Mental Health Risk and Resilience among Latinx SGM Adolescents and their Parents - Project Summary/Abstract This application is in response to NOT-OD-23-166, PAR-21-358, and aligns with NIMHD's key areas of interest including family health and well-being for SGM adolescents. Family acceptance and support are critical factors that promote resilience and reduce mental health burden among sexual and gender minority (SGM) adolescents. The existing knowledge base on family relationships among SGM adolescents is limited in generalizability beyond predominately non-Latinx, White samples, and is often based on perspectives of one family member (either SGM adolescents or their parents). Yet, cultural strengths and stressors influence family relationships and resultant health of multiple family members. Framed by the SGM Health Disparities Research Framework and the Family Health Development Integrative Model, this study, through a multistage and multimethod design, seeks to understand intersectional family relationships and how they contribute to mental health among Latinx SGM adolescents and their parents. Culturally-informed qualities of family relationships are examined as direct contributors to family health and as potential targets for future intervention development to mitigate the harmful contributions of structural and social determinants of health for Latinx SGM adolescents and their parents. In Aim 1, Latinx SGM adolescents and academic and community experts who work with Latinx SGM adolescents and their families will help adapt, test, and validate the existing parent-report measure of acceptance for Latinx SGM adolescents in order to establish an adolescent-report version of this measure (the Parental Acceptance for Latinx SGM Adolescents [PALSA] measure). This measure will allow for dyadic, multireporter and culturally-responsive understandings of family relationships among Latinx SGM adolescents and their parents. Aim 2 examines how family relationships from multiple reporters within families converge/diverge and how they predict Latinx SGM adolescent and parent mental health. SGM adolescents and a primary parent (N = 249 dyads) will be purposively recruited to ensure representation of SGM identities (i.e., cisgender sexual minority; trans/nonbinary gender minority) in two established immigrant destinations (i.e., Arizona and Florida). Aim 3 of the proposal extends Aim 2 findings to understand how family relationships moderate the associations between structural and social determinants of health and key mental health outcomes. Aims 2 and 3 collectively will reveal unique strengths and barriers in Latinx families with SGM adolescents to inform targets to ameliorate SGM adolescent and parent mental health burden. The dyadic measures optimized in the study can be used to help facilitate resilience in Latinx families with SGM adolescents by community and clinical providers.