(CNN) When Justine Larson's son came out as transgender at age 11, she didn't know how to react. Despite being supportive of LGBTQ communities, Larson struggled to accept that her child, assigned female at birth, would have a different life than she imagined.
"We didn't give it as much attention as maybe we should have," she said of her and her husband's response. Their child "basically got pretty depressed and even was having some suicidal thoughts."
Feeling conflicted and hurt, Larson eventually realized that she needed to support her son however she could.
About 9.5% of youth ages 13 to 17 in the United States belong to the LGBTQ community, according to a 2020 survey conducted by the Williams Institute at UCLA School of Law. And LGBTQ youth who felt high social support from their families reported attempting suicide at less than half the rate of those who felt low or moderate support, according to The Trevor Project's 2022 National Survey on LGBTQ Youth Mental Health.
The acronym LGBTQ is short for lesbian, gay, bisexual, transgender, and queer, or questioning. The term also includes non-binary people.
Support from parents and caregivers can make an impact on a child's mental health. When a child comes out, parents don't always know what to do and what to say, and that's OK, said Caitlin Ryan, director of the Family Acceptance Project. The main thing is that you are there for your child, she added.
Here are some ways you can support your LGBTQ child's mental health.
When a child comes out, or speaks openly about their LGBTQ identity, it's important to listen to and respect what they have to say.
"You don't have to be an expert on LGBTQ identities and topics to support your LGBTQ child, you just need to discuss LGBTQ issues openly and respectfully," said Amit Paley, CEO and executive director of The Trevor Project, via email.
However, if you aren't ready to have these open conversations, or think that speaking with your child will lead to an argument, it can be helpful to take a step back and focus on learning more about your child's identity, said Michael LaSala, professor of social work at Rutgers University in New Brunswick, New Jersey. He is also author of "Coming Out, Coming Home."
Instead, you can listen respectfully to what your child is saying without interrupting them, punishing them or ridiculing them, Ryan said.
"Even if you're still struggling and are very hesitant, you're saying to your child, 'I love you, I'm here for you, I'm not going to abandon you, and I'm going to learn how I need to care for you as an LGBTQ young person," Ryan said.
When children come out, some parents and guardians initially struggle to understand their child's identity. Additionally, for some parents of transgender or non-binary youth, it can be difficult to adapt to their child's chosen name and pronouns. However, it's important to use a child's chosen name and pronouns regardless of internal emotions, Ryan said.
Just being there for your child and reminding them that you love and care about them can foster a safe and trusting environment. If a parent is unable to accept their child, they run the risk of losing them, LaSala said.
It's essential for parents and caregivers to do the seemingly smaller actions -- which are actually crucial -- like respecting pronouns, one 19-year-old referred to by the pseudonym "Alex" told CNN.
The teenager, who asked to remain anonymous due to not being completely out, uses the gender-neutral or gender-inclusive pronouns zie/zem/zeir.
It's been hard for the teen to come out to zeir mother, especially as non-binary, because the mother often misgenders people and calls them their old names rather than their preferred names. Alex said that is demoralizing to zem.
There is a lot of misinformation about sexual orientation and gender identity, Ryan said, and that can lead to some parents rejecting their child when they come out.
When Larson's son came out, she didn't fully understand what being transgender meant. She said it was important for her to realize that being transgender was not a choice. At first, Larson told her son that he didn't need to decide right away, but she learned more and realized his gender was not a decision.
"This is a journey and where you are now is probably not where you're going to be on this in a couple of years," LaSala said. "Be patient with yourself and keep educating yourself. And, once you're able to calm down, keep the lines of communication open and get as much education (as you can)."
Parents and caregivers may respond to their child coming out with complex emotions, including grief and fear. In some cases, they may express those emotions in ways that sound rejecting. You don't have to be discouraged over these emotions, LaSala said.
Some parents may experience a sense of mourning for their child and the childhood they expected their son or daughter to have. This is especially common for parents of transgender and non-binary children, LaSala added.
A common emotion that people experience once their child comes out is fear, according to Angela Weeks, director of the National SOGIE Center at the University of Maryland School of Social Work in Baltimore. The center promotes the well-being of youth with diverse sexual orientation and gender identity and expression. This fear can stem from a variety of factors, including the fear of losing community, fear of being judged as a parent, fear that their child will have a more challenging life or be discriminated against, and fear of not knowing what to say.
While it's normal to have those fears and concerns, it's important to learn how to deal with those emotions and begin to unpack them away from the child. It's ideal if the nonjudgmental other is equipped to tolerate intolerance, such as a therapist, but it's OK to talk to anyone you feel safe with, LaSala said.
Parents can also join support groups for parents of LGBTQ children, such as the network PFLAG.
Youth in the LGBTQ community often hear negative things about their identities, and parents or caregivers can be a great buffer against some of the negativity, Ryan said. People may mistreat or discriminate against LGBTQ youth in school, religious congregations or other community spaces.
Parents can learn how to advocate for their children, as well as teach them how to protect and advocate for themselves.
Alex said it would be easier to come out if zeir family had created a more supportive environment at home.
"It's important to be able to come home and be like, 'Yes, this is a safe place. This is where people will accept me no matter what,'" Alex said.
Larson said there is no substitute for the acceptance and support of one's parents, and that it was crucial that her son knew that she and her husband accepted and loved their son.
"Your kid is going to take their journey, whether you approve or not," Larson said. "You can help them and support them with it, or you can make it harder for them."