Family acceptance and psychological well-being among Chinese LGBT university students: serial mediation by self-esteem and sexual identity acceptance

Sexual and gender minority youth in China endure elevated mental health risks within a collectivistic culture that prioritises familial harmony and heteronormative continuity, positioning family acceptance as a critical yet underexplored protective factor. Grounded in minority stress theory adapted to the Chinese context, this study tested a serial mediation model positing that family acceptance enhances psychological well-being through sequential pathways involving self-esteem and sexual identity acceptance among 316 LGBT college students. Serial mediation analysis revealed that family acceptance robustly predicted psychological well-being (total effect b = 0.69), with significant independent mediation by self-esteem and sexual identity acceptance, and a notable serial indirect effect (b = 0.08, 95% BC CI [0.05, 0.11]). All hypothesised paths were supported, illuminating a hierarchical mechanism amplified by cultural norms of filial piety and normative conformity. These findings extend minority stress theory by delineating culturally contingent sequential processes in collectivistic societies, where self-esteem serves as a foundational gateway to identity affirmation. They underscore the transformative potential of family-inclusive interventions tailored to Chinese cultural realities, offering actionable pathways to foster resilience and reduce disparities among this vulnerable population.