Who Really Counts as Family? New LGBTQ+ Study Reveals the Power of Unconditional Love

Family is often defined by the people we are born into, but new research involving 748 LGBTQ+ people in Britain and the United States suggests that the relationships individuals value most cannot always be explained by biology. Unconditional love, acceptance and dependable support emerged as important elements of how participants understood family, raising questions about whether healthcare services and wider society adequately recognise the people someone relies upon during difficult periods.

Published on 3 November 2026 in BMC Public Health, the study examined social support, mental healthcare and suicide prevention through the experiences of LGBTQ+ participants. Its findings offer an insight into chosen family, a concept with particular historical significance within LGBTQ+ communities, while exploring how personal relationships might inform more compassionate and responsive mental health services.

The research does not suggest that biological relationships are less valuable than friendships or that LGBTQ+ people universally experience rejection from relatives. Instead, it highlights the importance of understanding family through the quality of relationships, including the emotional security, practical assistance and sense of belonging individuals receive from those around them.

What did researchers discover about family and support?

The research team, led by Alicia A. Dahl, collected written responses from LGBTQ+ participants in the United Kingdom and United States using an online survey. Participants were asked about improving mental health services, seeking support during suicidal thoughts or behaviour, and their understanding of family, allowing researchers to examine how these experiences were connected.

Rather than limiting respondents to predefined descriptions of family, the researchers used qualitative analysis to identify recurring themes within their accounts. They developed 29 analytical codes, enabling them to examine how participants described relationships, support and healthcare needs while exploring differences associated with gender identity, openness about LGBTQ+ identity and geographic location.

Unconditional love emerged as a prominent feature of how participants defined family, regardless of whether relationships involved biological relatives. This is significant because conventional discussions of family support often assume that parents, siblings or other relatives are the people someone will approach first when experiencing difficulties.

For some LGBTQ+ individuals, that assumption may be entirely appropriate because they enjoy close and supportive relationships with their relatives. Others may have developed equally meaningful connections with friends, partners or community members, while some rely on a combination of biological and chosen family for companionship, practical assistance and emotional reassurance.

Chosen family has a long history within LGBTQ+ communities, particularly during periods when discrimination and social exclusion made it difficult for people to live openly. Friendships, community organisations and LGBTQ+ venues have provided opportunities to develop supportive relationships, while the HIV/AIDS crisis demonstrated the importance of networks offering care and companionship to people experiencing illness and stigma.

The latest research did not investigate that historical development directly, but its findings suggest that relationships defined through acceptance and mutual support continue to have considerable significance. They also challenge the assumption that a family must follow a particular structure to provide meaningful emotional security, while recognising that individual experiences differ considerably.

Why could this influence LGBTQ+ mental healthcare?

The study's focus on mental health and suicide prevention makes its findings particularly relevant to healthcare professionals who need to understand where patients find support during periods of emotional distress. Participants frequently described disclosing, or intending to disclose, suicidal thoughts or behaviour to people within their close social networks, suggesting that trusted relationships can play an important role in seeking help.

However, the researchers also identified the need for accessible professional services and compassionate treatment, demonstrating that personal relationships and clinical support should not be treated as interchangeable. Friends and family may provide reassurance and practical assistance, but appropriate mental healthcare remains essential when someone requires specialist assessment or treatment.

Transgender participants were proportionally more likely than cisgender participants to discuss the importance of compassionate care, including treatment that recognised their gender identity. This finding suggests that the quality of interactions with healthcare professionals may be particularly significant for some groups, although the study does not establish that all transgender people experience identical needs or difficulties.

One practical implication concerns how healthcare services identify an individual's support network. A professional might traditionally ask whether a patient has family members available to help, but that question could overlook important relationships if the individual understands family more broadly than biological relatives.

Asking who someone trusts, who provides support and who they would want involved in their care may offer a more accurate picture of their circumstances. Such an approach would not require healthcare professionals to assume that chosen family is always preferable, but would allow patients to explain their relationships in their own terms.

The wider British context demonstrates why LGBTQ+ mental health has received considerable research attention. The UK Government's National LGBT Survey, which received 108,100 valid responses in 2017, found that respondents rated their average life satisfaction at 6.5 out of 10, compared with 7.7 among the general UK population, while transgender respondents reported an average of approximately 5.4.

Those figures are historical and come from a self-selected survey rather than a nationally representative sample, so they should not be interpreted as current estimates of LGBTQ+ wellbeing in 2026. Nevertheless, they provide context for longstanding concerns about mental health inequalities, while the new study contributes a more detailed understanding of how individuals describe their support needs.

There are limitations to the latest research because the 748 participants were not a representative sample of all LGBTQ+ people in either country. Recruitment methods differed between the United Kingdom and United States, while missing responses and differences in compensation restricted some comparisons, meaning the findings should be understood as perspectives from the people who participated rather than universal conclusions.

The study also captured participants' experiences at one point rather than following them over time, so it cannot establish that chosen family directly reduces suicide risk or produces better clinical outcomes. Further research would be needed to examine whether healthcare approaches that explicitly recognise chosen family improve engagement, treatment experiences or longer-term wellbeing.

Nevertheless, the findings offer an encouraging perspective on the importance of relationships built through acceptance, loyalty and care. For LGBTQ+ communities, they provide academic recognition of connections that have long contributed to belonging, while suggesting that healthcare services may benefit from asking people who they consider family rather than assuming the answer.

Research and sources: BMC Public Health study (2026) | UK Government National LGBT Survey