2.2 Latinx Critical Theory

Latinx Critical Theory (LatCrit) is important to consider in understanding Latinx communities. Developed to understand the role of race and ethnicity in legal proceedings in the United States, LatCrit offers a unique lens from which to view institutional systems and the ways in which they harm Latinx communities (Valdes, 2005). For Latinx communities, the heterogeneity of their identities and experiences are erased when laws and policies insist on conceptualizing Latinx people’s experiences as unidimensional, such as using broad terms like “Hispanics” or assuming that all Latinx people are cisgender and heterosexual. Therefore, one of the principal intentions of LatCrit is to give voice to the different experiences of Latinx people. To this end, it is important to not generalize the same cultural dynamics for all Latinx people. Specific to the experiences of Latinx LGBTQ people and their families, LatCrit calls for us to understand that family members have different experiences depending on their individual characteristics such as being darker skin vs. lighter skin or White, undocumented vs. documented, and LGBTQ vs. heterosexual and cisgender. Providers cannot assume that all Latinx families operate within the same rules, norms, and assumptions. Therefore, culturally sensitive interventions should place effort in learning about specific differences of each family member to best understand the interactions and functioning of the family as a collective.

4.2.3 Minority Stress Model

The Minority Stress Model further helps us grasp the impact of discrimination and oppression on Latinx LGBTQ people, including within their family unit. As conceptualized by the Minority Stress Model (Brooks, 1981, 1992; Meyer 2003, 2015), LGBTQ individuals experience distal stressors, or external experiences of negative occurrences (e.g., discrimination), that impact them at a proximal level, or at the internal level, as a result of negative perceptions about their sexual and/or gender identity (e.g., internalized heterosexism, fear; Brooks, 1981, 1992; Meyer 2003, 2015). From a systems perspective, if Latinx LGBTQ people are not affirmed, they cannot play their part in the family system because their cognitive and emotional capacity is being used to constantly address environmental stressors, both within and out of the family unit. For example, Latinx LGBTQ youth may experience bullying at school for their sexual orientation and/or gender identity (distal stressor), which could lead to the internalization of self-hate and/or low self-esteem. It is possible that the discomfort experienced by the child is then manifested in family dynamics (e.g., youth experiences depression and isolation from family members), which is exacerbated if family members are not supportive of their LGBTQ identity (see Abreu et al., 2022). Consequently, helping Latinx families understand the stressors that their LGBTQ family members face, as well as helping them identify resources available to increase support and acceptance of LGBTQ people, could result in increased family cohesion.

4.3 Latinx LGBTQ People and Their Families: An Overview

Latinx LGBTQ people often grapple with embracing their authentic selves while honoring their culture’s values, beliefs, and traditions. In addition, family members of Latinx LGBTQ people often struggle to support their LGBTQ family members while grappling with cultural values, beliefs, and traditions that are not always inclusive of sexual and gender diversity. The importance of family has been of interest and continues to generate attention on how Latinx LGBTQ people navigate relations with their communities, such as prioritizing the needs of family members over their own. For example, in a qualitative study with 20 LGBQ Latinx people, participants expressed that familismo was an important cultural value that influenced their decision to disclose or conceal their sexual identity. Some participants expressed concerns about disclosing to their parents for fear that other family members would find out and disapprove or reject them (Gattamorta & Quidley-Rodriguez, 2018). In another study with 25 bisexual Latinx young adults, participants shared that their family’s lack of support of their sexual identity provoked a great deal of stress, causing them to avoid conversations about their sexual identity in order to avoid disruption in the family unit. Interestingly, most participants shared that lack of family acceptance did not affect their positive regard for the family and described a strong emotional connection to their families (Muñoz-Laboy et al., 2009). It is important to note that some studies have found that when Latinx LGBT youth do not feel supported by their families, they experience negative mental health outcome such as high levels of depression and suicidality and decreased self-esteem (Abreu et al., 2022; Abreu et al., 2023b; Ryan et al., 2010).

The literature on the experiences of parental figures of LGBTQ people reports varying experiences, most commonly of psychological distress, sadness, depression, guilt, and shame when learning about their child’s LGBTQ identity (see review in Abreu et al., 2019; Phillips & Ancis, 2008; Saltzburg, 2004). Specific to Latinx family members of Latinx LGBTQ people, research shows that cultural aspects such as familismo, gender norms, and religion and spirituality influence how Latinx families interact with their LGBTQ family members (Abreu et al., 2020a, b; Baiocco et al., 2015). For example, in a qualitative study with Latinx fathers of sexual minority children, Abreu et al. (2020a) found that Latinx fathers reported that familismo was a crucial aspect in choosing to accept their child’s sexual identity. For instance, for Latinx fathers, making sure that their child felt part of the family was a strong motivator to accept them. Similarly, in a study by Abreu et al. (2020b), Cuban American and Puerto Rican parents of LGBTQ people reported the importance of maintaining the family unit intact as the main reason for accepting their child’s sexual and gender identity. Furthermore, the role of gender norms in Latinx culture plays a crucial role in how Latinx families interact with their LGBTQ members and, ultimately, their decision to affirm and accept their sexual and/or gender identity. For example, some parents can reject the strict gender norms endorsed by their culture such as machismo, while others struggle to reframe these strict gender norms and express discomfort with “effeminate” or “flamboyant” behavior (Abreu et al., 2020a, b).

Religious and spiritual beliefs oftentimes lead Latinx family members to struggle to interact with their LGBTQ family members (e.g., Abreu et al., 2020a, b; Gattamorta et al., 2019). For example, in a study by Gattamorta et al. (2019), a mother reported, “I am the mother that allowed my son to go to hell.” As we can see, religion and spirituality play a crucial role in how Latinx parental figures react to their child’s LGBTQ identity. Other studies have found similar patterns about the influence of religion and spirituality in Latinx families’ reaction to their LGBTQ family members, and is often a source of stress and rupture in the parent-child relationship (e.g., Abreu et al., 2020a; Ryan et al., 2010).

4.4 Implications for Resilience Practice: Culturally Sensitive Interventions

Considering the complexity of family dynamics requires a framework that helps visualize the interconnectedness of family parts that together make the whole. Based on von Bertalanffy’s (von Bertalanffy & Woodger, 1933; von Bertalanffy, 1968) framework, we understand systems as a set of units that create subsystems that work together in their specific role and function to maintain the working of the entire system. Further, each subsystem is affected by the other, meaning that any changes in one subsystem affect the other; ultimately affecting the whole system’s functioning. Von Bertalanffy explained that the survival of the systems depends on their openness or closeness to the environment. In families, there can be many subsystems that make up their system. For example, we can consider a family of six individuals (units) composed of various subsystems (parental figures, siblings, grandparents). A family systems framework complements intersectionality framework, LatCrit, and the minority stress model, and provides the context to understand interpersonal relationships within the family and the influence of Latinx cultural values, beliefs, and traditions in Latinx family dynamics when interacting with members of the family who identify as LGBTQ.

Culturally sensitive interventions for Latinx families have shown effective in reducing health disparities for Latinx youth (Prado et al., 2008; Santisteban et al., 2011). Furthermore, the value of attuning to cultural values when working with Latinx families has proven crucial in family therapy for Latinx communities. Emerging research has further shown the importance of considering and incorporating Latinx cultural values in working with Latinx LGBTQ people and their families (Abreu et al., 2020a, b; Lozano et al., 2022). As research continues to evolve in parenting and family functioning of Latinx LGBTQ people and their families, there is a need to consider incorporating a lens of intersectionality, the minority stress model, and LatCrit. Without a doubt, Latinx families have the resources needed to affirm and serve as a source of resilience for their LGBTQ members. Below we provide recommendations for how providers can incorporate culturally sensitive interventions with Latinx LGBTQ people and their families.

  1. 1.

    Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA): Borrowing from Structural Family Therapy (Minuchin & Nichols, 1998), Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) is an effective evidence-based intervention in working with Latinx youth and their families (Santisteban et al., 2011). In Structural Family Therapy, Minuchin speaks to the importance of recognizing the boundaries that exist within family structures. Minuchin further explains that boundaries that surround family members can be entangled or rigid, which in either extreme is what causes difficulties within family units. For instance, if the boundaries are enmeshed, Minuchin explains that members are not differentiated enough to provide their resources (such as time, energy, engagement) to the family functioning. Likewise, rigid boundaries do not allow the influx of resources and further restrict providing resources within the family unit. Therefore, Minuchin proposed that flexible boundaries that adapt to their environment are the most likely to thrive in adverse circumstances. Through this lens, CIFFTA aims to target the process of communication patterns as critical indicators of the member’s boundary, which the CIFFTA therapist targets through different culturally appropriate interventions. For instance, CIFFTA therapists are called to “block” negative interactions harmful to members, creating a new experience of positive communication patterns for the family. CIFFTA has been applied to work with Latinx LGBTQ youth and their families and has specific psychoeducational components for children and parents on gender identity and sexual orientation. For instance, therapists are encouraged to provide time for guided conversations with parents on sexual and gender identity development (Santisteban et al., 2011).

  2. 2.

    Familias Unidas. Familias Unidas is another evidence-based, culturally sensitive intervention to consider when working with Latinx families and youth. Developed to address the increasing health disparities of HIV and substance use in Latinx youth, Prado et al. (2008) created Familias Unidas to strengthen parent-child relationships by reshaping communication patterns. Like CIFFTA, Familias Unidas targets the structure of families by giving parents the leadership and resources to enhance parenting practices in the face of many stressors such as immigration and acculturation. A unique component of Familias Unidas is that parents participate in therapy group sessions with other parents, building a support system. Through these sessions, parents hear the experiences of other parents and build a network of support to evolve their parenting practices. Recent preventive science literature is growing in developing culturally sensitive family interventions for Latinx LGBTQ youth and their families. Familias con Orgullo (Lozano et al., 2022) was created from a series of studies actively incorporating feedback from Latinx sexual minority youth and their families. With a similar structure to Familias Unidas, Familias con Orgullo includes various levels of intervention in the family unit (e.g., youth sessions, family sessions, parent support group), with specific psychoeducation on sexual minority needs and information for parents on the LGBTQ community. For instance, specific components of psychoeducation were added as LGBTQ youth reported the need for parents to be informed about the specific needs of Latinx LGBTQ people. Additionally, communication components of the training provide parents with tools to enhance their interpersonal relationships with their LGBTQ child.

  3. 3.

    Expressive Writing Interventions. As more literature grows on the importance of parenting practices among Latinx parents of Latinx LGBTQ youth, researchers are using creative and expressive interventions. Abreu et al. (2020b) explored the Latinx cultural values (e.g., familismo, machismo) that play a role in parent-child relationships using writing interventions. Specifically, through journaling, Abreu et al. (2020b) asked participants to identify Latinx cultural values that present strengths and challenges in accepting their LGBTQ youth. Through this lens, researchers and practitioners have begun to use non-conventional ways to explore further how these cultural concepts inform the parenting practices of Latinx parents of Latinx LGBTQ youth. Further understanding of the motivators behind parenting practices can aid the harnessing of cultural strengths to move Latinx LGBTQ youth and their families towards wellness within their culture. Using a writing intervention can be powerful in creating foundational understandings of feelings and emotions experienced by family members who are struggling to accept their LGBTQ child. Specifically, writing interventions may benefit those who have difficulty expressing themselves verbally. Thus, writing interventions can offer a unique way for family members of Latinx LGBTQ people to communicate and better understand each other’s experiences.

4.5 Concluding Remarks

Latinx LGBTQ people are disproportionately impacted by health disparities and adverse health outcomes compared to their non-Latinx White counterparts due to societal stigma associated with their LGBTQ identity and their racial and ethnic identity (e.g., Lozano et al., 2022; Ocasio et al., 2016). As explored in this chapter, Latinx LGBTQ people hold multiple marginalized identities that make them vulnerable to multiple forms of oppression, including tension with their family members. Latinx people have a long history of experiencing structural, relational, and personal discrimination in the United States (see review in Adames & Chavez-Dueñas, 2016). From enforcement of anti-immigrant policies to the passing of anti-LGBTQ bills, Latinx LGBTQ people and their families are positioned within multiple forms of oppression, including racism, homophobia, heterosexism, ethnocentrism, and nativism. Thus, the authors suggest that clinicians commit to understanding the ways in which oppression impacts the interaction between Latinx LGBTQ people and their families. Specifically, we posit that clinicians must learn about different Latinx cultural values, beliefs, and traditions, as well as about different frameworks that contextualize how Latinx LGBTQ people experience privilege and oppression, before implementing interventions that may ultimately harm or inaccurately address the presenting concerns of Latinx LGBTQ people and their families. Finally, although researchers and clinicians have been slow to develop interventions that address the intersectional needs of Latinx LGBTQ people within the context of their families and communities, CIFFTA, Familias Unidas, and expressive writing interventions have been successful in working with Latinx LGBTQ people and their families.

Questions for Thought and Discussion

  1. 1.

    How can practitioners who work with Latinx LGBTQ people and their families incorporate frameworks of intersectionality, LatCrit, and minority stress in conceptualizing these communities’ presenting concerns?

  2. 2.

    What is the importance of understanding and incorporating Latinx cultural values, beliefs, and traditions in working with Latinx LGBTQ people and their families?

  3. 3.

    Which aspects of the culturally sensitive interventions outlined in this chapter (i.e., CIFFTA, Familias Unidas, and expressive writing), do you find most valuable in working Latinx LGBTQ people and their families?