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ObjectiveThe present study expands the use of ambiguous loss theory into the realm of religion and religious rejection for sexual‐ and gender‐minority people, an area that has previously been addressed primarily as an issue of minority stress.BackgroundResearch has demonstrated that religion‐based, nonaffirming messaging from family and faith communities is correlated with decreased health and well‐being of sexual‐ and gender‐minority persons, who are, like most Americans, likely to have been raised in religious (predominately Christian) homes. Existing research has begun to explain why nonaffirming faith affiliation seems to negatively impact sexual gender minority people, but it does not explain the mechanisms of long‐term distress.MethodsThis study is a qualitative thematic analysis of religion and family data from semistructured interviews with 63 transgender youth from the United States, Canada, and Ireland who reported being raised in religious Christian homes.ResultsAnalysis revealed that the narratives of participants who had been members of a psychological family of faith included all of the core elements of ambiguous loss, suggesting that individuals can experience ambiguous loss in relationship to a faith community and to God.DiscussionThis study presents a new application of Boss's ambiguous loss theory and offers a framework for understanding why sexual‐ and gender‐minority people from Christian backgrounds might experience long‐term distress in relation to faith and spirituality whether they stay in their faith communities of origin or move on to something else.ImplicationsThe experiences of transgender people examined through the framework of ambiguous loss and the concept of the psychological family of faith could be applied to research with people from any demographic in relation to loss of faith or faith community. This information may contribute to the study of family ruptures that occur as a result of family experiences of ideological or moral incompatibility (e.g., deconversion, political realignment, leaving a cult).

Abstract
Religious mental health practitioners who hold traditional views of gender and sexuality may face moral and ethical dilemmas when working with sexual and gender minority (SGM) clients. Typical responses to this dilemma include selective positioning, values-based referrals, and attempted objectivity. Grounded in social work ethics and values, this article examines the evidence base, viability, and repercussions of these approaches. This article demonstrates the importance of cultural competence and affirmative therapeutic practices for religious mental health practitioners, whether or not they expect to work with gender and sexual minority clients or their families. In addition, the author tackles the difficult issue of providing ethical, evidence-based therapeutic services for religiously conservative parents of SGM children and adolescents. SGM people exist in every community, in every faith, and in every kind of family. The ethical treatment of SGM clients is relevant to all mental health practitioners, regardless of personal values or the type of practice they maintain.

ObjectiveTo explore family boundary ambiguity in the parent–child relationships of transgender youth.BackgroundTransgender youth may perceive a lack of clarity about whether parents will accept their authentic gender expression, continue to support them physically and emotionally, and regard them as a member of the family. Uncertainty about being in or out of the family and whether family relationships endure is stressful and can lead to psychological distress, a sense of ambiguous loss, and frozen grief.MethodEthnographic content analysis was conducted based on interviews with 90 transgender youth recruited from community centers in 10 regions across 3 countries.ResultsNarratives revealed that transgender youth experienced family boundary ambiguity related to relational ambiguity, structural ambiguity, and identity ambiguity. Each experience of ambiguity obscured whether participants remained in the family and interpersonally connected to their parents.ConclusionTransgender youth actively navigated complex and ambiguous parent–child relationships whereby participants attempted to reconcile their need for authentic gender expression combined with their need for family connectedness and acceptance.ImplicationsFamily clinicians, educators, and policymakers are urged to consider family and transgender resilience through a lens of ambiguous loss and to promote a gender‐affirmative life‐span approach to clinical care for transgender individuals and their families.

Family courts have lacked familiarity with evidence‐based recommendations regarding the best interests of transgender and gender‐nonconforming (TGNC) children, resulting in some affirming parents losing physical and/or legal custody. This exploratory, qualitative study with 10 affirming mothers of TGNC children who had experienced custody‐related challenges reported on salient themes, including "blame" for causing children's gender nonconformity, coercion by ex‐partners, bias in the courts, negative impact on children, emotional and financial toll on participants, and the critical importance of adequate resources. Findings indicate the need for better‐educated family court professionals, as well as socioemotional support and financial and legal assistance for affirming parents of TGNC children.

In this article, we use an ambiguous loss framework to guide a process for decentering cisnormativity (the assumption that biological sex and gender are aligned) within families, specifically for those experiencing the gender identity transitions of family members. Individual family members have varied experiences with regard to gender transition and may or may not experience ambiguous loss depending on their position within the family system. Trans* persons themselves may also experience ambiguous loss as a result of the dialectical tension of acceptance and rejection by family members. We apply resilience processes developed for work with persons facing ambiguous loss to support trans* persons and their families as they navigate gender transitions.

The presence of a trans* family member can challenge existing theoretical notions about the development of gender in families. Emerging knowledge about trans* identities consolidates around 5 primary challenges to existing theoretical notions of gender: (a) non‐dimorphic sex, (b) nonbinary gender, (c) the biological and social construction of gender, (d) gender identity development, and (e) family meaning making about transgender identity. These challenges structure an examination of hetero‐ and cisnormative expectations within family theory and help unpack long‐standing tensions between essentialist and social constructionist views of gender development. This can play out in family theory through a recognition of the tension between upholding and decentering cisnormativity within families. This article pinpoints locations where current family theories require reexamination and expansion to accurately conceptualize the flexibility and variability of families with trans* members.

ObjectiveTo understand which aspects of residential communities are most salient for determining whether sexual minority parents classify their residential community climates as tolerant versus supportive.BackgroundMetropolitan hubs for lesbian, gay, and bisexual (LGB) parents are well established, but less is known about nonmetropolitan community climates for LGB parents. Residential community climate toward nonmetropolitan LGB persons may be particularly important to LGB parents because of the potential influences on child and family well‐being.MethodOpen‐ and closed‐ended survey data from a sample of 55 LGB parents were collected along with publically available data regarding their residential communities. Self‐reported residential community climate (tolerant vs. supportive) and community involvement, as well as objective county and municipal climate were analyzed.ResultsCompared with LGB parents who perceived their communities to be tolerant (n = 38), parents who considered their residential communities to be supportive (n = 17) were more likely to live in counties characterized by legal support and broad social acceptance, were personally more likely to participate in LGB‐focused social and political activities, had children with more exposure to other LGB families, and attended church less frequently.ConclusionHaving basic features of equity such as city ordinances and LGB organizations provides a foundation for tolerance in a community; however, individuals in a community must access personal and social supports and activities beyond work and church to feel truly supported.ImplicationsLGB parents' perceptions of climate reveal specific community features that need to be strengthened to promote family well‐being.

Through their participation in youth programs, young people have access to opportunities to learn and build important skills. A total of 214 youth between the ages of 10-19 (mean 15.5 years) completed an online survey about characteristics of youth programs they participated in, didn't participate in, and had participated in but quit. We found that youth participated in activities that provided a benefit to meet personal goals or develop skills. However, our findings suggest that youth may leave activities, or never join them, based on different sets of motivations than the reasons they stay in activities. There was variability across demographic groups: Males reported more problems with past activities, sexual minority youth were more likely to endorse social problems with past and never joined activities, and ethnic minorities reported less support for personal goals and connection to adults in current activities and more logistic barriers for activities never joined.

Through their participation in youth programs, young people have access to opportunities to learn and build important skills. A total of 214 youth between the ages of 10-19 (mean 15.5 years) completed an online survey about characteristics of youth programs they participated in, didn't participate in, and had participated in but quit. We found that youth participated in activities that provided a benefit to meet personal goals or develop skills. However, our findings suggest that youth may leave activities, or never join them, based on different sets of motivations than the reasons they stay in activities. There was variability across demographic groups: Males reported more problems with past activities, sexual minority youth were more likely to endorse social problems with past and never joined activities, and ethnic minorities reported less support for personal goals and connection to adults in current activities and more logistic barriers for activities never joined.