{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T17:02:31Z","timestamp":1791651751996,"version":"4.3.4"},"reference-count":101,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R21MD012687"],"award-info":[{"award-number":["R21MD012687"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec032\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>Disparities in the behavioral health outcomes for lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) adults\u2014such as depression, anxiety, and alcohol use\u2014are often attributed to experiences of discrimination, victimization, and lack of supportive environments, including hetero- and cis-normative family settings. Yet, how family environments in childhood influence LGBTQ+ adults\u2019 behavioral health and internalized homonegativity has not been extensively examined.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec033\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study utilized a U.S. national dataset of LGBTQ+ adults (<jats:italic>N\u2009<\/jats:italic>=\u2009499). Data were collected in November 2020 using an online survey. A series of multivariate ordinary least squares regression models and Sobel tests were performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec034\">\n<jats:title>Results<\/jats:title>\n<jats:p>Results showed that as homophobic messages from family increased, levels of depression (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.19, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), anxiety (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.17, <jats:italic>p\u2009<\/jats:italic>&lt;\u2009.001), and internalized homonegativity (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.13, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) increased. As the conservatism level in families increased, levels of alcohol use (<jats:italic>\u03b2\u2009<\/jats:italic>=\u2009.11, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), and internalized homonegativity (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.15, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) increased. In the mediation analysis, internalized homonegativity was found to partially mediate the relationship between homophobic messages from family and depression (<jats:italic>z<\/jats:italic>\u2009=\u20093.35, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), homophobic messages and anxiety (<jats:italic>z<\/jats:italic>\u2009=\u20093.09, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), and conservatism in family and alcohol use (<jats:italic>z<\/jats:italic>\u2009=\u20092.80, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Internalized homonegativity also fully mediated the relationship between homophobic messages and alcohol use (<jats:italic>z<\/jats:italic>\u2009=\u20092.66, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), conservatism in family and depression (<jats:italic>z<\/jats:italic>\u2009=\u20093.76, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and conservatism in family and anxiety (<jats:italic>z<\/jats:italic>\u2009=\u20093.45, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec035\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Study findings underscore the importance of inclusive climates within a family and internalized homonegativity as a mediator for LGBTQ+ individuals\u2019 behavioral health. Implications for intervention and future research are discussed.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0327370","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T17:40:13Z","timestamp":1751046013000},"page":"e0327370","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["The relationship between family environments growing up and behavioral health among LGBTQ+ adults: The mediating role of internalized homonegativity"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3625-1571","authenticated-orcid":true,"given":"Pin-Chen","family":"Chiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7463-8889","authenticated-orcid":true,"given":"Yinuo","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise Yookong","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4075-2429","authenticated-orcid":true,"given":"Ankur","family":"Srivastava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake A.","family":"Leite","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8502-2357","authenticated-orcid":true,"given":"Adam R.","family":"Englert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"issue":"7","key":"pone.0327370.ref001","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.jaac.2021.02.021","article-title":"Health Justice for LGBT Youths: Combining Public Health and Human Rights","volume":"60","author":"SL Adelson","year":"2021","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"pone.0327370.ref002","volume-title":"LGBT adults report anxiety, depression at all ages [Internet]","author":"M 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