Creating Affirming Environments: A Toolbox to Help Programs Serve LGBTQ+ Relationships Effectively

LGBTQ+ couples share many similarities with heterosexual couples across many characteristics.

• LGBT Americans cite love and companionship as primary motives to marry at rates similar to heterosexual Americans.¹⁵
• Nationally representative data show same-sex couples to be no more likely to break up than heterosexual couples in married or marriage-like unions.¹⁶

However, some important demographic differences may shape interpersonal dynamics.

• Same-sex couples are more frequently in interracial marriages (31.6%) than heterosexual couples (18.4%).¹⁷ This underscores the importance of understanding how intersecting identities may affect romantic relationships as LGBTQ+ individuals may be more likely to represent diversity in multiple aspects of their relationship.
• Same-sex couples are more likely than different-sex couples to each hold at least a bachelor’s degree, and male same-sex couples report higher average incomes than different-sex couples and female same-sex couples.¹⁸ This may reflect that, even among LGBTQ+ populations, gender-based pay inequities may still play a role in shaping the economic trajectories for families.

Children are an important part of LGBTQ+ family life.

• Nationally representative data show that about 15 percent of same-sex couples are currently raising children.¹⁸
•  Female same-sex couples are more likely than male same-sex couples to be currently raising children.¹⁹
• Forty-eight percent of LGBTQ millennials (ages 18-35) plan to grow their families by adding children.²⁰
• Extensive research shows that children of same-gender couples have similar levels of well-being as children raised in different gender households in terms of academic outcomes, family relationships, mental health, social skill development, and other outcomes. ^21,22

LGBTQ+ romantic relationships have more diversity in relationship

• Non-monogamy is more prevalent among LGBTQ+ romantic relationships²³ than heterosexual relationships. Research shows that partners in consensually non-monogamous relationships report high quality and satisfying romantic relationships.^24-26

There tends to be more equitable division of household labor and decision making.

• Studies have found that household labor and responsibilities are often more equally distributed among same-sex couples than among heterosexual couples where these responsibilities fall more heavily on women.^27-29

Some LGB romantic relationships may be “heterosexual-appearing” but contain partners who do not identify as heterosexual.

• For example, bisexual or pansexual people in a romantic relationship may be assumed to be heterosexual, despite their lived experiences in the world as an LGB person. Data from 2020 suggest a slightly higher proportion of LGBT people are married to different-sex partners (11.4%) compared to same-sex partners (9.6%).³⁰

Though not exhaustive, the following terms are important for understanding and communicating with people who identify as LGB.^a Understanding and using the right terminology is an important step toward inclusive programming.³¹ It is important to recognize that language use is dynamic; the meanings and connotations of terminology may change and evolve and may even differ across generations, regions, and cultures. Service providers should be aware of their audiences’ context to use the proper language.³² The following terms reflect our understanding of language use and best practices at the time of publication based on the referenced material.

LGBTQIA+

An acronym for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual- and gender-minoritized identities. This acronym is often shortened to LGBTQ or LGB. Each of the letters included in this acronym are explained in this section.

• Queer: The “Q” in LGBTQIA+. Used as an inclusive/umbrella term for people who do not identify as cisgender and/or heterosexual; may be used broadly to describe LGB people or by an individual to describe their identity. NOTE: Although this was historically used as a derogatory slur, many LGB people and allies use this term today. It should still be used mindfully, especially among older LGB individuals.³³

Terms related to gender identities:

• Cisgender: A person whose gender expression and gender identity are the same as their sex assigned at birth.
• Gender binary: The belief that there are only two gender identities (man/boy and woman/girl) and that everyone belongs to one or the other; it also rejects the idea of any other identities and expressions. Belief in the gender binary also upholds the idea that the two genders are distinct in measurable ways.
• Gender identity: One’s internal self-identification of gender, which may or may not be the same as with one’s gender assigned at birth based on sex characteristics.
• Non-binary: A person who does not identify with a gender that falls into the binary categories of men and women. Some may identify with characteristics of both men and women; some may not identify with either; and others may fall somewhere in between.
• Gender nonconforming: A person whose gender identity/expression do not conform with the culturally or socially expected gender norms (e.g., someone who presents as a masculine woman or a feminine man or someone whose identity is different from or outside of the gender binary).
• Genderqueer: A person who rejects the normative gender categories of men and women. They may identify as neither a man or woman, identify as somewhere between the binary genders, or identify as somewhere outside the gender binary.
• Transgender: The “T” in LGBTQIA+. A person whose gender identity and/or gender expression is different from their sex assigned at birth.

Terms related to sexual identities:

• Asexual: The “A” in LGBTQIA+. An umbrella term to describe a person who experiences little or no sexual attraction to others and/or experiences little or no sexual interests in sexual relationships/behaviors. A person who identifies this way may still be physically, emotionally, romantically, or spiritually attracted to others.
• Bisexual: The “B” in LGBTQIA+. A person who experiences attraction to people of their own gender and another gender.
• Gay: The “G” in LGBTQIA+. A person who is solely or primarily attracted to people of the same gender. Primarily used to describe men who are attracted to other men but is also sometimes used as an umbrella term to describe anyone who identifies with the LGBTQIA+ populations.
• Lesbian: The “L” in LGBTQIA+. Historically, this term has been used to describe a woman who is solely or primarily attracted to other women. However, people of all identities (e.g., trans, gender nonconforming) may choose to identify this way as well.
• Pansexual: A person who is attracted to any gender identity/expression. Gender does not necessarily play a significant role when it comes to attraction. This identity is similar to identifying as bisexual, but pansexual people may be attracted to someone who identifies outside the gender binary.

Terms related to sexual characteristics:

• Intersex: The “I” in LGBTQIA+. A person who is born with a combination of sex characteristics (hormones, chromosomes, gonads, internal sex organs, external genitals) that typically do not fit in the binary definition of male or female.

Words that are helpful for discussing romantic relationships:

• Consensual non-monogamy
  The practice of consensually being involved romantically and/or sexually with more than one partner. People in consensually non-monogamous relationships reject the idea that exclusivity is required for having healthy relationships and may determine unique boundaries and parameters for their relationship. Examples of consensually non-monogamous relationships include swinging, open relationships, and polyamory. For more information on consensually non-monogamous relationships and
  these definitions, see Moors et al. (2023).³⁴
• Heteronormativity
  The cultural belief or assumption that heterosexuality is the normal sexual orientation and is superior to forms of attraction or family formation. It also includes the assumption of gender norms based on one’s sex assigned at birth.

Language tips:

• Use people-centered language.
• Use transgender person/men/women, instead of referring to people as transgenders, transgendered, or transsexual.
• Use assigned female/male at birth, instead of biologically female/male, born female/male, or female-bodied/male-bodied. This language is people-centered and gives people more agency over their identification with their bodies.
  • Use “a gay person” or “a person who is transgender,” instead of using “a gay” or “a transgender.”
• Use gender-inclusive language.
• Use parents-to-be or expectant parents, instead of mom- or dad-to-be.
• Use child or kid, instead of saying daughter/son.
• Use partner, instead of saying husband/wife, boyfriend/girlfriend.

Consider the historical context of the language.

• Instead of saying homosexual, use LGBTQ (or LGB or LGBTQIA)
• For some people, homosexual may be the only term they know to address people who identify as LGB. However, this term is considered outdated and has a disrespectful connotation given its history of being associated with pathology and homophobic prejudice.³⁵ Additionally, queer, once considered a derogatory term, is now being accepted by some LGB people as an encompassing, appropriate way to address the LGB population. Queer may be more appropriate to use with younger individuals or couples. It is most important to let your knowledge of your audience inform your language use.

HMRE providers should be aware of the unique stressors that may affect the lives and relationships of LGBTQ+ participants. In the following paragraphs we introduce minority stress theory as a framework for understanding the experiences of marginalized individuals. We highlight how minority stress can affect relationship characteristics that HMRE programs seek to affect, such as quality, satisfaction, and conflict. Far less work has explored the experiences of romantic relationships among transgender and gender diverse individuals, though they are often subject to higher rates of discrimination in general.³⁶

Minority stress theory (MST)37 remains the most used framework to understand the disparities in health and well-being that affect LGBTQ+ people. MST postulates that LGBTQ+ people experience disproportionate levels of stress due to the marginalization of their identities in society.^37,38 This stress can be caused by external factors—such as discrimination, prejudice, and homophobia—as well as by internal factors—such as internalized shame, internalized homophobia, and fear of rejection resulting from living in environments where one feels their sexual or gender minoritized identity causes others to perceive or treat them differently. LGBTQ+ individuals may internalize others’ negative or discriminatory beliefs such that they become shameful or even feel self-hatred toward their own LGBTQ+ identity.

Minority stress has been studied extensively and is shown to increase the risk of mental health problems, including depression, anxiety, and substance abuse.^38,39Additionally, as highlighted below, minority stress can affect LGB romantic relationships across a range of outcomes.^40-42

Internalized stress can infiltrate romantic relationships and negatively affect relationship satisfaction.¹¹ LGBTQ+ individuals experience disproportionate levels of stress, and individual experiences of minority stressors—such as internalized homophobia and discrimination—have been found to negatively affect relationship quality and relationship satisfaction.^13,43

LGB couples may experience stressors uniquely related to being in a stigmatized romantic relationship. Couple-level experiences of minority stress—such as experiencing discrimination as a couple in public or feeling shame about one’s relationship—can have deleterious effects on romantic relationships.^41,42 For example, experiences of stigma have been shown to affect how close partners feel to
one another.⁴⁰ Additionally, this type of stress can exacerbate conflict between partners 13 and is linked to
worse mental health.⁴¹

Minority stress can create barriers to receiving support from others, including from one’s family
or community. These barriers can introduce additional stressors and sources of conflict for couples. For
example, the rejection (or perceived rejection) of one’s romantic partner by one’s family of origin may lead
to conflict about relationship visibility and commitment and negatively impact the romantic relationship.⁴⁴

Legal or institutional factors that limit where, whether, and how LGBTQ couples can raise children may place additional stress on romantic relationships. For example, it is legal to discriminate against LGB families in 22 states regarding foster care placements. Similarly, 17 states allow discrimination toward LGB families regarding adoption placements and decisions.⁴⁵

Importantly, LGBTQ+ individuals and families demonstrate great resilience and strength in facing and navigating stigma to build healthy and thriving relationships. While recognizing the barriers and challenges that LGBTQ+ romantic relationships may face, it is essential for programs to recognize and leverage these strengths to effectively support relationship health. In existing couple-based HMRE programs, largely targeted to heterosexual couples, promoting relational resilience and protective factors plays an important role in supporting couples’ relationship quality and commitment.⁴⁶ Following are some of the internal and external resilience and promotive factors that research has shown help support healthy relationships among LGBTQ+ people.

Research highlights that acceptance and love for
oneself promotes resiliency and serves as an important cornerstone for building strong romantic relationships. Particularly in the face of experiencing discrimination, LGBTQ+ couples’ and families’ mutual acceptance, respect, and appreciation for each other’s individual characteristics also facilitate building healthy relationships.¹³ At the individual level, having higher self-confidence, self-esteem, self-efficacy,
and self-care all contribute to the demonstration of resilience.^47,48 Specific to same-sex couples, mutual
acceptance, respect, and appreciation for each other’s individual characteristics also facilitate building healthy relationships.¹³

Effective communication and conflict management skills may be especially important for same-sex couples when it comes to navigating challenges presented by minority stress.¹³ Effective conflict management also contributes to same-sex couples’ relationship satisfaction, sense of togetherness, and most importantly, relationship resilience.⁴⁹

Emotional openness, intimacy, and responsiveness are factors that can help LGB couples thrive.

Emotional openness has been identified as one of the factors that can promote LGB individuals’ psychological health.50 Being emotionally open and intimate with one’s partner also facilitates positive outcomes in same-sex couple relationships such as relational resilience and satisfaction.^13,49,51

Social support is vitally important for LGB individuals and their partners. Research shows there is great variability in the levels of support that same-sex couples receive.52 For many who identify as LGB, the choice of coming out also comes with the risk of losing ties and kinship with their families of origin. Chosen family usually refers to close friendships and kinships that fill the roles often filled by biological family members in heterosexual relationships. Support from one’s family of origin and from one’s chosen family are both critical to LGB couples’ well-being,^47,51,53 relationship satisfaction,¹³ and relationship longevity.¹⁴

Connection to LGBTQ+ community is essential. Having access to LGBTQ+-friendly environments, being connected to the LGBTQ+ community, and having access to supportive community resources are all important factors to promote LGBTQ+ families’ resilience and increased well-being.^49,54-56

• American Psychological Association: LGBT Resources for Practitioners

• Approaches to Providing Healthy Marriage and Relationship Education Programming for Lesbian, Gay, and Bisexual Populations: An Exploratory Study

• John Gottman Institute’s Research on Same-Sex Couples

• How Do You Support LGBTQ+ Families in Community Work?

• Simple Solutions to Create Inclusive and Welcoming Training Material

• Understanding the Well-Being of LGBTQI+ Populations

• The Williams Institute

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Rivas-Koehl, M., Wei, M., Scott, M.E., & Wildsmith, E. (2023). Creating affirming environments: A toolbox to
help programs serve LGBTQ+ relationships effectively. Marriage Strengthening Research and Dissemination
Center. https://mastresearchcenter.org/mast-center-research/creating-affirming-environments-a-toolboxto-
help-programs-serve-lgbtq-relationships-effectively/

The authors thank the steering committee of the Marriage Strengthening Research and Dissemination Center (MAST Center), Catherine Schaefer, and Dr. Allen Barton for their feedback on earlier drafts of this toolkit and thank Ria Shelton for her research support.

Editor: Mark Waits
Designer: Catherine Nichols

Matthew Rivas-Koehl is a PhD student in the Department of Human Development and Family Studies at the University of Illinois Urbana-Champaign. His research focuses on promoting health and satisfaction in romantic relationships, particularly for LGBTQ+ families.

Menglin Wei is a PhD student in the Department of Human Development and Family Science at Auburn University. Her research focuses on couple relationships, their health behaviors, and health co-regulation with a focus on relationship education programming and evaluation.

Mindy E. Scott, PhD, is Co-Principal Investigator of the MAST Center and leads the Program Implementation and Evaluation research area. She is a sociologist and family demographer at Child Trends whose primary research interests relate to family formation, family strengthening, responsible fatherhood, and adolescent sexual and reproductive health. Dr. Scott studies the design and implementation of healthy marriage and relationship education programs through several projects focused on youth, diverse family structures and relationships, and fathers.

Elizabeth Wildsmith, PhD, is Co-Principal Investigator of the MAST Center and oversees the Center’s building capacity activities. She is a sociologist and family demographer at Child Trends who studies family formation and reproductive health. Her research examines marriage, cohabitation, and childbearing, as well as how social and family contexts may increase exposure to, or offer protection from, risk factors associated with the negative health and well-being of women, children, and families.