"I Have No Idea What's Going On Out There:" Parents' Perspectives on Promoting Sexual Health in Lesbian, Gay, Bisexual, and Transgender Adolescents.

Lesbian, gay, bisexual, transgender, and other sexual and gender minority (LGBTQ) adolescents experience higher rates of negative sexual health outcomes relative to their heterosexual and cisgender peers. Healthy parent-adolescent relationships and effective parenting are robust predictors of sexual health in heterosexual adolescents, but very little is known about barriers to and facilitators of effective parenting from the perspective of parents of LGBTQ adolescents. This study conducted online focus groups with 44 parents of LGBTQ adolescents in order to describe the factors influencing effective sexual health communication and parental monitoring in this population. Parents described generally positive relationships with teens, but many noted they went through a transition process in which they struggled with their child's identity and were less supportive of their LGBTQ teen. Lack of understanding about LGBTQ-specific sexuality was a commonly endorsed barrier to effective communication, and this was most commonly endorsed by parents of cisgender girls. Parents of cisgender boys and transgender/gender-nonconforming teens described fears about long-term sexual health (i.e., sexual predators, consent) as a barrier to parental monitoring. Parents of LGBTQ adolescents need information and skills to optimize their teen's sexual health. Parent-based programs for LGBTQ adolescents are long overdue for addressing these issues.