CHAPTER 13

Lesbian, Gay, Bisexual, Transgender,

and Queer Siblings

Dawn M. Szymanski and Angela N. Hilton

Despite the importance of sibling relationships, scant research has been

conducted on siblings where at least one sibling identifies as lesbian,
gay, bisexual, transgender, and/or queer (LGBTQ). In her review of
the research on LGBTQ siblings, Rothblum (2010) noted that sibling
research focused narrowly on identifying causes of sexual orientation (e.g.,
heredity, genetics, hormones) and examining how LGBTQ individuals are
similar to and different from their heterosexual siblings on demographic,
relational, and household task variables. For example, when compared
to their heterosexual siblings, LGB persons report higher educational
attainment, greater geographic mobility, and more liberal political views.
In addition, lesbian and gay couples are more likely to share house-
work and childcare responsibilities evenly and have less contact with their
family of origin than heterosexual couples. Similarly, when compared to
their cisgender sibling, transgender individuals report higher educational
attainment, less support from their parents, and less likelihood of being

D. M. Szymanski (B)
Department of Psychology, University of Tennessee, Knoxville, TN, USA
A. N. Hilton
Department of Behavioral Sciences, Maryville College, Maryville, TN, USA

© The Author(s) 2021 223

A. Buchanan and A. Rotkirch (eds.), Brothers and Sisters,
https://doi.org/10.1007/978-3-030-55985-4_13
224 D. M. SZYMANSKI AND A. N. HILTON

in a partnered relationship. Since Rothblum’s (2010) review, a small but

growing body of research has moved beyond these confines to examine
predictors of coming out to siblings and factors that are associated with
heterosexual siblings’ acceptance and support of their LGBTQ brother or
sister. In addition, it has examined how the coming out process influences
identity, coping, and relationship dynamics among LGBTQ persons and
their siblings. In this chapter, we review findings from this exciting new
area of research and discuss implications for mental health providers and
educators.
Research documents that LGBTQ individuals are coming out to their
heterosexual and cisgender siblings. For example, Salvati et al. (2018)
found that 62% of their sample of Italian lesbian and gay adults had
come out to a sibling. Among United States (U.S.) sexual minority youth
aged 14–21 years, 84% reported that at least one sibling knew of their
sexual orientation (D’Augelli et al. 2008). Similarly, among U.S. LGBTQ
young adults aged 18–24 years, 75% of the siblings knew of the respon-
dents’ minority sexual orientation and/or gender identity (Toomey and
Richardson 2009).
Research indicates that LGBTQ persons often disclosure first to either
their mother or their sibling (Chan 1989; Pistella et al. 2020; Savin-
Williams 2001; Toomey and Richardson 2009). Many find it easier to
come out to their sibling than their parents due to a lack of financial
dependence on their sibling vs parents and less fear about encountering
negative feelings and reactions to the disclosure (Haxhe and D’Amore
2014). Consistent with this, Pistella et al. (2020) found that parents were
more likely to react negatively to Italian lesbian and gay men’s sexual
orientation disclosure than their sibling. In a qualitative study of gay men,
Cain (1991) found that sibling rejection of one’s sexual orientation was
perceived as less distressing than rejection from parents.

Predictors of Coming Out to Siblings

Although some research has examined potential differences in sexual
orientation disclosure to siblings (in general as well as based on the gender
and birth order of the sibling) between lesbians and gay men, the find-
ings are conflicting and not clear (c.f., D’Augelli et al. 2008; Pistella
et al. 2020; Salvati et al. 2018; Toomey and Richardson 2009). Other
research has begun to examine predictors of LGBTQ persons’ disclosure
to their siblings. LGB youth in the U.S. whose siblings did not know of
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 225

their sexual orientation reported meeting sexual identity milestones (i.e.,

awareness of same-sex attractions, self-identification as a sexual minority,
coming out to others) at older ages, more internalized heterosexism (i.e.,
more acceptance of negative attitudes about being LGBTQ), less lifetime
verbal sexual orientation-based victimization from siblings, and more fears
about sibling rejection than those whose siblings did know (D’Augelli
et al. 2008). Among adults, Salvati et al. (2018) found that internalized
heterosexism was related to less sexual orientation disclosure to siblings
but only for gay men, not lesbians living in Italy. Toomey and Richardson
(2009) found LGBTQ young adults were more likely to be out to a
sibling if they perceived the relationship as close and if the sibling also
identified as LGBTQ. In a qualitative study, Harvey (2007) found that
some LGBTQ persons choose to come out to their sibling because of
their close relationship and/or belief that they would respond positively
and to decrease isolation and increase support, guidance, and feelings of
safety.

Predictors of Siblings Reactions to Coming Out

In terms of LGBTQ persons’ perceptions of their sibling reactions to
their coming out, gender of the sibling and quality of the sibling relation-
ship seem to be important. Two studies found that female siblings were
perceived as more accepting than male siblings (D’Augelli et al. 2008;
Toomey and Richardson 2009). LGBTQ youth and young adults who felt
more closeness to their sibling (Toomey and Richardson 2009) and expe-
rienced less lifetime verbal sexual orientation-based victimization from
their sibling (D’Augelli et al. 2008) were more likely to report positive
reactions from siblings concerning their coming out about their sexual
orientation. However, sexual identity milestones and adjustment indica-
tors (i.e., internalized heterosexism, self-esteem, psychological distress)
were not related to LGB youth’s reports of their sibling’s reactions to
their sexual orientation (D’Augelli et al. 2008).
Research exploring transgender persons’ perceptions of their cisgender
sibling’s reaction to the disclosure of their minority gender identity is
scant. We found one quantitative study (Bosse 2019) that investigated
the degree that social support, including sibling acceptance or rejec-
tion, predicted symptoms of depression among transgender young adults.
Results revealed that, when examined together, both perceived parental
226 D. M. SZYMANSKI AND A. N. HILTON

rejection and rejection from siblings uniquely predicted higher levels of

depression among transgender young adults.
Examining heterosexual siblings reports of their acceptance of their
lesbian sister or gay brother, Hilton and Szymanski (2014) found that the
quality of the sibling relationship; having contact with LGBTQ individ-
uals; a liberal political ideology; knowledge of the LGBTQ community
and supporting civil rights; higher level of education; identifying as
female; not having a fundamentalist or orthodox view of religion; and less
church attendance were correlated with higher levels of acceptance. When
these variables were examined together, higher sibling relationship quality,
having contact with LGBTQ individuals, supporting LGBTQ civil rights,
and less church attendance emerged as unique predictors of acceptance.

Sibling Experiences Related

to Sexual Orientation Coming Out
Several qualitative research studies have provided rich, nuanced under-
standings of how the coming out process to siblings influences identity,
experiences, coping, and relationship dynamics among LGBTQ persons
and their siblings. We identified seven studies that focused on LGBTQ
persons coming out about their sexual orientation to their siblings. Four
were published journal articles or book chapters (Haxhe and D’Amore
2014; Haxhe et al. 2018; Hilton and Szymanski 2011; Huang et al. 2016)
and three were unpublished doctoral dissertations (Barrow 2013; English
2008; Harvey 2007). Three studies focused on heterosexual siblings
experiences and included 22 adult participants who had a lesbian sister
(English 2008), 14 White highly educated U.S. adults with a lesbian sister
or gay brother (Hilton and Szymanski 2011), and 10 second-generation
adult Taiwanese and Chinese Americans with a lesbian sister or gay
brother (Huang et al. 2016). Three studies sampled sibling dyads/groups
and included 10 adult U.S. White sibling dyads where one sibling had
disclosed a minority sexual identity to the other at least one year before
the study (Harvey 2007), 102 Belgian adults (19 lesbians, 25 gay men,
and 58 siblings; Haxhe and D’Amore 2014), and six Belgian French-
speaking adults (three White sisters with one being lesbian and three
Romani brothers with one being a gay man; Haxhe et al. 2018). One
study included 15 racial/ethnically diverse adult sexual minority persons
in the U.S. who were the second sibling in their family to come out as
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 227

a LGBTQ (Barrow 2013). There was a remarkable similarity in the find-

ings across these studies. Therefore, we summarize and synthesize the
main finding from these studies below.

Reactions to the Disclosure

Heterosexual siblings reported reacting differently after the initial disclo-
sure or discovery of their sibling’s sexual minority identity. Initial disclo-
sures were most often direct but sometimes heterosexual siblings found
out indirectly or from someone else. Some heterosexual sibling’s felt
negative emotions such as confusion (e.g., not understanding, being
unsure how to respond, uncertain for what this would mean for
their sibling relationship), denial (because they didn’t believe it), shock
(because they had no idea), ambivalence (wrestling with love for their
sibling while holding negative attitudes towards LGBTQ persons), embar-
rassment, disappointment, devastation, and loss (Harvey 2007; Hilton
and Szymanski 2011; Huang et al. 2016). Some heterosexual siblings
felt that they couldn’t relate to their LGBTQ sibling because it felt so
different/foreign to them which often led to increased distance in the
sibling relationship (Hilton and Szymanski 2011). Others reported expe-
riencing hurt and anger because they felt betrayed and lied to (Huang
et al. 2016), felt the sibling withdraw from them prior to the disclo-
sure when they were most likely trying to figure out and come to terms
with their sexual minority identity (English 2008), or didn’t like the way
they found out, typically when it was not directly disclosed by the sibling
(Havey 2007). For some, feelings of abandonment and loss persisted
because they felt left out of their LGBTQ sibling’s life long after the
initial disclosure (English 2008).
Some heterosexual siblings expressed anxiety, protectiveness, and/or
concern about their LGBTQ sibling’s physical and psychological well-
being due to sexual orientation-based stigma in the larger culture
that often manifests in prejudice, discrimination, and violence towards
LGBTQ persons (English 2008; Harvey 2007; Hilton and Szymanski
2011). Other heterosexual siblings reacted with nonchalance or indif-
ference because they were not surprised or negatively impacted by the
disclosure (Huang et al. 2016). This relates to two other studies that
found that many heterosexual siblings reported some awareness that their
sibling might be a sexual minority either before they came out or shortly
228 D. M. SZYMANSKI AND A. N. HILTON

after via hindsight and reflection (Harvey 2007; Hilton and Szymanski
2011). Suspecting that their sibling might be a sexual minority was often
based on gender-related stereotyping of lesbian and gay persons, their
sibling’s lack of romantic relationships with a person of a different gender,
and/or their sibling being perceived by others as lesbian/gay.
Other heterosexual sibling’s reported positive feelings and reactions
to finding out about their sibling’s sexual orientation. They described
supporting and accepting their LGBTQ sibling which resulted in happi-
ness, excitement, relief, and acceptance for both the heterosexual and
LGBTQ sibling (English 2008; Harvey 2007; Hilton and Szymanski
2011; Huang et al. 2016). Other benefits, particularly for the LGBTQ
sibling, included decreased isolation, being able to share previously
hidden aspects of themselves, and increased self-efficacy about being more
“out” to others (Harvey 2007).
For those not reporting immediate acceptance of their sibling’s sexual
orientation, some were able to become accepting over time, whereas
others still struggled with coming to terms with their sibling’s sexual
orientation (Hilton and Szymanski 2011; Huang et al. 2016). Hetero-
sexual siblings who reported becoming more comfortable with their
sister/brother’s sexual minority identity overtime attributed this to
engaging in self-reflection, increasing their awareness and knowledge of
LGBTQ issues, increasing exposure to their LGBTQ sibling’s lives and
the LGBTQ community, realizing their own heterosexist attitudes, and a
growing understanding of heterosexual privilege (English 2008; Harvey
2007; Hilton and Szymanski 2011; Huang et al. 2016). Heterosexual
siblings often confronted, and had to work through, difficulties associ-
ated with handling their LGBTQ sister/brother’s level of outness and
public displays of affection with their romantic partner (Harvey 2007).
In addition, openly discussing sexuality, integrating same-sex partners into
the family, and questions about family allegiances emerged as challenges
(Harvey 2007). Acknowledging differing cultural experiences and facing
conflicting cultural and/or religious beliefs was also part of the process,
particularly for religious and racial/ethnic minority siblings (Huang et al.
2016).
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 229

Changes in Sibling Relationship

Research indicates that the impact of the coming out process on the
sibling relationship can be negative, unchanged, or positive (Harvey
2007; Hilton and Szymanski 2011). Hilton and Szymanski (2011) found
that these changes often mimicked the pre-existing relationship. That is, if
the sibling relationship was close prior to disclosure, the sibling relation-
ship was typically strengthened and improved as a result of the disclosure.
If the sibling relationship was negative or distant before disclosure, the
disclosure often amplified this tension, conflict, and disengagement. For
those experiencing positive changes, participants reported feeling closer
to their sibling, spending more time together, increasing communica-
tion and openness, using better communication skills (e.g., intentional
listening), talking about sensitive or previously taboo topics, and for
heterosexual siblings being more aware and empathetic towards LGBTQ
issues and experiences (Haxhe and D’Amore 2014; Harvey 2007; Hilton
and Szymanski 2011). For some, increased closeness was directly related
to sexuality, especially for siblings that included a heterosexual sister and
gay brother because they bonded over “girly” things and the fact that
they both liked men (Harvey 2007; Hilton and Szymanski 2011). More
closeness also occurred when the heterosexual sibling was the first, or one
of the few, to learn about their sister/brother’s sexuality (Harvey 2007;
Huang et al. 2016) and/or they were a supportive ally in a heterosexist
context (Harvey 2007).
For sisters/brothers who were the second sibling in their family to
come out as a LGBTQ, they described feelings of appreciation and respect
for their LGBTQ sibling who was the first to come out (Barrow 2013).
Many reflected that watching their sibling come out provided them with
the courage to do it themselves. They described a deep understanding
about being LGBTQ that the two siblings shared and the positive impact
that this had on them and their relationship.

Navigating Family Dynamics and Reactions to Disclosure

Some heterosexual siblings provided vital support for their LGBTQ
sibling’s sexual minority identity and/or for coming out to other
members of the family either through encouragement or mere visible
presence when the disclosure occurred (Haxhe and D’Amore 2014;
230 D. M. SZYMANSKI AND A. N. HILTON

Haxhe et al. 2018; Huang et al. 2016). Navigating tricky family dynamics
emerged for siblings in families where the LGBTQ sibling had disclosed
to some but not all family members, or there was a discomfort with
sexuality in general within the family (Harvey 2007). This often led
to constrained or uncomfortable communication within the family. For
example, if parents were not aware of their child’s LGBTQ identity,
this stunted the relationship between their heterosexual sibling and the
parents because it was something they needed to keep secret.
Navigating challenging family dynamics also emerged for siblings in
families when other family members reacted negatively to the disclo-
sure (English 2008; Harvey 2007; Haxhe and D’Amore 2014). Some
heterosexual siblings reported feeling angry, frustrated, resentful, and
disappointed with these family members which often resulted in rela-
tional strain (English 2008; Hilton and Szymanski 2011; Huang et al.
2016). Others were placed in a mediator role, providing support not
only to their LGBTQ sibling, but also to their parents (Harvey 2007;
Haxhe and D’Amore 2014) and serving as a go-between their LGBTQ
sibling, parents, and other siblings. Some heterosexual siblings helped ease
parental fears, reduce conflict/tension between family members, increase
communication, challenge family members heterosexist/heteronormative
beliefs, promote acceptance of the LGBTQ family member, facilitate new
ways of relating within the family system, and celebrate growth (Harvey
2007; Haxhe and D’Amore 2014; Haxhe et al. 2018).

Coming Out as a Sibling of a LGBTQ Brother/Sister

For heterosexual siblings who reacted positively to their sister/brother’s
coming out, many reported that they became more open-minded and
accepting of others in general, as well as to LGBTQ persons (Harvey
2007; Hilton and Szymanski 2011; Huang et al. 2016). Many were
willing to disclose to others that they were the sibling of a LGBTQ sister
or brother. Strategies used to come out to others as a sibling of a LGBTQ
sister/brother included getting to know others to determine if they would
be affirming, waiting until they felt ready, being direct, and using humour
(English 2008; Harvey 2007; Hilton and Szymanski 2011). Many hetero-
sexual siblings reflected that they distanced themselves from people who
were not LGBTQ supportive, were more willing to challenge others who
made heterosexist remarks, and became politically and socially engaged as
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 231

LGBTQ allies and advocates (Harvey 2007; Hilton and Szymanski 2011;
Huang et al. 2016).

Sibling Experiences Related

to Gender Identity Coming Out
Two qualitative, unpublished doctoral dissertation studies focused on
disclosure about one’s gender minority identity in the sibling relation-
ship. Bartel (2012) interviewed seven transgender women, one gender
non-binary individual, and one cisgender sibling; whereas, Davis (2018)
focused solely on the experiences of 11 cisgender siblings. For the trans-
gender women and gender non-binary participants, perceptions of the
closeness of their sibling relationship were instrumental in predicting
whether or not their disclosure would lead to acceptance of their gender
identity (Bartel 2012). Those who believed they had a close relationship
were more likely to believe that their gender identity disclosure would
be accepted, whereas those who felt that the relationship was fractured
in some way were less likely to expect acceptance (Bartel 2012). Further-
more, cisgender siblings revealed the closeness and open-mindedness of
their overall family system influenced their ease in adjusting to their
transgender sibling’s disclosure (Davis 2018).
Despite most of the participants experiencing worry and fear before
disclosure, results indicated that they were mostly provided acceptance
(Bartel 2012; Davis 2018). Transgender women who did not experi-
ence immediate acceptance from at least one of their siblings, noted that
conservative religious views seemed to influence their sibling’s decision
and the lack of acceptance led to a fractured sibling relationship (Bartel
2012). Although cisgender siblings reported feeling surprised, shocked,
sad, and confused by the disclosure, they also noted experiencing relief
in knowing as well as sympathy and empathy for their sibling (Bartel
2012; Davis 2018). Some also described worrying about their transgender
sibling’s overall well-being, feelings of uncertainty regarding their future,
yet also viewing the transition as a positive for their quality of life (Davis
2018).
In Davis’ (2018) study, cisgender siblings recounted that, after their
sibling’s disclosure, they gained a new, even broader, conceptualization
and awareness of gender diversity and adjusted fairly easily to the use of
chosen pronouns, names, and physical changes. Most reported a greater
232 D. M. SZYMANSKI AND A. N. HILTON

understanding of the discrimination and other issues that gender non-

conforming individuals face and an awareness of their own privilege as
a cisgender individual. Almost half reported feeling the need to take on
the role as the protector of their transgender sibling from discrimina-
tion, bullying, and gender-minority stress. Additionally, several cisgender
siblings believed they provided an important source of emotional and
instrumental (e.g., helping them access trans-affirmative information and
organizations) support for both their transgender/gender non-binary
sibling and their parents (Davis 2018).
Transgender and gender non-binary siblings also reported that accep-
tance after their disclosure led to greater social support and increased
satisfaction with their lives (Bartel 2012). Importantly, for both the
cisgender and transgender sibling, acceptance led to deepening the
closeness of their sibling relationship (Bartel 2012; Davis 2018).

Limitations and Directions for Future Research

Research on LGBTQ siblings is in its infancy and much more research
is needed in this area. Studies that have been conducted have utilized
small sample sizes and are largely qualitative and descriptive. Most use
convenience samples that are likely to include siblings who are more
likely to be accepting of their sister/brother’s sexual orientation and/or
gender minority identity and that focus on the experiences of the hetero-
sexual or cisgender sibling rather than the LGBTQ’s sibling perspective.
More research is warranted on siblings who are not accepting of their
sister/brother’s sexual orientation and/or gender identity. Additionally,
research focusing on the LGBTQ’s siblings perceptions of their hetero-
sexual or cisgender sister or brother’s reaction to their coming out and its
impact on them and the sibling relationship is needed. Furthermore, the
majority of research has focused on lesbian and gay issues. Sibling issues
related to bisexuality and gender minority identities and expressions also
needs to be explored. With the exception of Huang et al.’s (2016) study
using Asian American siblings, samples used have been predominately or
exclusively White. Thus, research using racial/ethnic minority siblings is
needed.
Future research might examine additional correlates of coming out
to a sibling as LGBTQ, such as religious involvement, involvement in
LGBTQ activism, identity salience, and stigma consciousness. Similarly,
investigations that identify other correlates of heterosexual and cisgender
siblings’ acceptance of their LGBTQ sister or brother, as well as potential
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 233

mediators and moderators in the relationship between LGBTQ sibling

disclosure and acceptance by the heterosexual or cisgender sibling is
warranted. Longitudinal research that follows siblings over time would
provide more information about the developmental processes that siblings
go through in navigating coming out processes and how it impacts well-
being and the sibling relationship. Quantitative studies are needed to
examine if the quality of the sibling relationship and heterosexual and
cisgender sibling acceptance serve as protective factors against internal-
ized oppression and mental health risks for LGBTQ individuals who
have experienced parental rejection and sexual orientation and gender
identity-based discrimination (Hilton and Szymanski 2014).

Practice Implications
Taken together, the findings from existing research examining sibling rela-
tionships where at least one sibling is LGBTQ provides useful information
for practitioners, including mental health providers and educators. The
findings provide insight when working with LGBTQ individuals who are
in the coming out process, heterosexual and/or cisgender siblings who
are coming to terms with their LGBTQ sibling coming out, and sibling
dyads. They also offer directions for training, education, and advocacy
interventions.
When working with LGBTQ individuals who are in the coming out
process, therapists might consider siblings as a potential source of support.
In deciding whether or not to come out to a sibling, a therapist might
ask the LGBTQ client questions about the level of closeness in the
sibling relationship, how siblings have handled conflict within their rela-
tionships, the religious beliefs of the sibling, their sibling’s attitudes
towards LGBTQ issues, whether they have had exposure to LGBTQ
individuals, and their racial/ethnic cultural family values to help them
in the decision-making process (Bartel 2012; Harvey 2007; Huang et al.
2016). Exploring potential costs (e.g., rejection, worsening of the sibling
relationship) and benefits (e.g., relief, increased quality of the sibling
relationship, improved mental health, and well-being) of coming out to
their sibling might be helpful. Therapists might also assess the LGBTQ
client’s level of internalized heterosexism/cissexism that might be related
to disclosure issues and challenge negative attitudes about being LGBTQ
that might be present (Kashubeck-West et al. 2008).
234 D. M. SZYMANSKI AND A. N. HILTON

When working with heterosexual and/or cisgender sibling who are

coming to terms with their LGBTQ sibling coming out, therapists might
first focus on assessing whether the sibling is expressing ambivalence,
rejection, or acceptance, as this will provide direction for further ther-
apeutic work in this area. It is imperative that therapists normalize,
validate, and provide a safe space for the heterosexual and/or cisgender
sibling to explore feelings of discomfort, shame, grief, confusion, shock,
decide whether/how to share their sibling’s identity with others, and/or
discuss concerns about family dynamics and the sibling relationship (Davis
2018; Hilton and Szymanski 2011, 2014). Therapists might take into
consideration and explore with heterosexual and/or cisgender sibling
clients the level of closeness in their sibling relationship and how her/his
religious beliefs, political affiliation, and exposure to the LGBTQ commu-
nity may influence their reactions (Davis 2018; Hilton and Szymanski
2011, 2014). For siblings struggling to accept their sister or brothers
sexual or gender minority identity, therapists might teach emotional
regulation skills, help them explore their values and beliefs, especially if
these are conflicting, and challenge heterosexist and cissexist attitudes
(Huang et al. 2016; Hilton and Szymanski 2014). Increasing connec-
tion with their LGBTQ sibling, gaining LGBTQ affirmative informal
(e.g., friends) and formal (organizations such as Parents and Friends of
Lesbians and Gays) support, and increasing knowledge about and expo-
sure to LGBTQ issues/communities might also be helpful (Davis 2018;
Hilton and Szymanski 2011, 2014).
For siblings who are accepting, therapists can highlight the important
role they can play in providing emotional and instrumental support to
their sibling and being a LGBTQ ally and advocate. Therapists might also
attend to the unique issues that may arise for the heterosexual and/or
cisgender sibling, particularly negative reactions to family members who
are not accepting, anxiety and worry related to trying to protect their
LGBTQ sibling from discrimination, and stress associated with serving
as a mediator between their LGBTQ sister/brother and other family
members (Huang et al. 2016; Davis 2018). Empathetic responding to the
heterosexual and/or cisgender sibling’s feelings, teaching them effective
communication and conflict resolution skills, and encouraging self-care
and boundary setting may be useful interventions.
Therapists might also consider working with siblings in dyads/groups.
In this work, therapists might facilitate each sibling sharing their experi-
ences and feelings with each other, fostering dialogue, and encouraging
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 235

perspective taking by considering the other’s feelings and point of view

(Bartel 2012; Haxhe and D’Amore 2014). A therapist could encourage
consistent contact and teach effective communication skills such as inten-
tional listening, paraphrasing, reflecting feelings, providing empathy and
compassion, and asking open-ended questions as a way of promoting
sibling relationship quality (Davis 2018; Harvey 2007). Therapists might
also help siblings discuss and navigate potential problems that might
arise such as family loyalty issues, differing levels of comfort with being
out, how to incorporate romantic partners into the family, adjusting to
gender transitions, and dealing with other family member’s negative reac-
tions (Davis 2018; Harvey 2007; Haxhe and D’Amore 2014; Hilton and
Szymanski 2011; Huang et al. 2016).
Beyond the therapy room, mental health professionals and educators
might incorporate the research reviewed above into relevant undergrad-
uate and graduate courses (e.g., life span development, multicultural
psychology, couples and family counselling), training of mental health
professionals, and support groups and outreach programmes for siblings
and/or families. Outreach programmes targeting heterosexual and/or
cisgender siblings who may be more likely to react negatively to sexual
orientation and gender minority identity disclosure such as men, reli-
giously orthodox or fundamentalist individuals, those who are politically
conservative, and/or lack knowledge or contact with LGBTQ individuals
might be fruitful (Hilton and Szymanski 2014). We offer these as exam-
ples, but there are many ways that practitioners can work to increase the
public’s knowledge about and support for LGBTQ individuals and their
siblings.

References
Barrow, K. M. (2013). When a second child comes out as LGBT: Examining sibling
relationships and family [Unpublished doctoral dissertation]. Virginia Tech
University.
Bartel, C. M. (2012). Relational factors influencing self-disclosure of gender iden-
tity in sibling relationships [Unpublished doctoral dissertation]. The Chicago
School of Professional Psychology.
Bosse, J. (2019). Transgender young adults, sibling relationships, and
mental health [Unpublished doctoral dissertation abstract]. University
of Massachusetts-Amherst. https://scholarworks.umass.edu/dissertations_2/
1566.
236 D. M. SZYMANSKI AND A. N. HILTON

Cain, R. (1991). Relational contexts and information management among gay

men. Families in Society, 72, 344–352. https://doi.org/10.1177/104438949
107200603.
Chan, C. S. (1989). Issues of identity development among Asian-American
lesbians and gay men. Journal of Counseling and Development, 68, 16–20.
https://doi.org/10.1002/j.1556-6676.1989.tb02485.x.
D’Augelli, A. R., Grossman, A. H., & Starks, M. T. (2008). Families of gay,
lesbian, and bisexual youth: What do parents and siblings know and how do
they react? Journal of GLBT Family Studies, 4, 95–115. https://doi.org/10.
1080/15504280802084506.
Davis, S. (2018). Examining the experience of trans identity and gender tran-
sition through the lens of cisgender siblings: A phenomenological investigation
[Unpublished doctoral dissertation]. Simon Fraser University.
English, K. (2008). Siblings of lesbian sisters: Conceptually mapping their roles and
experiences throughout the family’s coming-out process [Unpublished doctoral
dissertation]. Chestnut Hill College.
Haxhe, S., & D’Amore, S. (2014). Siblings in the coming-out process. In H.
Pereira & P. Costa (Eds.), Coming-out for LGBT: Psychology in the current
international scenario (pp. 298– 305). Libson, Portugal: University of Beira
Interior.
Haxhe, S., Cerezo, A., Bergfeld, J., & Walloch, J. C. (2018). Siblings and the
coming-out process: A comparative case study. Journal of Homosexuality, 65,
407–426. https://doi.org/10.1080/00918369.2017.1321349.
Harvey, R. G. (2007). The experience of disclosure of queer identity within sibling
dyads [Unpublished doctoral dissertation]. Syracuse University.
Hilton, A. N., & Szymanski, D. M. (2011). Family dynamics and changes in
sibling of origin relationship after lesbian and gay sexual orientation disclosure.
Contemporary Family Therapy, 33, 291–309. https://doi.org/10.1007/s10
591-011-9157-3.
Hilton, A. N., & Szymanski, D. M. (2014). Predictors of heterosexual siblings’
acceptance of their lesbian sister or gay brother. Journal of LGBT Issues in
Counseling, 8, 164–188. https://doi.org/10.1080/15538605.2014.895664.
Huang, J., Chen, E. C., & Ponterotto, J. G. (2016). Heterosexual Chinese
Americans’ experiences of their lesbian and gay sibling’s coming out. Asian
American Journal of Psychology, 7, 147–158. https://doi.org/10.1037/aap
0000051.
Kashubeck-West, S., Szymanski, D. M., & Meyer, J. (2008). Internalized hetero-
sexism: Clinical implications and training considerations. The Counseling
Psychologist, 36, 615–630. https://doi.org/10.1177/0011000007309634.
Pistella, J., Caricato, V., & Baiocco, R. (2020). Coming out to siblings and
parents in an Italian sample of lesbian women and gay men. Journal of Child
 13 LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUEER SIBLINGS 237

and Family Studies, 29, 2916–2929. https://doi.org/10.1007/s10826-019-

01597-0.
Rothblum, E. D. (2010). Lesbian, gay, bisexual and transgender siblings. In J.
Caspi (Ed.), Sibling development: Implications for mental health practitioners
(pp. 123–145). New York, NY: Springer.
Salvati, M., Pistella, J., Ioverno, S., Laghi, F., & Baiocco, R. (2018). Coming out
to siblings and internalized sexual stigma: The moderating role of gender in a
sample of Italian participants. Journal of GLBT Family Studies, 14, 405–424.
https://doi.org/10.1080/1550428X.2017.1369916.
Savin-Williams, R. C. (2001). Mom, dad. I’m gay. Washington, DC: American
Psychological Association.
Toomey, R. B., & Richardson, R. A. (2009). Perceived sibling relationships of
sexual minority youth. Journal of Homosexuality, 56, 849–860. https://doi.
org/10.1080/00918360903187812.