Journal of Happiness Studies (2021) 22:1359–1383

https://doi.org/10.1007/s10902-020-00276-y

RESEARCH PAPER

Coming Out as LGBTQ +: The Role Strength‑Based Parenting

on Posttraumatic Stress and Posttraumatic Growth

Claudia Zavala1 · Lea Waters2

Published online: 31 May 2020

© Springer Nature B.V. 2020

Abstract
For LGBTQ + individuals, coming out can be an experience of marked adversity. Indeed,
research has shown that the experience can trigger psychological ill-health (e.g. depression
and anxiety) as well as posttraumatic stress symptoms (PTSS) such as sleep disturbance,
somatic symptoms and cognitive distress. While studies have investigated the pain associ-
ated with coming out, much less is known about the potential for this life event to lead
to growth. The aim of the current study, therefore, was to explore levels of posttraumatic
stress and the presence of posttraumatic growth (PTG) in LGBTQ + adults who had come
out. Additionally, this study examined that the role that strength-based parenting plays in
levels of PTSS and PTG after coming out. The interaction between SBP, PTSS and PTG
was examined in a Peruvian sample of LGBTQ + individuals who had disclosed their sex-
ual and/or gender minority identity to parents (N = 208). The results showed, firstly, that
individuals experienced both PTSS and PTG; secondly, that SBP plays a direct protective
role (reducing PTSS) and a promoting role (increasing PTG); and thirdly, that SBP indi-
rectly influenced PTG through its inverse relationship with PTSS. Bisexual individuals
experience less growth than other LGBTQ + individuals in the all PTG dimensions, illus-
trating an additional difficulty for this minority group. The results are discussed in light of
leading researchers, clinicians and LGBTQ + individuals towards growth-based outcomes
following identity disclosure.

Keywords LGBTQ + · Coming out · Posttraumatic growth · Posttraumatic stress ·

Strength-based parenting · Positive psychology

* Claudia Zavala
claudia.zavalaluque@gmail.com
1
Pontificia Universidad Católica del Perú, Av. Universitaria 1801, 15088 San Miguel, Lima, Peru
2
Centre for Positive Psychology, Melbourne Graduate School of Education, University
of Melbourne, 100 Leicester Street, Carlton, Melbourne, VIC 3010, Australia

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1360 C. Zavala, L. Waters

1 Introduction

1.1 Coming Out and Posttraumatic Stress

For sexual and gender minority individuals, being open about their identity is a vital com-
ponent of living an authentic life (Savin-Williams and Cohen 2015). Yet, given that most
societies and cultures hold heterosexual and cisgender identities as the norm (Pollitt et al.
2019), the onus is put on lesbian, gay, bisexual/pansexual transgender and queer individuals
to disclose their identity or be assumed to be something they are not (Mills-Koonce et al.
2018). As such, LGBTQ + individuals are perpetually faced with the choice of whether or
not to ‘come out of the closet’ (Bosson et al. 2012).
Sexual orientation refers to who an individual is sexually or romantically attracted to,
which encompasses identities such as heterosexual, lesbian, gay, bisexual, pansexual, or
queer (Glenn 2019). Gender identity refers to one’s internal experience and understand-
ing of their own gender, which can include identities such as woman, man, non-binary,
genderfluid, or others (Glenn 2019). Cisgender denotes persons whose sense of personal
identity and gender corresponds with their sex assigned at birth, in contrast to transgen-
der, which denotes individuals who do not identify with their sex assigned at birth (Glenn
2019). Many of the identities outlined above (lesbian, gay, bisexual, pansexual, queer, non-
binary, transgender, etc.) are categorized as sexual or gender minority identities, since they
are not considered by larger society as what is normative or expected (Galupo et al. 2015).
Coming out is viewed as an important milestone for sexual and gender minorities
(Savin-Williams and Cohen 2015) and has been conceptualized in various ways in the lit-
erature. Williams et al. (2015) take a ‘process’ approach and conceptualise coming out as
the personal and social process of exploring, defining, and disclosing one’s sexual and/or
gender minority identity. During this process, individuals integrate their sexual or gender
identity with other aspects of their self, including their work, family and social identities.
Authors like Grafsky and Gary (2018) and Jhang (2018) take an ‘event-based’ approach to
disclosure and define it as the event, or act, of disclosing or revealing one’s sexual orienta-
tion or gender identity to others. The current study has adopted the event-based approach
and assesses LGBTQ + individuals’ self-reports regarding their levels of distress and
growth following disclosure of their minority sexual or gender identity to parents. Addi-
tionally, we assessed the degree to which having strength-based parenting is a buffering
factor for PTSS and a boosting factor for PTG following disclosure.
Research examining family responses to LGBTQ + individuals who disclose has
revealed that a variety of reactions can be shown. Some families respond with acceptance,
support, and love (Price and Prosek 2019). Others react with physical violence, psycholog-
ical abuse, rejection and/or ex-communication (Mills-Koonce et al. 2018). One factor that
influences family responses is culture (Pistella et al. 2016; Tamashiro 2015). Nealy (2019)
argues that disclosure experiences within families of color are more complex because par-
ents may struggle with how their child’s identity “compounds the family’s experiences of
discrimination and oppression in the world” (p. 131), since being a sexual or gender minor-
ity might reflect negatively on their larger racial or ethnic culture.
In Latin American cultures, the collective, familial, and religious values held may con-
tribute to parents having a negative reaction to their child because their sexuality or gen-
der identity goes against Catholic values and/or because they fear for how their children
will navigate their minority identities in a culture that is hostile towards sexual and gender
minorities (Katz-Wise et al. 2016; Nealy 2019). Corrales (2020) found that Latin American

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Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1361

countries show the highest rate of rejection and violence against sexual and gender minori-
ties worldwide. This may be why recent data shows that in Peru, which is the focus of
the current study, only 44% of sexual and/or gender minority individuals have come out,
and 64% of those individuals report a lack of acceptance from family members (Instituto
Nacional de Estadística e Informática 2018).
Research shows that lack of acceptance from family after disclosure can pose a sig-
nificant risk to the mental health of LGBTQ + individuals in the form of increased rates
of suicidal tendencies, drug use, risk behaviours, anxiety, and depression, after disclosure
(Dziengel 2015; Ryan et al. 2010). In addition to these negative mental health outcomes,
researchers such as Alessi and Martin (2017) and Cohen et al. (2018) argue that coming
out can be traumatic for some individuals due to loss of support systems (Brown 2003)
invalidation of identity (Nealy 2019) and/or the experience of prejudice-related events such
as hate crimes, bullying, threats, verbal abuse, sexual abuse, and physical harassment fol-
lowing disclosure (Dragowski et al. 2011; Roberts et al. 2010; Stiles-Shileds and Carroll
2015).
Trauma can be defined as an event, series of events, or circumstances that are experi-
enced by an individual as physically or emotionally harmful and have lasting effects on
their functioning and wellbeing (Kimberg 2019). According to Bonanno (2008), many
individuals who go through trauma are able to recover and show only minor disruptions
in their functionality. However, another possible outcome of trauma is the experience of
a posttraumatic stress response (Alessi et al. 2013), which ranges along a continuum from
posttraumatic stress symptoms to posttraumatic stress disorder.
PTSD was initially studied in the twentieth century, primarily on heterosexual, white,
cisgender male soldiers (Root 1992), and has only recently been studied in LGBTQ + sam-
ples (Dragowski et al. 2011). Posttraumatic stress responses present some or all of the fol-
lowing symptoms: (1) intrusion, (2) avoidance, (3) negative alterations in cognition and
mood, and (4) hyperarousal (National Center for PTSD 2010). Intrusion includes flash-
backs of the event; avoidance entails efforts to distance oneself from elements associated
with the traumatic event; negative alterations in cognition and mood include lacking the
desire to be with others; and hyperarousal includes feeling overly alert (National Institute
of Mental Health 2017). In order to receive a PTSD diagnosis, individuals are required to
have at least one intrusion symptom, one avoidance symptom, two symptoms of negative
alterations in cognition and mood, and two hyperarousal symptoms, which must be pre-
sent for at least one month following the event and must impact social and/or occupational
functioning (American Psychiatric Association 2013).
Currently, it is understood that PTSD can develop as a result of any event that an indi-
vidual subjectively perceives as traumatic, regardless of the nature of such event (Kimberg
2019). One type of event that has been shown to lead to PTSD is LGBTQ + discrimination,
real or anticipated (Alessi et al. 2013). Roberts et al. (2010) found that sexual minority
individuals had double the lifetime prevalence of PTSD than heterosexual individuals and
suggested that this is because of higher exposure to homophobic violence, bullying due
to gender non-conformity and discrimination. Although PTSD has not been examined as
an outcome of identity disclosure, Alessi and Martin (2017) posit that any prejudice- or
discrimination-related event may lead LGBTQ + individuals to develop PTSD; therefore,
it may that some individuals who have difficult disclosure experiences may develop this
disorder after coming out.
Further, many individuals who do not develop the full disorder may still experience sig-
nificant posttraumatic stress symptoms (Cohen et al. 2016). For example, they may have
hyperarousal, mood, and intrusion symptoms but not display avoidance, or they may have

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1362 C. Zavala, L. Waters

symptoms that fall into all four categories but not have the full number of symptoms to
warrant a PTSD diagnosis. Posttraumatic responses that do not meet criteria for PTSD but
still clearly indicate distress resulting from trauma are referred to as posttraumatic stress
symptoms (PTSS) (Dragowski et al. 2011). Studies show that PTSS is widely prevalent,
yet under reported, across society (Reisner et al. 2016), and especially after experiences of
minority stress (Alessi et al. 2013; Cohen et al. 2018). This is because, as Alessi and Mar-
tin (2017) outline, those who experience discrimination and hostility in relation to their
identity must continue to hold a heightened alertness or vigilance towards future victimi-
zation. Alessi and Martin (2017) further suggest that this heightened alertness does not
only apply to possible discrimination from individuals but also from structural forces they
encounter in everyday life. This elevated exposure to prejudice creates conditions for PTSS
such as hypervigilance, avoidance and physiological stress responses (related to the intru-
sion dimension) to occur (Reisner et al. 2016).
While PTSS has been studied in LGBTQ + individuals following many minority stress
experiences (Yu et al. 2017), research on PTSS following coming out is absent. This is an
important gap to address (Alessi et al. 2013) in order to assist clinicians to help LGBTQ +
individuals cope with the potential risks and trauma of coming out. In the current study we
were interested in examining if PTSS is present in sexual and gender minorities after com-
ing out to their parents.

H1 LGBTQ + individuals will report signs of PTSS and PTSD following identity
disclosure.

1.2 Coming Out and Posttraumatic Growth: A Positive Psychology Approach

To date, the majority of studies on coming out have focused on the negative effects that
follow disclosure (Vaughan et al. 2014); however, not all consequences are negative. For
some people, disclosure is a positive experience that increases self-esteem, self-realization,
and perceived internal resources (Rhoads 1995). The evidence for positive outcomes fol-
lowing disclosure is aligned with Bonanno’s (2008) review paper on recovery and resil-
ience showing that most people are resilient after loss, violence and life-threatening events
and that “resilience to the unsettling effects of interpersonal loss is not rare but relatively
common” (p. 105). Although Bonanno (2008) was referring to loss following the death of
loved one, his work can be applied to the cases where an LGBTQ + individual loses a rela-
tionship after coming out. While Bonanno (2008) did not specifically consider LGBTQ +
individuals, his assertion—that people have a greater capacity for resilience than past lit-
erature indicates—is something that can be applied to the disclosure experience.
Resilience is defined as “a relatively stable, healthy levels of psychological and physical
functioning” (Bonanno 2008, p. 102). However, beyond resilience (stable healthy levels of
functioning) there is also possibility for improvement in psychological health post disclo-
sure (Rhoads 1995). In Rhoad’s (1995) study, participants reported profound experiences
of reaching levels of self-realization, meaning in life, and internal strength that they had not
previously experienced prior to disclosure. Further, their disclosure experiences were cru-
cial in reducing dysfunctional psychological patterns, such as internalized homophobia and
the cognitive load of concealing identity. The improvement in mental health suggests that,
for some people, disclosure is not only a pathway to resilience but a gateway to growth
(Moradi et al. 2009).

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Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1363

To the authors’ knowledge there are only three studies that have examined growth
in relation to identity disclosure. Bonet et al. (2007) reported that lesbian and bisexual
women showed “relatively high levels of stress-related growth” (p. 12) after coming
out, including perceiving themselves as stronger and more enriched by surviving the
adversity they experienced following their disclosure. Cox et al. (2010) found similar
results, asserting that LGB individuals show stress-related growth after disclosure when
they are able to benefit from the support offered by LGBTQ + communities. Further,
Vaughan and Waehler (2010) showed that lesbian and gay individuals who come out
have the potential to grow in two board domains: individualistic growth (authenticity,
wellbeing, and identity) and collectivistic growth (LGBTQ +-affirming views, a sense
of belonging to the LGBTQ + community). They labelled growth in these two domains
‘coming out growth.’
Though these findings are aligned with the field of positive psychology, a field that
studies the conditions for growth and flourishing (Rusk and Waters 2013), there has been
minimal empirical research in positive psychology with LGBTQ + individuals. Indeed,
according to Lytle et al. (2014) “positive psychology literature has almost entirely excluded
sexual and gender minority individuals and their unique life experiences” (p. 3). A simi-
lar argument was made by Horne et al. (2014) who contend that “the field of psychology
has been slow to recognize the psychological strengths related to being LGBTQ” (p. 190).
This research gap is important to address because scientific inquiry into the positive experi-
ences of LGBTQ + individuals can inform therapeutic approaches that help clients reduce
distress and experience strong mental health following disclosure. This research can also
provide LGBTQ + communities with hopeful findings and positive references. Aside from
the benefits that may occur to the LGBTQ + individuals and communities, addressing this
research gap has benefits to the field of positive psychology itself which has been criticized
as being WASPish (Yakushko and Blodgett 2018). By conducting research on wellbeing in
minority experiences, positive psychology can extend its boundaries and can use research
on minority samples to inform and tailor theories about human flourishing. We address this
gap by examining the possibility for psychological growth in the form a positive psychol-
ogy construct, posttraumatic growth, in LGBTQ + individuals who have come out.
Posttraumatic growth (PTG) is the transformational experience of positive change in an
individual’s life after struggling with, processing, and giving meaning to trauma. People
who experience PTG have marked positive changes in their perceptions of self, life, rela-
tionships and spiritual matters. According to Cryder et al. (2006), PTG “involves move-
ment beyond pre-trauma adaptation, a qualitative change in functioning across domains”
(pp. 65–66). Tedeschi and Calhoun (1996), who coined the term posttraumatic growth,
suggest that it involves interpreting the world and reconstructing one’s life in more fulfill-
ing ways.
Tedeschi and Calhoun’s (1996) posit five key components of PTG: (1) personal strength,
(2) relationships with others, (3) new possibilities, (4) appreciation of life, and (5) spiritual
growth. First, personal strength entails perceiving oneself as stronger after overcoming the
event. Second, relationships with others involves deepening trust and intimacy with those
who helped the individual during adversity, and expressing gratitude for one’s social sup-
port network. Third, people who experience PTG discuss the new possibilities that have
emerged post the adversity such as embarking on a new path in life or finding new interests
that were previously overlooked. Fourth, PTG provokes a new-found appreciation for life
following the adversity, together with the commitment to live a more fulfilling and authen-
tic life. Finally, Spiritual Growth entails giving meaning to the adverse experience by lean-
ing on one’s faith and beliefs in order to cope.

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1364 C. Zavala, L. Waters

Currently, there is only one study that has employed Tedeschi and Calhoun’s PTG the-
ory in a sample who have come out (Solomon et al. 2015). They reported evidence of PTG
post-coming out and identified that positive and negative reactions to the disclosure facili-
tated PTG, while internalized homonegativity1 decreased it. We add to their research by
moving beyond Caucasian LGBT individuals to focus on a Peruvian sample. Additionally,
our study will examine differences between cisgender and transgender individuals which
was not assessed by Solomon et al. (2015). When considering the likelihood of experienc-
ing PTG following sexual/gender minority identity disclosure, we make suggestions for
each dimension below.
In relation to personal strength, new-found fortitude may be experienced when, after
navigating the distress of coming out to parents, individuals believe that they have become
more equipped to deal with other stressors related to being LGBTQ + (Carastathis et al.
2017). Along these lines, Vaughan et al. (2014) discuss the bravery and social intelligence
that LGBTQ + people develop to manage the stress of their minority status. Similarly,
the sample in Rhoads’ (1995) study mentioned transmitting the bravery they summoned
for disclosure into other life challenges. It may be that the process of coming out allows
LGBTQ + individuals to more clearly see, use and appreciate the strengths they have
developed through previous adversity. In terms of relationships, coming out may increase
a person’s bond with family, friends, and other LGBTQ + individuals. In support of this,
Haxhe et al. (2017) showed that coming out increased communication and closeness
between family members. Third, new possibilities may manifest as the person engages with
new environments, individuals, and opportunities previously avoided due to being clos-
eted (Rhoads 1995). Fourthly, when it comes to appreciation of life following one’s sexual
identity disclosure, individuals may experience a new view of the world as a result of their
identity being validated and affirmed by their loved ones (Budge 2014). Finally, in terms
of spiritual changes, Murr (2013) found that, after coming out, some LGBTQ + individuals
were able to transform their religious beliefs into spiritual values, such as universal love,
compassion, and respect. The research above leads to hypothesis two.

H2 LGBTQ + individuals who have come out will display PTG.

1.3 The Relationship Between Posttraumatic Stress and Posttraumatic Growth

We have argued above that some LGBTQ + individuals who come out may experience
both PTSS and PTG. This assertion is in line with PTG theory suggesting that distress and
growth can co-exist. In fact, rather than frame growth and distress as two ends of a single
continuum, Zhang et al. (2018) propose that they are two separate dimensions that can be
simultaneously experienced. Hafstad et al. (2010) refer to this as the “negative and positive
sequelae of trauma” (p. 248). In a sample of HIV-positive gay men, Yu et al. (2017) found
evidence of this ‘double track’ of PTSD and PTG. Similarly, King et al.’s (2008) qualita-
tive study of coming out in the workplaces found that disclosure was distressing yet free-
ing, and that context and other people’s reactions mattered a great deal to the psychological
outcomes their sample reported.

1
Frost and Meyer (2009) define internalized homonegativity as the LGBTQ + individual internalising
society’s negative views of homosexuality.

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Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1365

Tedeschi et al. (2007) move beyond the idea of correlation to suggest that the two
dimensions are actually causally related. Specifically, they posit that distress is a catalyst
of growth. In a sample of LGBT individuals experiencing stigma, Cárdenas et al. (2018)
found that higher perceived stigma was associated with higher levels of PTG; similarly,
in Solomon et al.’s (2015) study, negative reactions from others were positively related
to PTG growth after coming out. These studies provide evidence for the hypotheses that
PTSS is a predictive factor in levels of PTG. Price and Prosek (2019) suggest that anxiety
is a common part of the process and is linked to two aspects of growth: authenticity and
appreciation of supportive relationships. The hard-won gain of living authentically is more
prized if the person has had to overcome fear and anxiety in the first place. Those who are
anxious about coming out have a greater appreciation of the role that supportive relation-
ships play in helping them disclose and feel accepted.
Elaborating on this relationship, Shakespeare-Finch and Lurie-Beck’s (2014) meta-anal-
ysis suggests that a curvilinear relationship exists between PTSS and PTG (Shakespeare-
Finch and Lurie-Beck 2014). Those experiencing little posttraumatic stress symptoms
may not perceive the event as severe enough to challenge their core assumptions about
life, leaving little motivation for growth. For those experiencing moderate symptoms, the
event may be seismic enough to shatter one’s assumptions about the world (Janoff-Bulman
1992), promoting a search for meaning and facilitating PTG. Finally, those with a severe
amount of stress symptoms may feel too emotionally overwhelmed to find benefits, there-
fore disturbing their functioning and thwarting the growth process (Johnson et al. 2007).
This curvilinear pattern has been found across a range of samples, such as war veterans
(Tsai et al. 2014), assault survivors (Kleim and Ehlers 2009), adolescents exposed to ter-
ror (Levine et al. 2008), and bereaved individuals (Eisma et al. 2019), but has not yet been
tested in sexual/gender minority samples. Based upon Shakespeare-Finch and Lurie-Beck’s
(2014) meta-analytic paper, we have developed hypothesis three below.

H3 PTSS and PTG will show a curvilinear relationship.

1.4 The Role of Positive Parenting in PTSS and PTG After Coming Out

Considering the importance of diminishing trauma responses and promoting growth out-
comes after disclosure, it seems fruitful to examine variables that could facilitate PTSS and
PTG after coming out (Owens 2016). As outlined previously, research shows that paren-
tal responses play a pivotal role in mental health outcomes after coming out (D’Amico
et al. 2015). While rejection from parents can lead to negative mental health consequences
(Mills-Koonce et al. 2018), support from parents can lead to positive identity development
(Ryan et al. 2010), higher self-esteem and autonomy (Ryan et al. 2015), and lower levels of
anxiety about future stigmatization or discrimination (Brandon-Friedman and Kim 2016).
Hence, it is no surprise that Solomon et al. (2015) surmise that “social context within the
family can moderate the effects of coming out” (p. 7).
While research has been conducted on the impact of parental responses on the men-
tal health of an LGBTQ + individual after they come out, the impact of the longer-
term relationship between the individual and their parents before coming out is an under
explored topic. Yet, it is reasonable to assume that the parenting approach an LGBTQ +
individual was raised with and the nature of the enduring parent–child bond experienced
by the LGBTQ + individual growing, up will have an impact upon the degree of both
PTSS and PTG during disclosure. In non-LGBTQ + samples, retrospective studies have

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found that parental care during childhood and adolescence predicts resilience (Heydar-
ian et al. 2013), wellbeing (Huppert et al. 2010) and emotional intelligence (Cameron
et al. 2020) in adulthood. Moreover, adults who report growing up with parents who
were warm and assertive during their childhood are more likely to engage in active cop-
ing strategies as adults (Schofield et al. 2014).
In the current study, we have adopted a positive psychology approach to examine
a relatively new positive parenting construct, that of strength-based parenting (Waters
2015a; Waters et al. 2019) and the role it may have retrospectively played in predict-
ing levels of PTSS and PTG after coming out. Strength-based parenting (SBP) is an
approach to parenting that actively seeks to identify and cultivate positive states, pro-
cesses, and qualities in one’s children (Waters 2015a). SBP focuses on building upon
the child’s assets and puts emphasis on their strengths (e.g., humour, courage, loyalty,
etc.) (Sağkal 2019; Sağkal and Özdemir 2019; Waters 2015b; Waters et al. 2018).
Research on SBP has identified two overarching findings: (1) SBP is a buffering factor
that is inversely related to anxiety, depression, psychological distress and stress in chil-
dren (Loton and Waters 2017; Sağkal and Özdemir 2019; Waters 2015a) and (2) SBP is
a building factor that is positively related to life satisfaction, self-efficacy, and subjec-
tive wellbeing (Jach et al. 2018; Loton and Waters 2017; Sağkal and Özdemir 2019;
Waters 2015b; Waters et al. 2019).
Presumably, an LGBTQ + individual who has been raised through SBP will have a
positive parent–child bond (Waters 2015a). Since the most stressful part of disclosure
for LGBTQ + individuals is the fear of damaging their relationships with loved ones
(Charbonnier and Graziani 2016), the presence of this bond leads us to suggest that the
event of coming out is less likely to be marked by fear of rejection from one’s parents
and, thus, may lead to lower levels of distress. Moreover, in experiences that are marked
by a lack of acceptance, individuals who have been raised to know their strengths can
rest assured that these qualities will remain consistent through the disclosure process,
and use them as an anchor point to help them navigate the distress of coming out. In this
sense, Nealy (2019) suggests that leaning on strengths such as courage and resilience
during difficult disclosure experiences can buffer against negative impacts on mental
health. The ideas above lead to hypothesis four of this study.

H4 The greater the SBP received in childhood as reported by the participants, the lower
PTSS an LGBTQ + person will experience following identity disclosure.

Beyond the buffering effect of SBP on levels of PTSS, LGBTQ + individuals who
were raised through strength-based parenting may be likely to show improvements in a
number of the PTG dimensions such as personal strength, relationships with others, and
new possibilities. Rhoads (1995) wrote that the process of disclosure requires strengths
such as bravery and patience. Additionally, strengths such as honesty, love, open-mind-
edness, social intelligence, gratitude, creativity and humour may help the individual to
rise above distress and turn their disclosure into an experience that allows for transfor-
mation and growth, by leaning on an internal, coherent anchor point while opening up
to new perspectives. Regardless of the particular strengths of the individual, the under-
lying knowledge of oneself as a good/strong person that occurs through SBP (Waters
2017) can be leveraged post disclosure to create new opportunities and become their
authentic self. Additionally, the psychological resources developed through SBP such
as mental toughness (Sağkal 2019; Sağkal and Özdemir 2019), a growth mindset (Jach

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1367

et al. 2018), strength-based coping skills (Waters 2015a), self-efficacy and perseverance
(Waters et al. 2018) may help LGBTQ + individuals to develop new relationships and
seek out new opportunities.

H5 The greater the SBP received in childhood as reported by the participants, the greater
PTG following identity disclosure.

SBP may also have an indirect effect on PTG through its influence on PTSS. As dis-
cussed above, the presence of distress can be a trigger for growth, but only if the distress
levels are not too high. When distress is too high, all of the individuals’ resources are mobi-
lized towards the goal of stress reduction (Drolet et al. 2007). In the case where SBP helps
to reduce PTSS (as predicted in hypothesis four) the stress may be more manageable, thus
allowing the individual to direct their strengths towards the dual aims of reducing PTSS
and enhancing PTG. This is supported by Kunz et al. (2017), who have shown that, the
more an individual’s internal resources are flexible and available, the more likely they will
be able to use them for growth. As such, we suggest that in addition to the direct impact
of SBP on PTG, it will also have an indirect effect through its negative relationship with
PTSS.

H6 PTSS will mediate the influence of SBP on PTG.

The objective of the present study is to examine levels of PTSS and PTG in adults after
disclosing their sexual and/or gender minority identity. The study of PTSS and PTG is rela-
tively new in LGBTQ + samples, yet an understanding of these outcomes is crucial given
that past research shows these individuals are at heightened risk of experiencing trauma
(Roberts et al. 2010) This study addresses the fact that LGBTQ + samples are unrepre-
sented in positive psychology research by examining the constructs of PTG and SBP.
Examining the relationship between coming out and growth can inform clinicians, fam-
ily members, support networks and LGBTQ + individuals themselves on how to navigate
this important life milestone in ways that are more likely to lead to desired mental health
outcomes.

2 Methods

2.1 Participants and Procedure

Two hundred and eight LGBTQ + adults from Peru were recruited for this study. The age
of the sample ranged from 18 to 42 years old (μ = 24.24, σ = 4.39). In terms of gender iden-
tity, 53.4% of the sample identified as women, 39.9% as men, and 6.7% as other. Further,
90.9% identified as cisgender and 9.1% identified as transgender. In terms of sexual orien-
tation, 22.6% participants identified as lesbian, 36.1% as gay, 37% as bisexual/pansexual,
and 4.3% as queer or other. The age of coming out ranged between ages 9 to 35 (μ = 19.66,
σ = 3.80). More than half of the participants were currently in a relationship (58.2%). The
number of years spent concealing identity ranged from 0 to 21 (μ = 5.74, σ = 4.40). Finally,
the number of years since coming out ranged from 0 to 18 (μ = 4.61, σ = 3.75).
Sexual and gender minorities are a hard-to-reach population and the fear of being dis-
criminated against may make them reluctant to provide information (Cárdenas et al.

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1368 C. Zavala, L. Waters

2018). Online communities can serve as safe spaces where one may disclose as much as
they are comfortable with, and receive support from other LGBTQ +-identifying indi-
viduals (Formby 2012). Consequently, on-line recruitment techniques are common in
LGBTQ + research (see Legate et al. 2012). The current study recruited participants on-
line via LGBTQ + forums, Facebook groups, volunteer organizations, and activist groups.
After Ethics Approval by Pontifical Catholic University of Perú, the researchers requested
permission from each on-line groups’ site administrators to post a standardized message
explaining the study and a link to the online questionnaires.
Upon entering the link, informed consent was requested, the processes to protect confi-
dentiality were outlined and further information about the study was provided. Participants
were given the questionnaire only if they responded that they had disclosed their sexual or
gender minority identity to at least one parent. Participants could opt out of the question-
naire at any point along the survey completion.

2.2 Instruments

2.2.1 Demographics

Participants reported on their gender identity (female, male, other—please specify), sexual
orientation (lesbian, gay, bisexual, pansexual, queer, other—please specify), presence of
partner, education level, age at time of disclosure to parents, and number of years since
disclosing to parents.

2.2.2 Posttraumatic Stress

The Posttraumatic Checklist (PCL-5) for the DSM-5 (Weathers et al. 2013) was used to
assess PTSS and PTSD in the current study. This scale measures the degree of post trauma
symptoms with respect to DSM-5 criteria. Individuals were asked to identify how much
they experienced each symptom specifically as a result of their coming out experience,
in the months following the event. The scale has 20 items with four subscales: (1) intru-
sions, (2) avoidance, (3) negative alterations in cognition and mood, and 4) hyperarousal
and reactivity. Answers are measured on a Likert scale from 0 (not at all) to 4 (extremely)
based upon how much the individual reports to have experienced each symptom. Exam-
ples items include “Loss of interest in activities you used to enjoy” (negative alterations in
cognition and mood), and “Feeling distant or cut off from other people” (avoidance). The
PCL-5 has demonstrated adequate psychometric properties in a Latin American sample
(a = .87–.96) (Pereira-Lima et al. 2019). In the present study, reliability coefficients for all
dimensions ranged from .77 to .96.

2.2.3 Posttraumatic Growth

The current study utilized Tedeschi and Calhoun’s (1996) Posttraumatic Growth Inventory
(PTGI) to measure positive changes of coming out. Individuals were asked to identify how
much they experienced each change specifically as a result of their coming out experience.
The inventory consists of 21 items that measure five sub-scales: (1) personal strength, (2)
relationships with others, (3) new possibilities, (4) appreciation of life, and (5) spiritual
growth. Each item is rated on a Likert scale ranging from 0 (no change) to 5 (extreme
change). Example items include “I changed my priorities about what is important in life”

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Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1369

(Appreciation of Life) and “I discovered that I’m stronger than I thought I was” (Personal
Strength). Strong internal consistency for the PTGI has been found in a Latin American
sample (a = .92) (Páez et al. 2012). In the present study, reliability was acceptable to strong
(a = .79–.94). The one exception was the ‘Spiritual Change’ sub-scale (a = .58), which was
subsequently excluded from further analyses.

2.2.4 Strength‑Based Parenting

The Strength-Based Parenting Questionnaire (SBPQ), first developed by Waters (2015a,

b) and later refined by Waters and her team (Jach et al. 2018), measures two dimensions
of strength-based parenting: (1) strength awareness and (2) strength use. Strengths knowl-
edge assesses the degree to which a parent has awareness of their child’s strengths while
strength use assesses the degree to which a parent encourages a child to use their strengths.
Answers are recorded on a Likert scale, where 1 is “strongly disagree” and 5 is “strongly
agree”. Each scale has seven items. Example items include “My parent knows the things I
am good at” (strength awareness) and “My parent gives me lots of opportunities to use my
strengths” (strength use).
This scale has been used with children and teenage samples and reliability has been
shown to be strong in across studies (see Waters 2015a, b; Jach et al. 2018; Loton and
Waters 2017; Waters et al. 2019). (a = .94 for the global scale, a = .87 for strengths aware-
ness, a = .94 for strengths use).
For the present study, a retrospective methodology was applied so that the adult par-
ticipants could reflect on the parenting they received growing up. The use of retrospec-
tive designs to allow adults to reflect and rate the parenting they received is a common
approach in the parenting literature and has been used by researchers to have adult sam-
ples rate various aspects of the parenting they received including parental warmth/coldness
(Vaillant 2002, 2012), parental bonding (Huppert et al. 2010) and parental care (Enokido
et al. 2014). In the current study items were modified to reflect an evaluation of the parent-
ing that the LGBTQ + sample felt they received in their childhood and adolescence. For
instance, the item “My parents encourage me to use my strengths every day” was modified
to “During my childhood and adolescence my parents encouraged me to use my strengths
every day”. In the present study, reliability coefficients were .90 for strengths awareness
and .95 for strengths use.

2.3 Data Analysis

The data were cleaned for invalid or missing data, out of range values, and outliers. Skew
and Kurtosis checks found that all variables were within acceptable range (Hair et al.
2010). Descriptive statistics were obtained, followed by preliminary analyses to examine
if demographic variables, age of coming out and length of time since coming out were sig-
nificantly related to the study variables. Next, hypotheses one and two were examined via
bivariate correlations (Pearson’s correlation coefficient). To test hypothesis three, the cur-
vilinear effects, the linear and squared terms of PTSS were entered into a regression model.
Finally, hypotheses four through six were tested via Hayes’ (2013) PROCESS macro for
SPSS using Model 4. This model generates total, direct, and indirect effects while con-
trolling for covariates, using 95% bootstrapped confidence intervals (CIs). Bootstrapping
allows the estimation of population variables by resampling the empirical sample in a con-
tinuous manner. Hayes (2013) states that if the CI for the indirect effect does not include

13
1370 C. Zavala, L. Waters

Table 1  Means, standard deviations, reliability, skew and kurtosis

Variable Range M SD α Skew Kurtosis

SBP total 16–70 48.65 13.89 .96 − .37 − .73

SBP: awareness 9–35 24.96 6.74 .90 − .36 − .77
SBP: use 7–35 23.69 7.74 .95 − .31 − .73
PTSS total 0–80 28.94 22.72 .96 .45 − 1.01
PTSS: ­intrusiona 0–4 1.22 1.17 .90 .80 − .46
PTSS: avoidance 0–4 1.42 1.34 .77 .56 − .97
PTSS: NACM 0–4 1.48 1.20 .91 .42 − 1.10
PTSS: hyperarousal 0–4 1.60 1.30 .92 .39 − 1.20
PTG ­totalb 1–95 70.07 19.03 .94 − 1.11 1.02
PTG: personal s­ trengthc 0–5 4.01 1.12 .88 − 1.52 2.13
PTG: relationships with others 0–5 3.75 1.08 .89 − 1.08 .89
PTG: new possibilities 0–5 3.54 1.25 .83 − .89 − .05
PTG: appreciation for life 0–5 3.37 1.35 .79 − .92 .15

N = 218
SBP strength-based parenting, PTSS posttraumatic stress symptoms, PTG posttraumatic growth, NACM
negative alterations in cognitions and mood
a
Because each subscale of Post-Traumatic Stress Disorder Checklist has a different number of items and,
thus, would have a different range of scores, these have been converted to a range of 0–4 for the sake of
consistency and to allow comparison between the dimensions
b
Although the total score of the Post-Traumatic Growth Inventory is typically 105, in the current study we
did not utilize the dimension of Spiritual Change as it did not reach acceptable reliability, thus, making 95
the highest possible score in this scale
c
Because each subscale of Post-Traumatic Growth Inventory has a different number of items and, thus,
would have a different range of scores, these have been converted to a range of 0–5 for the sake of consist-
ency and to allow comparison between the dimensions

zero, then the indirect effect is significant. This PROCESS tool has been commonly used
to test mediation hypotheses (Eze et al. 2019). In this analysis, PTG was the dependent
variable, PTSS and SBP were the independent variables, and the covariates were gender
identity, being cisgender vs. transgender, sexual orientation, level of education, age at dis-
closure, and time in the closet. Including the quadratic term in the model has been done by
several other studies who find curvilinear relationships between study variables (Hofmans
et al. 2015; Höltge et al. 2018). All analyses were done using SPSS 25 and were considered
significant at the p < 0.05 level.

3 Results

Descriptive statistics for the study variables are presented in Table 1. In this study, 43.8%
of the sample met the symptom criteria for PTSD (i.e., one intrusion symptom, one avoid-
ance symptom, two symptoms of negative alterations in cognition and mood, and two
hyperarousal symptoms). However, since other aspects such as functionality and duration
were not measured, this does not signify that these individuals experienced the full disorder
of PTSD. With respect to PTSS, the LGBTQ + individuals in this sample reported a mean
score of 28.94 (σ = 22.72). Of interest is the large standard deviation within this sample,

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1371

showing that some people experienced very high PTSS while others had low levels. These
results support hypothesis one of the study, that LGBTQ + individuals would show signs of
PTSS and PTSD. The mean score for PTG was 70.07 (σ = 19.03) out of 95. This result sup-
ports hypothesis two that the LGBTQ + individuals who had come out would show aspects
of PTG. With regard to SBP, the mean score for strengths awareness (μ = 24.96) was higher
than that for strengths use (μ = 23.69).

3.1 Preliminary Analyses

Analyses were conducted to look for differences in total SBP, PTSS, and PTG and sociode-
mographic variables. One-way ANOVAs were used to look for differences based on gender
identity (women, men, and other), and education level (primary, secondary, higher, and
post-graduate). Independent T-tests were used to examine differences in sexual orientation
(lesbian/gay/queer/other vs. bisexual), being cisgender vs. transgender, and current pres-
ence of partner.
Those who identified as transgender had higher levels of PTSS than those who identi-
fied as cisgender (p < .05). Those who identified as men reported significantly higher lev-
els of PTG than those who identified as women (p < .05). No significant differences were
found for those with non-binary or transgender identities (p > 0.05). Presence of partner did
not make a significant difference to SBP, PTSS, or PTG scores. There were significant dif-
ferences regarding education level, such that those with post-graduate education had higher
SBP than those with secondary education (p < .05), and those with post-graduate educa-
tion had lower levels of PTSS than those with university education (p < .05). No significant
differences were found in PTSS between bisexual and lesbian/gay/queer/other individuals
(p > .05). However, bisexuals had significantly lower scores than lesbian/gay/queer/other
individuals on PTG.
Correlations were employed to examine the relationships between aspects of disclosure
experience and main study variables. Age at coming out was negatively related to PTSS,
but no relationship was found between PTSS and time spent in the closet or time since the
event. Conversely, PTG was not significantly correlated with age at coming out, but was
positively related with time spent in the closet on the dimension of ‘personal strength’. No
significant correlations were found between PTG and time since the disclosure. None of
the disclosure variables were related to SBP.
Paired T-tests were conducted to test for significant differences between subscales, so as
to better understand how PTSS, PTG and SBP occurred in this sample. For PTSS, hypera-
rousal was significantly higher than the other three dimensions (p < .05) and intrusion was
significantly lower than all other dimensions (p < .05). For PTG, personal strength was
significantly higher than all the other dimensions (p < .05), relationships with others was
significantly higher than new possibilities and appreciation for life; new possibilities was
significantly higher than appreciation for life. For SBP, awareness was significantly higher
than use (p < .05).

3.2 Main Analyses

Pearson’s correlation analysis tested the relationship between the study variables (see
Table 2). PTSS was significantly, positively related to PTG. SBP was significantly, nega-
tively related to PTSS and was significantly, positively, related to PTG.

13
 1372

13
Table 2  Bivariate correlations between study variables
Variables 1 2 3 4 5 6 7 8 9 10 11 12

1. SBP total
2. SBP: awareness .95**
3. SBP: use .97** .84**
4. PTSS total − .32** − .35** − .26**
5. PTSS: intrusion − .25** − .29** − .19** .89**
6. PTSS: avoidance − .24** − .25** − .21** .83** .74**
7. PTSS: NACM − .33** − .35** − .29** .94** .74** .75**
8. PTSS: hyperarousal − .30** − .34** − .24** .94** .79** .70** .85**
9. PTG total .13* .13* .11 .12* .01 .05 .13* .19**
10. PTG: personal strength .14* .15* .12* .09 .01 .10 .08 .14* .84**
11. PTG: relationships with others .15* .16* .13* .03 − .05 − .02 .06 .08 .88** .62**
12. PTG: new possibilities .11* .09 .11 .13* .05 .03 .15* .21** .87** .67** .68**
13. PTG: appreciation for life .01 .01 .01 .21** .13* .11 .20** .25** .78** .68** .56** .56**

N = 218
SBP strength-based parenting, PTSS posttraumatic stress symptoms, PTG posttraumatic growth, NACM negative alterations in cognitions and mood
*p < .05; **p < .01
C. Zavala, L. Waters
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1373

Table 3  Curvilinear relationship Variable Total PTG

analysis
B B

Step 1
PTSS .12* .71**
Step 2
PTSS × PTSS − .62**
R2 .02 .05**
ΔR2 .03

*p <.05; **p < .01

In order to test for a curvilinear relationship between PTSS and PTG, PTSS scores were
squared so as to create a quadratic term. Then, in a two-step regression where PTG was the
dependent variable, the linear PTSS term was entered into the first step and the quadratic
PTSS term ­(PTSS2) was entered into the second step (see Table 3). The results indicate that
the addition of a quadratic predictor explained an additional 3% of variance (­ R2 = .05) com-
pared to the linear term alone ­(R2 = .02). In the final model, both the linear term (β = .71,
SE = .20, p < .01) and the quadratic term (β = −.62, SE = .01, p < .05) predicted PTG. This
suggests that a curvilinear relationship better explains the link between PTSS and PTG, as
opposed to a linear one, providing support for hypothesis three. Hence, those with inter-
mediate levels of PTSS reported the highest levels of PTG, whereas those with very low or
very high PTSS reported lower PTG.
To test the mediation hypothesis, Hayes (2013) PROCESS macro was used, with SBP
and PTSS (both the linear and quadratic term) as predictors of PTG (Table 4). Covariates
(gender identity, being cisgender vs. transgender, sexual orientation, level of education, age
at disclosure, and time in the closet) were included based on their significant relationships
with main study variables. In terms of covariates, results showed that only gender iden-
tity remained a significant predictor of PTG, in the manner that those who identified their
gender as male reported higher growth than those who identified their gender as female.
In terms of the main variables, SBP and the linear PTSS term were significant positive
predictors of PTG, while the quadratic PTSS term was a significant negative predictor of
PTG. Effect size ­(R2) for the model was .15 [F(9, 197) = 3.98, p < .001)]. The total and
direct effects of SBP were significant; further, the CIs for the indirect effects of SBP did
not include zero, confirming that the indirect effect was also significant. The direct effect
being larger than the indirect effect suggests a suppression effect of PTSS on the relation-
ship between SBP and PTG. In this sense, when PTSS is controlled for, the effect of SBP
on PTG increases, thus supporting hypothesis six.

4 Discussion

4.1 Coming Out, Posttraumatic Stress and Posttraumatic Growth

The current study examined the role of two positively-oriented constructs, posttraumatic
growth and strength-based parenting, and investigated how these constructs interact with
PTSS/PTSD following sexual and gender identity disclosure to parents. Results showed

13
1374 C. Zavala, L. Waters

Table 4  Mediation of SBP on B SE p 95% CI

PTG through PTSS and P ­ TSS2
Lower Upper

SBP (IV)
SBP (IV) to PTSS (M1) − .49 .11 .00 − .70 − .28
SBP (IV) to ­PTSS2 (M2) − 33.33 7.71 .00 − 48.54 − 18.12
Total effect .16 .10 .04 .03 .35
Direct effect .23 .10 .02 .04 .42
PTSS (M1)
Direct effect .69 .20 .00 .31 1.08
PTSS2 (M2)
Direct effect − .01 .00 .00 − .01 − .01
Indirect effect
Total indirect effect − .07 .04 .01 − .15 − .01
Through PTSS − .33 .14 .01 − .65 − .09
Through ­PTSS2 .27 .14 .01 .04 .58
Partial effect of covariates
Gender identity 7.02 2.66 .01 1.77 12.27
Cisgendera − 9.27 5.61 .10 − 20.34 1.80
Sexual ­orientationb − 4.80 2.83 .09 − 10.37 .78
Level of education − .09 2.06 .96 − 4.15 3.96
Age at disclosure .25 .39 .52 − .52 1.02
Time in closet .30 .32 .34 − .32 .92

Dependent variable in the model: PTG posttraumatic growth, IV inde-

pendent variable, DV dependent variable, M mediator, SBP strength-
based parenting, PTSS posttraumatic stress symptoms (linear term),
PTSS2 posttraumatic stress symptoms (quadratic term), SE standard
error of the point estimate, 95% CI 95% confidence interval
a
Cisgender versus transgender individuals
b
Lesbian/gay/queer/other versus bisexual individuals

that LGBTQ + individuals experienced the dual outcomes of distress and growth—what
Hafstad et al. (2010) refer to as the “negative and positive sequelae of trauma” (p. 248).
Additionally, this study found that the degree of strength-based parenting with which indi-
viduals were raised had a buffering effect on distress and a building effect on growth, as
well as a mediating effect on growth through its reduction of distress.
PTSD and PTSS have been studied with regards to a range of LGBTQ + minority expe-
riences such as discrimination, threat, homophobia/transphobia, and being HIV-positive
(Roberts et al. 2010; Yu et al. 2017), but have not yet had studies with respect to identity
disclosure. In the current study, the mean score of PTSS places this sample in the middling
range of PTSS compared to other studies with minority sexual identity individuals which
range from 19 (Cohen et al. 2016; sexual identity concealment in young adults) to 39
(Reisner et al. 2016, discriminatory experiences in transgender teenagers). Hyperarousal
was the highest dimension of PTSS. This component represents an enduring reactive state
that impedes the individual from returning to psychological and biological homeostasis
after the stressful event (McFarlane 2010). This may be the most salient and problematic
aspect of distress for LGBTQ + individuals, as assuming a minority identity means they

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1375

must constantly look for signs of possible acts of harassment or discrimination (Alessi and
Martin 2017). In order to combat these feelings of insecurity and lack of safety, LGBTQ +
individuals can build resilience through having a solid identity and seeking social support
(Alessi and Martin 2017). In this vein, strength-based parenting, which promotes identify-
ing positive aspects of oneself, may provide a buffer against discrimination or rejection and
aid the individual in using social skills to seek out key allies.
The study of PTG in LGBTQ + individuals is very new, with few studies having con-
sidered growth possibilities post-coming out (e.g. Bonet et al. 2007; Cox et al. 2010; Solo-
mon et al. 2015; Vaughan and Waehler 2010). Our study found evidence of PTG, with per-
sonal strength being the highest dimension of PTG in the current sample. This aligns with
a study conducted by Rhoads (1995) where college students recognized their bravery and
inner strength after disclosing. It also supports Bonanno’s (2008) assertion that resilience
is a more common reaction to loss and violence than previous studies have found. Clearly,
the use of strengths to help people grow through the process of coming out, and the study
of what strengths are heightened (or more appreciated) following disclosure, offers much
potential for future research.

4.2 Strength‑Based Parenting, Posttraumatic Stress and Posttraumatic Growth

One way that people become connected to their strengths is through the parenting they
receive (Jach et al. 2018; Waters 2015b). In youth samples, SBP has been shown to build
coping resources such as a strength-based coping style (Waters 2015a), perseverance
(Waters et al. 2018) and mental toughness (Sagkal and Özdemir 2019). Additionally, SBP
significantly predicts a host of factors that may assist with growth such as self-efficacy
(Waters et al. 2018), growth mindset (Jach et al. 2018) and positive emotions (Waters et al.
2019). In the current study, retrospective reporting of SBP were inversely related to PTSS
(buffering) and positively related to PTG (building). This shows that the buffering and
building effects of SBP are not only significant when the child is young and living with
their parents but may also persist and endure into adulthood. This aligns with Newcomb
et al.’s (2019) review paper highlighting the importance of parenting in LGBTQ + individ-
uals’ health over time. To further test this in both LGBTQ + individuals and other samples,
we suggest future researchers engage in prospective and longitudinal research.
These results may be understood through the lens of the Minority Stress Model (Meyer
2003). This model asserts that the mental health outcomes of LGBTQ + individuals are
impacted by an interaction between minority stress (e.g., discrimination, hostility, internal-
ized homophobia, distress about coming out) and the ‘psychological processes’ they can
use to deal with distress. Psychological processes include the following three elements:
coping abilities, self-schemas, and social support (Hatzenbuehler 2009).
With regard to the first psychological process, coping abilities, we have suggested above
that the positive coping abilities fostered by SBP during childhood can persist into adult-
hood, thus, helping LGBTQ + individuals reduce distress levels caused by disclosure.
Future researchers could directly assess such coping abilities to deepen the knowledge of
what helps LGBTQ + individuals in the process of coming out.
With regard to the second psychological process, self-schemas, Waters (2015a) theo-
rizes that SBP builds a positive identity by creating a strength-based filter where the child
is able to see themselves, first and foremost, through the lens of their strengths. In this line,
studies have shown that leaning on these strengths (e.g. confidence, pride) can be vital after
disclosure because they allow the individual to maintain a firm internal identity even when

13
1376 C. Zavala, L. Waters

parents express rejection towards it (Carastathis et al. 2017; Harkness et al. 2020). This can
be used both to combat distress and to promote growth-based outcomes.
Finally, regarding the third element of social support, strengths such as social skills,
engaging in constructive dialogue, and setting boundaries can be useful in finding sup-
port from allies (Ali and Lambie 2018) and managing rejection after disclosure (Harkness
et al. 2020). Hence, perhaps one reason the current sample showed an inverse relationship
between SBP and PTSS and a direct relationship between SBP and PTG is that SBP pro-
vides the ‘psychological process’ of social support through putting individual in touch with
the strengths mentioned above.
Another key finding was the mediating effect of PTSS on the relationship between SBP
and PTG. Specifically, a suppressor effect was found such that when PTSS was controlled
for, the relationship between SBP and PTG was strengthened. Hence, during identity dis-
closure, it is likely that individuals’ resources—coping abilities, self-schemas, and social
support—are divided into both the task of managing distress and fostering growth. We
suggest that the more an individual devotes psychological resources to manage their dis-
tress, the less likely they will be able to use them for growth. The flip side to this is that
when an individual has lower distress they are free to direct those resources towards growth
outcomes. This may explain why the relationship between SBP and PTG became stronger
when PTSS was suppressed in the model.

4.3 Future Research and Implications

A number of suggestions for future research have been raised in this discussion including
studying the role of strengths (as separate from SBP) during the coming out process. This
line of inquiry could include research into how LGBTQ + individuals can intentionally
draw upon their strengths to manage PTSS and cultivate PTG after disclosure (e.g., integ-
rity, courage, social intelligence, etc.) and what factors help LGBTQ + individuals identify
and use these strengths.
In relation to the role of parents in helping LGBTQ + individuals to adopt a strength-
based approach following disclosure we examined retrospective levels of SBP. Future
research could add to this by studying current levels of SBP being provided to LGBTQ +
individuals immediately following disclosure. We have also suggested that prospective and
longitudinal research is needed to test whether the effects of SBP shown to occur during
childhood endure over time and assist in growing through trauma in adulthood.
Results suggest that PTSS are not uncommon when coming out. Hence, it would be helpful
to educate LGBTQ + individuals about minority stress as a way of normalising, rather than
pathologizing, response to the trauma experienced by some when coming out and, thus, in
helping to heal from PTSS/PTSD. Equally, we advocate for offering LGBTQ + individuals
hope regarding possibilities for growth post-coming out. This could occur by hearing others’
experiences of PTG after disclosure, through vicarious PTG (Arnold et al. 2005). Importantly,
education about the co-existence of distress and growth is needed to promote awareness that
one does not discount the possibility for the other. This balance is necessary, as Budge (2014)
cautions that infusing positivity into clinical practice with LGBTQ + individuals may unwit-
tingly invalidate the adversities these clients face. Adopting a strength-based approach can
help to strike the balance between acknowledging distress and promoting growth, since this
approach, far from denying strengths, looks to connect the individual to resources in order
to navigate the hardships and move towards growth (Waters 2017). Lytle et al. (2014) rec-
ommend that clinicians incorporate strength-based questionnaires into their sessions and help

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1377

LGBTQ + “experience themselves and their abilities from a position of affirmation, celebra-
tion and strength” (p. 2).
The finding that age at coming out was negatively related to PTSS suggests that clinicians
would be wise to consider age when supporting LGBTQ + individuals through the process
of disclosure. Hegna and Wichstrøm (2007) also reported worsened mental health in sexual
minority youth who come out at younger ages, positing this event may be better dealt with
when individuals have acquired further maturity with age. Further, the finding that transgen-
der individuals experience higher PTSS than cisgender individuals aligns with Reisnet et al.’s
(2016) assertion that transgender persons encounter additional stressors and discrimination;
hence, this population should be further studied to determine how to best support them and
diminish distress levels.
Finally, in terms of sexual orientation, this study found that bisexuals had significantly
lower scores on PTG compared to participants who identified as gay, lesbian, queer, or
other. This may be due to the presence of biphobia and bi-erasure in both heterosexual and
LGBTQ + circles (Pallotta-Chiarolli 2014). Common stereotypes about bisexual identities
include that they are promiscuous, in denial, trying to hold on to heterosexual privilege, or
have not yet fully come out (McLean 2007). As a uniquely stigmatized population, it is likely
that bisexual individuals have more difficulty in experiencing growth (Wandrey et al. 2015).
Unlike other sexual or gender minority identities, once they come out, bisexual individuals
cannot rely on a community that fully accepts them and must continue to assert their identity
(Gusmano 2018). This occurs with parents as well, since they have higher difficulty under-
standing this identity (Barker et al. 2012), disclosure experiences may be even more difficult.
In the face of these barriers, it is understandable that bisexual individuals may have a harder
time reaping benefits and growth experiences following identity disclosure.

4.4 Study Limitations

The results and implications outlined above must be considered within certain limitations. The
cross-sectional design using correlational data precludes causal inferences. As such, we can-
not say whether SBP causes lower PTSS and higher PTG as there may be an additional factor
connecting these three variables (e.g. personality). Moreover, it is possible that individuals
may have experienced PTSS initially followed by PTG, or vice versa, instead of simultane-
ously. However, this would not alter the fact that individuals in this study reported the dual
outcomes of stress and growth, even if this occurred at different points in time.
Additionally, a larger sample would have allowed us to achieve closer approximations of
the population means, as well as increasing the representativeness of the population. How-
ever, with a sample size of 208, we can be re-assured that the sample size met the 5:1 ratio of
participants to study variables recommended by Little (2013) to allow for statistical inference.
Moreover, a sample size of over 200 is large compared to other LGBTQ + studies, as these
populations are often difficult to recruit owing to the stigma and trauma aspects we have out-
lined in the introduction of this paper (Cárdenas et al. 2018).

5 Conclusion

Solomon et al. (2015) argue that, although coming out can initially be marked by fear and
rejection experiences, research on post-traumatic growth after disclosure can help both
practitioners and sexual and gender minorities to increase the possibilities for positive

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1378 C. Zavala, L. Waters

transformation. The current study contributes to this call and we hope that it encourages
further research into the factors that help to manage distress and promote growth during
sexual and/or gender identity disclosure.

Compliance with Ethical Standards

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 (Pontificia Universidad Católica
del Perú—Department of Psychology) and with the 1964 Helsinki declaration and its later amendments or
comparable ethical standards.

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

References
Alessi, E., & Martin, J. (2017). Intersection of trauma and identity. In K. Eckstrand & J. Potter (Eds.),
Trauma, resilience, and health promotion in LGBT patients. Berlin: Springer. https​://doi.
org/10.1007/978-3-319-54509​-7_1.
Alessi, E., Meyer, I., & Martin, J. (2013). PTSD and sexual orientation: An examination of criterion A1 and
non-criterion A1 events. Psychological Trauma, 5(2), 149–157. https​://doi.org/10.1037/a0026​642.
Ali, S., & Lambie, G. (2018). The impact of strengths-based group counseling on LGBTQ + young
adults in the coming out process. Journal of Gay & Lesbian Mental Health, 23, 1–18. https​://doi.
org/10.1080/19359​705.2018.15301​59.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Washington, D.C.: American Psychiatric Association. https​://doi.org/10.1176/appi.books​.97808​
90425​596.
Arnold, D., Calhoun, L. G., Tedeschi, R., & Cann, A. (2005). Vicarious posttraumatic growth in psycho-
therapy. Journal of Humanistic Psychology, 45(2), 239–263.
Barker, M. J., et al. (2012). The bisexuality report. Centre for Citizenship, Identity and Governance and
Faculty of Health and Social Care, The Open University. Retrieved from: https​://www.acade​mia.
edu/14427​510/The_Bisex​ualit​y_Repor​t.
Bonanno, G. (2008). Loss, trauma, and human resilience: Have we underestimated the human capacity to
thrive after extremely aversive events? Psychological Trauma: Theory, Research, Practice, and Pol-
icy, S(1), 101–113. https​://doi.org/10.1037/1942-9681.S.1.101.
Bonet, L. B., Wells, E., & Parsons, J. T. (2007). A positive look at a difficult time: A strength based exami-
nation of coming out for lesbian and bisexual women. Journal of LGBT Health and Resilience, 3(1),
7–14.
Bosson, J., Weaver, J., & Prewitt-Freilino, J. (2012). Concealing to belong, revealing to be known: Classifi-
cation expectations and self-threats among persons with concealable stigmas. Self and Identity, 11(1),
114–135. https​://doi.org/10.1080/15298​868.2010.51351​8.
Brandon-Friedman, R., & Kim, H. (2016). Using social support levels to predict sexual identity develop-
ment among college students who identify as a sexual minority. Journal of Gay and Lesbian Social
Services, 28(4), 292–316.
Brown, L. S. (2003). Sexuality, lies, and loss: Lesbian, gay, and bisexual perspectives on trauma. Journal of
Trauma Practice, 2(2), 55–68.
Budge, S. (2014). Navigating the balance between positivity and minority stress for LGBTQ clients who are
coming out. Psychology of Sexual Orientation and Gender Diversity, 1(4), 350–352.
Cameron, M., Cramer, K., & Manning, D. (2020). Relating parenting styles to adult emotional intelligence:
A retrospective study. Athens Journal of Social Sciences, 7(3), 185–196. https​://doi.org/10.30958​/
ajss.7-3-3.
Carastathis, G., Cohen, L., Kaczmarek, E., & Chang, P. (2017). Rejected by family for being gay or les-
bian: Portrayals, perceptions, and resilience. Journal of Homosexuality, 64(3), 289–320. https​://doi.
org/10.1080/00918​369.2016.11790​35.

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1379

Cárdenas, M., Barrientos, J., Meyer, I., Gómez, F., Guzmán, M., & Bahamondes, J. (2018). Direct and
indirect effects of perceived stigma on posttraumatic growth in gay men and lesbian women in
Chile. Journal of Traumatic Stress, 31, 5–13.
Charbonnier, E., & Graziani, P. (2016). The stress associated with the coming out process in the young
adult population. Journal of Gay & Lesbian Mental Health. https​://doi.org/10.1080/19359​
705.2016.11829​57.
Cohen, J., Blasey, C., Barr Taylor, C., Weiss, B., & Newman, M. (2016). Anxiety and related disorders
and concealment in sexual minority young adults. Behavioral Therapy, 47(1), 91–101. https​://doi.
org/10.1016/j.beth.2015.09.006.
Cohen, J., Mannarino, A., Wilson, K., & Zinny, A. (2018). Trauma-focused cognitive behavioral therapy
LGBTQ implementation manual. Pittsburgh: Allegheny Health Network.
Corrales, J. (2020). The expansion of LGBT rights in Latin America and the Backlash. In M. J. Bosia, S.
M. McEvoy, & M. Rahman (Eds.), The Oxford handbook of global LGBT and sexual diversity pol-
itics (pp. 185–201). New York: Oxford University Press. https​://doi.org/10.1093/oxfor​dhb/97801​
90673​741.013.14.
Cox, N., Dewaele, A., van Houtte, M., & Vincke, J. (2010). Stress-related growth, coming out, and
internalized homonegativity in lesbian, gay, and bisexual youth. An examination of stress-related
growth within the minority stress model. Journal of Homosexuality, 58(1), 117–137. https​://doi.
org/10.1080/00918​369.2011.53363​1.
Cryder, C., Kilmer, R., Tedeschi, R., & Calhoun, L. (2006). An exploratory study of posttraumatic
growth in children following a natural disaster. American Journal of Orthopsychiatry, 76(1),
65–69.
D’Amico, E., Julien, D., Tremblay, N., & Chartrand, E. (2015). Gay, lesbian, and bisexual youths com-
ing out to their parents: Parental reactions and youth outcomes. Journal of GLBT Family Studies,
11, 1–27. https​://doi.org/10.1080/15504​28X.2014.98162​7.
Dragowski, E. A., Halkitis, P. N., Grossman, A. H., & D’Augelli, A. R. (2011). Sexual orientation vic-
timization and posttraumatic stress symptoms among lesbian, gay, and bisexual youth. Journal of
Gay & Lesbian Social Services, 23(2), 226–249. https​://doi.org/10.1080/10538​720.2010.54102​8.
Drolet, M., Paquin, M., & Soutyrine, M. (2007). Strengths-based approach and coping strategies used by
parents whose young children exhibit violent behaviour: Collaboration between schools and parents.
Child and Adolescent Social Work Journal, 24, 437–453. https​://doi.org/10.1007/s1056​0-007-0094-9.
Dziengel, L. (2015). A be/coming-out model: Assessing factors of resilience and ambiguity. Journal of
Gay & Lesbian Social Services, 27(3), 302–325. https​://doi.org/10.1080/10538​720.2015.10536​56.
Eisma, M., Lenferink, L., Stroebe, M., Boelen, P., & Schut, H. (2019). No pain, no gain: Cross-lagged
analyses of posttraumatic growth and anxiety, depression, posttraumatic and prolonged grief
symptoms after loss. Anxiety Stress and Coping, 32(3), 231–243. https​://doi.org/10.1080/10615​
806.2019.15842​93.
Enokido, M., Suzuki, A., Sadahiro, R., Matsumoto, Y., Kuwahata, F., Takahashi, N., et al. (2014). Paren-
tal care influences leukocyte telomere length with gender specificity in parents and offsprings.
Biomolecular Psychiatry. https​://doi.org/10.1186/s1288​8-014-0277-9.
Eze, J., Ifeagwazi, C., & Chukwuorki, J. (2019). Core beliefs challenge and posttraumatic growth: Medi-
ating role of rumination among internally displaced survivors of terror attacks. Journal of Happi-
ness Studies, 2020(21), 659–676. https​://doi.org/10.1007/s1090​2-019-00105​-x.
Formby, E. (2012). Connected lesbian, gay, bisexual and trans communities? A scoping study to explore
understandings and experiences of ‘community’ among LGBT people. Discussion Paper. Swindon,
Arts and Humanities Research Council.
Frost, D., & Meyer, I. (2009). Internalized homophobia and relationship quality among lesbians, gay
men, and bisexuals. Journal of Counseling Psychology, 56(1), 97–109.
Galupo, M., Mitchell, R., & Davis, K. (2015). Sexual minority self-identification: Multiple identities and
complexity. Psychology of Sexual Orientation and Gender Diversity, 2(4), 355–364. https​://doi.
org/10.1037/sgd00​00131​.
Glenn, I. (2019). Diversity, equity and inclusion terms and definitions. Virginia: Hollins University.
Grafsky, E., & Gary, E. (2018). What sexual minority youths want in a program to assist with disclo-
sure to their family. Journal of Gay and Lesbian Social Services, 30(2), 172–191. https​://doi.
org/10.1080/10538​720.2018.14445​26.
Gusmano, B. (2018). Coming out through an intersectional perspective: Narratives of bisexuality and
polyamory in Italy. Journal of Bisexuality, 18(3), 1–20.
Hafstad, G., Gil-Rivas, V., Kilmer, R., & Raeder, S. (2010). Parental adjustment, family functioning,
and posttraumatic growth among Norwegian children and adolescents following a natural disaster.
American Journal of Orthopsychiatry, 80(2), 248–257.

13
1380 C. Zavala, L. Waters

Hair, J. F., Anderson, R. E., Babin, B. J., & Black, W. C. (2010). Multivariate data analysis: A global
perspective (7th ed.). Upper Saddle River, NJ: Pearson.
Harkness, A., Rogers, B., Albright, C., Mendez, N., Safren, S., & Pachankis, J. (2020). “It truly does get
better”: Young sexual minority men’s resilient responses to sexual minority stress. Journal of Gay
& Lesbian Mental Health.. https​://doi.org/10.1080/19359​705.2020.17132​76.
Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological
mediation framework. Psychological Bulletin, 135, 707–730. https​://doi.org/10.1037/a0016​441.
Haxhe, S., Cerezo, A., Bergfeld, J., & Walloch, J. (2017). Siblings and the coming out process: A com-
parative case study. Journal of Homosexuality, 65(4), 407–426. https​://doi.org/10.1080/00918​
369.2017.13213​49.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regres-
sion-based approach. New York, NY: Guilford Press.
Hegna, K., & Wichstrøm, L. (2007). Suicide attempts among Norwegian gay, lesbian and bisex-
ual youths: general and specific risk factors. Acta Sociologica, 50(1), 21–37. https​://doi.
org/10.1177/00016​99307​07488​0.
Heydarian, N. M., Hughes, A. S., Aguirre, K. M., & Castro, F. G. (2013). Retrospective parent-child
relationships, gender identity, and their effects on currentresilience. Panel presented at the Society
for Prevention Research Conference, San Francisco, California.
Hofmans, J., Debusscher, J., Doci, E., Spanouli, A., & De Fruyt, F. (2015). The curvilinear relationship
between work pressure and momentary task performance: The role of state and trait core self-
evaluations. Frontiers in Psychology, 6(1680), 1–11. https​://doi.org/10.3389/fpsyg​.2015.01680​.
Höltge, J., McGee, S., & Thoma, M. (2018). The curvilinear relationship of early-life adversity and
successful aging: The mediating role of mental health. Aging & Mental Health. https​://doi.
org/10.1080/13607​863.2018.14336​35.
Horne, S. G., Puckett, J. A., Apter, R., & Levitt, H. M. (2014). Positive psychology and LGBTQ popu-
lations. In J. Pedrotti & L. Edwards (Eds.), Cross-cultural advancements in positive psychology.
Perspectives on the intersection of multiculturalism and positive psychology (pp. 189–202). Ber-
lin: Springer. https​://doi.org/10.1007/978-94-017-8654-6_13.
Huppert, F., Abbott, R., Ploubidis, G., Richards, M., & Kuh, D. (2010). Parental practices predict psy-
chological well-being in midlife: Life-course associations among women in the 1946 British birth
cohort. Psychological Medicine, 40(9), 1507–1518.
Instituto Nacional de Estadística e Informática. (2018). Primera Encuesta Virtual para Personas LGBTI,
2017. Lima: Instituto Nacional de Estadística e Informática.
Jach, H., Sun, J., Loton, D., Chin, T., & Waters, L. (2018). Strengths and subjective wellbeing in adoles-
cence: Strength-based parenting and the moderating effect of mindset. Journal of Happiness Stud-
ies. https​://doi.org/10.1007/s1090​2-016-9841-y.
Janoff-Bulman, R. (1992). Shattered assumptions. New York: Free Press.
Jhang, J. (2018). Scaffolding in family relationships: A grounded theory of coming out to family. Inter-
disciplinary Journal of Applied Family Studies. https​://doi.org/10.1111/fare.12302​.
Johnson, K. L., Gill, S., Reichman, V., & Tassinary, L. G. (2007). Swagger, sway, and sexuality: Judging
sexual orientation from body motion and morphology. Journal of Personality and Social Psychol-
ogy, 93, 321–334. https​://doi.org/10.1037/0022-3514.93.3.321.
Katz-Wise, S., Rosario, M., & Tsappis, M. (2016). LGBT youth and family acceptance. Pediatric Clinics
of North America, 63(6), 1011–1025. https​://doi.org/10.1016/j.pcl.2016.07.005.
Kimberg, L. (2019). Trauma and trauma-informed care. In T. King, et al. (Eds.), Medical management
of vulnerable and underserved patients: Principles, practices, and populations (2nd ed., pp. 408–
424). New York: McGraw Hill Education.
King, E. B., Reilly, C., & Hebl, M. (2008). The best of times, the worst of times: Exploring dual per-
spectives of “coming out” in the workplace. Group & Organization Management, 33(5), 566–601.
https​://doi.org/10.1177/10596​01108​32183​4.
Kleim, B., & Ehlers, A. (2009). Evidence for a curvilinear relationship between posttraumatic growth
and posttrauma depression and PTSD in assault survivors. Journal of Traumatic Stress, 22, 45–52.
Kunz, S., Joseph, S., Geyh, S., & Peter, C. (2017). Posttraumatic growth and adjustment to spinal cord
injury: Moderated by posttraumatic depreciation? Psychological Trauma: Theory, Research, Prac-
tice, and Policy, 9, 434–444. https​://doi.org/10.1037/tra00​00164​.
Legate, N., Ryan, R. M., & Weinstein, N. (2012). Is coming out always a “good thing”? Exploring the
relations of autonomy support, outness, and wellness for lesbian, gay, and bisexual individuals.
Social Psychological and Personality Science, 3(2), 145–152.

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1381

Levine, S., Laufer, A., Hamama-Raz, Y., Stein, E., & Solomon, Z. (2008). Posttraumatic growth in ado-
lescence: Examining its components and relationship with PTSD. Journal of Traumatic Stress,
21(5), 492–496. https​://doi.org/10.1002/jts.20361​.
Little, T. D. (2013). The Oxford handbook of quantitative methods: Statistical analysis (Vol. 2). Oxford:
Oxford University Press.
Loton, D., & Waters, L. (2017). The mediating effects of self-efficacy in the connections between
strength-based parenting, happiness and psychological distress in teens. Frontiers in Psychology,
8, 1–13. https​://doi.org/10.3389/fpsyg​.2017.01707​.
Lytle, M., Vaughan, M., Rodriguez, E., & Shmerler, D. (2014). Working with LGBT individuals: Incor-
porating positive psychology into training and practice. Psychology of Sexual Orientation and
Gender Diversity, 1(4), 335–347. https​://doi.org/10.1037/sgd00​00064​.
McFarlane, A. C. (2010). The long-term cost of traumatic stress: Intertwined physical and psychological
consequences. World Psychiatry, 9(1), 3–10.
McLean, K. (2007). Hiding in the closet: Bisexuals, coming out and the disclosure imperative. Journal
of Sociology, 43(2), 151–166. https​://doi.org/10.1177/14407​83307​07689​3.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual popula-
tions: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. https​://doi.
org/10.1037/0033-2909.129.5.674.
Mills-Koonce, W., Rehder, P., & McCurdy, A. (2018). The significance of parenting and parent–child
relationships for sexual and gender minority adolescents. Journal of Research on Adolescence,
28(3), 637–649. https​://doi.org/10.1111/jora.12404​.
Moradi, B., Mohr, J., Worthington, R., & Fassinger, R. (2009). Counseling psychology research on sex-
ual (orientation) minority issues: Conceptual and methodological challenges and opportunities.
Journal of Counseling Psychology, 56(1), 5–22. https​://doi.org/10.1037/a0014​572.
Murr, R. (2013). ‘I became proud of being gay and proud of being Christian’: The spiritual journeys of
queer Christian women. Journal of Religion & Spirituality in Social Work: Social Thought, 32(4),
349–372. https​://doi.org/10.1080/15426​432.2013.83924​1.
National Center for PTSD. (2010). Reterived November 19, 2018, from Understanding PTSD. Recu-
perado de. https​://gafsp​.org/wp-conte​nt/uploa​ds/2013/03/Under​stand​ingPT​SD.pdf.
National Institute of Mental Health. (2017). Post-Traumatic Stress Disorder (PTSD). Retrieved Octo-
ber 15, 2019, from https​://www.nimh.nih.gov/healt​h/stati​stics​/post-traum​atic-stres​s-disor​der-ptsd.
shtml​#part_15546​8.
Nealy, E. (2019). Trans kids and teens: Pride, joy, and families in transition. New York: W.W. Norton &
Company.
Newcomb, M., et al. (2019). The influence of families on lgbtq youth health: A call to action for inno-
vation in research and intervention development. LGBT Health, 6(4), 139–145. https​://doi.
org/10.1089/lgbt.2018.0157.
Owens, G. (2016). Predictors of posttraumatic growth and posttraumatic stress symptom severity in
undergraduates reporting potentially traumatic events. Journal of Clinical Psychology, 72(10),
1064–1076. https​://doi.org/10.1002/jclp.22309​.
Páez, D., Reyes, C., & Villagrán, L. (2012). Evaluación del Crecimiento Postraumático Colectivo en
víctimas de catástrofes humanitarias. Manuscrito: Facultad de Psicología, Universidad del País
Vasco.
Pallotta-Chiarolli, M. (2014). Erasure, exclusion by inclusion, and the absence of intersectionality: Intro-
ducing bisexuality in education. Journal of Bisexuality, 14(1), 7–17. https​://doi.org/10.1080/15299​
716.2014.87245​4.
Pereira-Lima, K., Regina Loureiro, S., Maria Bolsoni, L., Dornela Apolinario da Silva, T., & Lima Oso-
rio, F. (2019). Psychometric properties and diagnostic utility of a Brazilian version of the PCL-5
(complete and abbreviated versions). European Journal of Psychotraumatology, 10(1), 1–9. https​
://doi.org/10.1080/20008​198.2019.15810​20.
Pistella, J., Salvati, M., Ioverno, S., Laghi, F., & Baiocco, R. (2016). Coming-out to family members and
internalized sexual stigma in bisexual, lesbian and gay people. Journal of Child and Family Stud-
ies, 25, 3694–3701. https​://doi.org/10.1007/s1082​6-016-0528-0.
Pollitt, A., Mernitz, S., Russell, S., Curran, M., & Toomey, R. (2019). Heteronormativity in the lives
of lesbian, gay, bisexual, and queer young people. Journal of Homosexuality. https​://doi.
org/10.1080/00918​369.2019.16560​32.
Price, E., & Prosek, E. (2019). The lived experiences of GLB college students who feel supported by
their parents. Journal of GLBT Family Studies. https​://doi.org/10.1080/15504​28X.2019.15932​78.
Reisner, S. L., White Hughto, J. M., Gamarel, K. E., Keuroghlian, A. S., Mizock, L., & Pachankis,
J. E. (2016). Discriminatory experiences associated with posttraumatic stress disorder symptoms

13
1382 C. Zavala, L. Waters

among transgender adults. Journal of Counseling Psychology, 63(5), 509–519. https​://doi.

org/10.1037/cou00​00143​.
Rhoads, R. A. (1995). Learning from the coming-out experiences of college males. Journal of College Stu-
dent Development, 36(1), 67–74.
Roberts, A. L., Austin, S. B., Corliss, H. L., Vandermorris, A. K., & Koenen, K. C. (2010). Pervasive
trauma exposure among US sexual orientation minority adults and risk of posttraumatic stress disor-
der. American Journal of Public Health, 100, 2433–2441. https​://doi.org/10.2105/AJPH.2009.16897​
1.
Root, M. (1992). Reconstructing the impact of trauma on personality. In L. S. Brown & M. Ballou (Eds.),
Personality and psychopathology: Feminist reappraisals (pp. 229–265). New York, NY: Guilford
Press.
Rusk, R., & Waters, L. (2013). Tracing the size, reach, impact and breadth of positive psychology. Journal
of Positive Psychology, 8(3), 207–221.
Ryan, W., Legate, N., & Weinstein, N. (2015). Coming out as lesbian, gay or bisexual: The lasting impact
of initial disclosure experiences. Self and Identity, 14(5), 549–569. https​://doi.org/10.1080/15298​
868.2015.10295​16.
Ryan, C., Russell, S., Huebner, D., & Sanchez, D. (2010). Family acceptance in adolescence and the health
of LGBTQ young adults. Journal of Child and Adolescent Psychiatric Nursing, 23(4), 205–213.
Sağkal, A. (2019). Direct and indirect effects of strength-based parenting on adolescents’ school outcomes:
Exploring the role of mental toughness. Journal of Adolescence, 76, 20–29. https​://doi.org/10.1016/j.
adole​scenc​e.2019.08.001.
Sağkal, A., & Özdemir, Y. (2019). Strength-based parenting and adolescents’ psychological outcomes: The
role of mental toughness. Journal of Psychologists and Counsellors in Schools, 29(2), 177–189. https​
://doi.org/10.1017/jgc.2019.2.
Savin-Williams, R., & Cohen, K. (2015). Gay, lesbian, and bisexual youth. International Encyclope-
dia of the Social and Behavioral Science, 9, 5892–5895. https​://doi.org/10.1016/B978-0-08-09708​
6-8.10203​-X.
Schofield, T. J., Conger, R. D., & Neppl, T. K. (2014). Positive parenting, beliefs about parental efficacy,
and active coping: Three sources of intergenerational resilience. Journal of Family Psychology, 28(6),
973–978. https​://doi.org/10.1037/fam00​00024​.
Shakespeare-Finch, J., & Lurie-Beck, J. (2014). A meta-analytic clarification of the relationship between
posttraumatic growth and symptoms of posttraumatic stress disorder. Journal of Anxiety Disorders,
28, 223–229.
Solomon, D., McAbee, J., Asberg, K., & McGee, A. (2015). Coming out and the potential for growth in
sexual minorities: The role of social reactions and internalized homonegativity. Journal of Homo-
sexuality. https​://doi.org/10.1080/00918​369.2015.10730​32.
Stiles-Shileds, C., & Carroll, R. A. (2015). Same-sex domestic violence: Prevalence, unique aspects, and
clinical implications. Journal of Sex and Marital Therapy, 41(6), 636–648.
Tamashiro, D. (2015). Coming Out. GLBTQ Archives. Retrieved February 5, 2019, from http://www.glbtq​
archi​ve.com/ssh/comin​g_out_ssh_S.pdf.
Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive
legacy of trauma. Journal of Traumatic Stress, 9, 455–471.
Tedeschi, R. G., Calhoun, L. G., & Cann, A. (2007). Evaluating resource gain: Understanding and mis-
understanding posttraumatic growth. Applied Psychology: An International Review, 56(3), 396–406.
https​://doi.org/10.1111/j.1464-0597.2007.00299​.x.
Tsai, J., El-Gabalawy, R., Sledge, W., Southwick, S., & Pietrzak, R. (2014). Post-traumatic growth among
veterans in the USA: Results from the National Health and Resilience in Veterans Study. Psychologi-
cal Medicine. https​://doi.org/10.1017/S0033​29171​40012​02.
Vaillant, G. E. (2002). Aging well. Boston: Little Brown.
Vaillant, G. E. (2012). Triumphs of experience: The men of the Harvard Grant study. Cambridge, MA:
Belknap, Harvard.
Vaughan, M., Parent, M., Tilghman, J., Miles, J., Shim, H., & Prokhoerts, S. (2014). A content analysis of
LGBT-themed positive psychology articles. Psychology of Sexual Orientation and Gender Diversity,
1(4), 313–324. https​://doi.org/10.1037/sgd00​00060​.
Vaughan, M. D., & Waehler, C. A. (2010). Coming out growth: Conceptualizing and measuring stress-
related growth associated with coming out to others as a sexual minority. Journal of Adult Develop-
ment, 17(2), 94–109.
Wandrey, R., Mosack, K., & Moore, E. (2015). Coming out to family and friends as bisexually identified
young adult women: A discussion of homophobia, biphobia, and heteronormativity. Journal of Bisex-
uality, 15(2), 204–229. https​://doi.org/10.1080/15299​716.2015.10186​57.

13
Coming Out as LGBTQ +: The Role Strength-Based Parenting on… 1383

Waters, L. (2015a). The relationship between strength-based parenting with children’s stress levels
and strength-based coping approaches. Psychology, 6, 689–699. https​://doi.org/10.4236/psych​
.2015.66067​.
Waters, L. (2015b). Strength-based parenting and life satisfaction in teenagers. Advances in Social Sciences,
2, 158–173.
Waters, L. (2017). The strength switch. New York: Avery.
Waters, L., Loton, D., Grace, D., Jacques-Hamilton, R., & Zyphur, M. (2019). Observing change over time
in strength-based parenting. Frontiers in Psychology.
Waters, L., Loton, D., & Jach, H. (2018). Does strength-based parenting predict academic achievement? The
mediating effects of perseverance and engagement. Journal of Happiness Studies, 8, 1–20.
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD
Checklist for DSM-5 (PCL-5).
Yakushko, O., & Blodgett, E. (2018). Negative reflections about positive psychology: On constraining the
field to a focus on happiness and personal achievement. Journal of Humanistic Psychology, 2018,
1–28. https​://doi.org/10.1177/00221​67818​79455​1.
Yu, N., Chen, L., Ye, Z., Li, X., & Lin, D. (2017). Impacts of making sense of adversity on depression, post-
traumatic stress disorder, and posttraumatic growth among a sample of mainly newly diagnosed HIV-
positive Chinese young homosexual men: The mediating role of resilience. AIDS Care, 29, 79–85.
https​://doi.org/10.1080/09540​121.2016.12100​7.
Zhang, Y., Xu, W., Yuan, G., & An, Y. (2018). The relationship between posttraumatic cognitive change,
posttraumatic stress disorder, and posttraumatic growth among chinese adolescents after the
Yancheng Tornado: The mediating effect of rumination. Frontiers in Psychology, 9(474), 1–8. https​://
doi.org/10.3389/fpsyg​.2018.00474​.

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