Key Dates

Related Announcements

Please refer to the table of eligible NOFOs in the IC-Specific Application and Submission Information section of this NOSI. 

Issued by

National Institute on Aging (NIA)

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

National Institute of Mental Health (NIMH)

National Institute on Minority Health and Health Disparities (NIMHD)

National Cancer Institute (NCI)

Tribal Health Research Office (THRO)

All applications to this funding opportunity announcement should fall within the mission of the Institutes/Centers. The following NIH Offices may co-fund applications assigned to those Institutes/Centers.

Division of Program Coordination, Planning and Strategic Initiatives, Office of Disease Prevention (ODP)

Office of Behavioral and Social Sciences Research (OBSSR)

Office of Research on Women's Health (ORWH)

Sexual and Gender Minority Research Office (SGMRO)

Purpose

The mission of the NIH is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability. The NIH is committed to supporting research that will increase scientific understanding of health and well-being and lead to the development of effective evidence-based strategies, interventions, and services for people of all ages and backgrounds. NIH places a high priority on research with individuals and populations at increased risk for adverse health outcomes, and especially those who have received insufficient attention from the scientific research enterprise. To this end, and in response to Executive Order 14075 on Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals, this Notice of Special Interest (NOSI) announces an interest in research on the impact and consequences of family support and family rejection on the health and well-being of sexual and gender minority (SGM, defined for NIH purposes in NOT-OD-19-139) individuals across the life course.

Family structure and composition have changed over the past several decades owing to a variety of factors, including lower rates of marriage and fertility, increased rates of divorce and cohabitation, the separation of marriage from child-raising, and growth in one-person households, as well as multigenerational and extended families. At the same time, the prevalence of other ties, such as step-kin and non-marital romantic partners, is increasing. These developments have expanded what is considered a family in modern times.

For the purposes of this NOSI, a “family” refers to two or more individuals who share enduring intimate social relationships that may be characterized by biological or legal ties, emotional closeness, shared residence, economic cooperation within or across borders, shared responsibilities, and/or a sense of mutual or collective obligation. This includes but is not limited to nuclear (e.g., siblings related by birth), extended (e.g., grandparents), blended (e.g., stepparents), kinship (e.g., families by choice and extended biological family), adopted, foster, and chosen (e.g., personal communities of people such as friends, partners, and other people with whom individuals share a kin-like relationship, but are not connected by biological or legal ties) families. The term “family support” includes but is not limited to physical, mental, emotional, spiritual, educational, financial, and/or other support for self-identified lesbian, gay, bisexual, transgender, queer, intersex, Two-Spirit and other SGM (LGBTQI2S+) family members. “Family rejection”, by contrast, includes but is not limited to intolerance, neglect, mistreatment, diminution, isolation, exclusion, or coercion of an LGBTQI2S+ individual by other family members.

Researchers may define families, support, and rejection differently; thus, applications should clearly define these terms within the context of the proposed research.

Background

Recent statistics indicate that a growing percentage of the U.S. population is endorsing an SGM identity as of 2021, with much of this growth attributed to increases in LGBT identification among younger generations. In recent years, multiple relevant policies and laws have been enacted in support of LGBTQI2S+ communities and their well-being. There is growing societal awareness and acceptance of LGBTQI2S+ people. However, there remains considerable variation in attitudes toward LGBTQI2S+ persons at the local and interpersonal levels. For example, according to the Trevor Project's 2022 National Survey on LGBTQ Youth Mental Health, only 37% of LGBTQ adolescents and young adults identified home as an LGBTQ-affirming space and only 32% of transgender and non-binary adolescents and young adults identified home as a gender-affirming space; this is a substantially smaller percentage than those identifying schools as affirming spaces (55% and 51%, respectively).

The family is an important social unit where negative or positive attitudes may have direct, significant, and unique effects on the health of its LGBTQI2S+ members. There is evidence to suggest that family support for SGM members is associated with improved well-being and can act as a buffer against negative health outcomes. Conversely, research has shown that family rejection can be harmful to SGM people, particularly with regard to its impact on mental and behavioral health. However, more research is needed to elucidate the full extent of the influences of family support and rejection on the health and well-being of SGM individuals at different points across the life course and to account for the considerable variety of family configurations, forms of support and rejection, and experiences of SGM people from different sociodemographic and sociocultural backgrounds. Research on interventions to improve family support or mitigate the negative consequences of family rejection is also needed.

Research Objectives

The goal of this NOSI is to boost research on the impact and consequences of family rejection and family support on the health and well-being of SGM persons across the life course. Research proposed under this NOSI may include behavioral, social, clinical, implementation, basic, complementary, integrative, and any other relevant research approaches that probe the influences of family rejection, acceptance, affirmation, support, and belonging on the immediate and long-term health and health outcomes of SGM individuals at any life stage. Studies may also include prevention, intervention, and service delivery research that seeks to prevent, reduce, or treat adverse effects associated with family rejection and/or improve or maintain SGM people’s health. Potential topics regarding how family support and rejection affect health include but are not limited to:

• Impact of family rejection and/or support on long-term well-being, including physical, mental, social, and financial well-being
• Impact of family rejection and/or support on mental health and wellness, including emotional, psychological, intellectual, behavioral, and social health
• Effects of family rejection and/or support on sexual orientation and gender identity formation
• Differential experiences and effects of family rejection and/or support based on sexual orientation, gender identity, or the confluence of both (e.g., coming out and transitioning)
• Differential experiences and effects of ethnic, racial, or tribal family, family network, and/or community support and rejection based on sexual orientation, gender identity, or the confluence of both
• Differential experiences of indigenous family structures, networks, and support systems that create a sense of belonging and positive American Indian or Alaska Native SGM identities, Two-Spirit identities, and identities at the confluence of both
• Means to build, factors affecting, and health effects of coping skills and resilience
• Relationship of family support and rejection to other relevant experiences, such as adverse childhood experiences, trauma, and joy
• Ways that parents or caregivers can provide support and their impacts
• Family support as a buffer against the negative impacts of discrimination on health
• General and SGM-specific parenting or caregiving practices that promote or discourage healthy development (e.g., monitoring, communication, attachment)
• Family-specific support and rejection in health and well-being (e.g., different types of families, roles of different family members and caregivers)
• Mediators, moderators, and mechanisms by which family support and rejection exert their effects (e.g., transduction into physiological alterations, associations with specific dimensions of interpersonal interactions, role of participation in SGM events or organizations)
• Consideration of the influence of relevant concepts on health outcomes related to family support and rejection (e.g., minority stress, social safety, internalized and enacted stigma)
• Cultural, community, and other social environmental influences on support and rejection
• Intersectionality with other identities and circumstances in support and rejection
• Needs, experiences, and outcomes of specific subgroups under the SGM umbrella with regard to family support and rejection, e.g., Two-Spirit persons, transgender and gender diverse folks of color, intersex populations and individuals with variations in sex characteristics
• Interventions to mitigate, eliminate, or prevent family rejection and negative responses and actions
• Interventions to help establish or build existing family support and promote positive, affirming experiences
• Relationship restoration processes and their utility in interventions that build long-term positive health outcomes
• Different contexts in which family support interventions can take place or be facilitated (e.g., clinical settings, mental health practices, community centers, churches, assisted living residences, hospice care)
• Research to determine optimal intervention configurations (e.g., simultaneous inclusion of family members, focus on separate individuals, involvement of parenting support services)
• Longitudinal studies to probe long-term mental, physical, behavioral, and other health outcomes in the context of youth experiences with family acceptance and/or rejection
• Longitudinal studies to characterize shifts from rejection to support or vice versa and their impacts on long-term well-being
• Ethical, legal, and social implications of conducting research on family rejection and/or support and executing preventive or intervention strategies

Data Harmonization

The NIH encourages the usage of common data elements (CDEs) and other standardized measurement protocols whenever feasible in research studies to strengthen data consistency, usability, and interoperability. CDEs and protocols for capturing sexual orientation and gender identity (SOGI), social determinants of health, and other relevant topics can be found, for example, in the PhenX Toolkit social determinants of health core collection and the NIH CDE Repository. The SGMRO site features a webpage with examples of SOGI questions used in national surveys that may be helpful for harmonization with these data sets.

Of relevance, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a consensus report in 2022 entitled Measuring Sex, Gender Identity, and Sexual Orientation. It presents evidence-based recommended measures to assess sexual orientation identity and associated research recommendations for consideration by applicants to this NOSI. The report also offers specific measures for gender identity (comprised of sex assigned at birth and current gender in a two-step question that allows for passive identification of transgender experience) and intersex characteristics and variations in sex traits, as well as associated research recommendations which may be pertinent to investigators interested in capturing and/or evaluating a broader range of aspects of SGM status and experience. 

IC Research Interests

Applicants should select the most appropriate IC to which to submit their application using the IC-specific research interests provided in this section. Investigators are strongly encouraged to reach out to the relevant scientific contacts listed in the Inquiries section of this NOSI to determine whether their proposed research is suitable for the IC to which the proposal is submitted.

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

The NICHD mission is to lead research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all. The NICHD's broad and diverse research portfolio includes research related to conception and pregnancy; typical and atypical development in childhood; childhood trauma, injury, and critical illness; the transition from adolescence to adulthood; reproductive health; rehabilitation; intellectual, developmental, and physical disabilities; and population dynamics across the lifespan.

For this NOSI, NICHD seeks applications on the impacts of family support and/or rejection on the health and development of SGM youth and young adults that are aligned with NICHD scientific priorities. Specific research interests include, but are not limited to, studies that examine the relationships between family support or rejection, pre- and peripubertal clinical interventions, and their impact on future reproductive health and fertility. NICHD especially welcomes projects that incorporate a life course approach, principles of trauma-informed care, longitudinal data, and/or population representative samples.

National Cancer Institute (NCI)

NCI areas of programmatic interest are:

• Impact on screening for and incidence of cancers with increased risk due to genetic markers or biological family history
• Influence on treatment decision-making and adherence, as well as treatment-related financial hardship
• Role of caregiver support of cancer patients and survivors, particularly at end-of-life
• Patient and caregiver quality of life issues, including mental health, at varying levels of family support
• Contribution to the success of lifestyle behavior interventions, particularly tobacco cessation and substance use
• Considerations specific to child, adolescent, and young adult issues across the cancer control continuum

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases. In the context of this NOFO, the NIAMS is interested in basic/translational biological, genetic, psychological, social, and behavioral studies that explore the impact of family acceptance or rejection on arthritis and musculoskeletal and skin diseases of SGM people.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIDDK is interested in applications focused on understanding how family rejection and family support contribute to development, progression, and/or management of diabetes and other endocrine and metabolic diseases; digestive diseases, nutritional disorders and obesity; and kidney, urologic, and hematologic diseases in SGM individuals. NIDDK encourages SGM-related research as defined in NOT-DK-22-003. NIDDK encourages research conducted using an equity lens, which considers—at each decision point—how processes, values, assumptions, and actions may affect inclusive excellence in our research and workforce and the overall well-being and health of diverse population groups. In addition, NIDDK encourages consideration of the social determinants of health, as well as health-related social needs, that relate to or result from family rejection or family support. Successful applicants will also leverage community-engaged research approaches that meaningfully include people who identify as SGM and who are living with NIDDK disease/conditions.

To be assigned to the NIDDK, applications must be directly related to the mission of the NIDDK. NIDDK has many research areas within its mission, but all research related to relevant diseases may not be appropriate for NIDDK. Applicants are strongly encouraged to contact NIDDK staff as soon as possible in the development of the application so that NIDDK staff can help the applicant understand whether the proposed project is within the goals and mission of the institute.

National Institute of Mental Health (NIMH)

All NIMH, support for clinical trials addressing mental health follows an experimental therapeutics approach whereby clinical trials are designed not only to test the intervention effects on outcomes of interest, but also to inform understanding of the intervention’s mechanisms of action. As such, applications that propose to develop and/or test the efficacy/effectiveness of preventive, therapeutic or services interventions must include specification of the intervention target(s)/mechanism(s) and assessment of intervention-induced changes in the presumed target mechanism(s) that are hypothesized to account for the intervention outcome. Please see the Eligible NOFOs section of this NOSI for more information about funding for NIMH clinical trial applications.

Examples of topics of interest to NIMH by NIMH division include:

Division of AIDS Research

• Better understand the relationship between family acceptance and support and HIV acquisition, engagement in HIV prevention strategies, and HIV-related treatment outcomes
• Develop and test interventions that target families to improve HIV prevention strategy use or HIV care continuum engagement among SGM populations

Division of Services and Intervention Research

• Examine the mechanisms by which family rejection, support, and associated aspects of family functioning impact treatment seeking and sustained engagement in mental health services
• Refine and test interventions that address aspects of family functioning that have been empirically associated with etiology or maintenance of mental health problems (e.g., depression, suicide risk) or mental health service access, engagement, and outcomes among SGM populations

Division of Translational Research

• Better understand the relationship between family rejection and support and risk for mental illnesses such as depression, anxiety, or suicidal thoughts and behaviors

National Institute on Aging (NIA)

NIA is particularly interested in supporting research that uses an age, period, and cohort approach, and studies on and with SGM members of NIA’s other Priority Populations, as specified in the NIA Health Disparities Research Framework, in the following topic areas:

• Pathways to social mobility for older adults with a history of family rejection
• The long-term consequences of early-life family rejection and family support on the health of close relationships and the quality of caregiving relationships
• The relation between a history of family rejection and victimization and/or perpetration of elder mistreatment (elder abuse and neglect)
• Preliminary (Stage I, II, and III) behavioral intervention development research for individuals, dyads, families, communities, organizations, or systems that capitalizes on and integrates basic research to inform the development of efficacious interventions, defined by their governing principles in accordance with the NIH Stage Model
  • Mechanism-focused intervention development research, with the goal of determining the underlying principles of interventions that improve health and well-being and serve to reduce health disparities

National Institute on Minority Health and Health Disparities (NIMHD)

The mission of NIMHD is to lead scientific research to improve minority health and reduce health disparities. Populations that experience health disparities include African Americans/Blacks, Hispanics/Latinos, American Indians/Alaska Natives, Asians, Native Hawaiians and other Pacific islanders, socioeconomically disadvantaged populations, underserved rural populations, and SGM populations. NIMHD is especially interested in the innovative application of community-engaged research approaches and utilization of the NIMHD Research Framework to address and understand the complex role of family-level factors among populations that experience health disparities and individuals with intersecting health disparity population membership across multiple levels of influence (i.e., individual, community, societal). Potential research topics may include:

• Examining appropriate timing and interventions to intervene on health outcomes among families with SGM individuals
• Developing culturally appropriate and tailored interventions for SGM populations who experience multiple marginalized statuses
• Interventions to improve family health and well-being among SGM populations and those with multiple marginalized statuses who are in the process of coming out or during gender developmental periods
• Examining resiliency, coping, and protective factors related to family health with SGM individuals

Office of Disease Prevention (ODP)

The ODP is the lead office at the NIH responsible for assessing, facilitating, and stimulating research in disease prevention. In partnership with the 27 NIH institutes and centers, the ODP strives to increase the scope, quality, dissemination, and impact of NIH-supported prevention research. The ODP is interested in providing co-funding support for research that has strong implications for disease and injury prevention and health equity and that include innovative and appropriate research design, measurement, and analysis methods. Furthermore, the ODP has a specific interest in projects that develop and/or test preventive interventions. For this NOSI, ODP is interested in intervention research to enhance family support and/or prevent and buffer against family rejection to improve health outcomes for SGM populations. For additional information about ODP’s research priorities and interests, please refer to the ODP Strategic Plan for Fiscal Years 2019–2023.

Office of Research on Women’s Health (ORWH)

ORWH is part of the Office of the Director, NIH, and works with the 27 NIH institutes and centers (ICs) to advance rigorous research of relevance to the health of women. ORWH does not award grants but co-funds women’s health-related applications and research projects that have received an award from one of the participating NIH ICs listed in the announcement. Applications seeking ORWH co-funding in response to this Notice should ensure that the proposed work is aligned with at least one goal and objective outlined in the Trans-NIH Strategic Plan for Women’s Health Research.

For this announcement, ORWH is interested in research projects that address social and structural gendered determinants of family rejection and support, including the impacts of gender roles and norms, gendered power dynamics, structural sexism, and gender in/equity and in/equality. Intersectional approaches are highly encouraged.

Application and Submission Information

Applicants must select the IC and associated NOFO to use for submission of an application in response to the NOSI. The selection must align with the IC requirements listed in order to be considered responsive to that notice of funding opportunity (NOFO). Non-responsive applications will be withdrawn from consideration for this initiative. In addition, applicants using NIH Parent announcements will be assigned to those ICs on this NOSI that have indicated those NOFOs are acceptable and based on usual application-IC assignment practices.

Investigators are strongly encouraged to reach out to the relevant contacts listed in the Inquiries section of this NOSI to determine whether the NOFO and funding mechanism selected are appropriate for the proposed research. DPCPSI offices may consider co-funding meritorious applications depending on the alignment with office-specific missions and priorities and the availability of funds. The following ICs accept applications to the NOFOs below or their subsequent reissued equivalents:

Please note the following IC-specific information with regard to eligible NOFOs.

NIAMS will accept R01s and R21s in response to this NOSI. Note that NIAMS will only accept R21 applications in response to a NOSI (see NOT-AR-23-019). Any clinical trial should not be submitted in response to this NOSI, but to a NIAMS clinical trial-specific NOFO instead (see https://www.niams.nih.gov/grants-funding/conducting-clinical-research/grants).

Those interested in submitting a clinical trial application to NIMH are encouraged to see the Support for Clinical Trials at NIMH web page for additional information regarding dedicated NOFOs for NIMH clinical trials and contact the program contacts listed as early as possible to discuss alignment with NIMH priorities and funding support. Please note that NIMH does not accept clinical trials/interventional studies in response to the NIH parent NOFOs.

All instructions in the SF424 (R&R) Application Guide and the notice of funding opportunity used for submission must be followed, with the following additions:

• Applicants should indicate the Notice number above (NOT-OD-23-166) in Field 4B on the SF 424 R&R application form and refer to NOT-OD-23-166 in the abstract to assist in identifying applications submitted to this NOSI.

Applications focusing on a non-responsive topic, that reference a NOFO beyond those listed in this NOSI, or that are otherwise nonresponsive to the terms of this NOSI will be withdrawn from consideration for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Please direct all inquiries to the Scientific/Research, Peer Review, and Financial/Grants Management contacts in Section VII of the listed notice of funding opportunity.

Please direct all inquiries related to this NOSI to the following:

Scientific/Research Contacts

Christopher Barnhart, PhD
Sexual & Gender Minority Research Office (SGMRO)
Telephone: 301-594-8983
Email: Christopher.Barnhart@nih.gov

Ronna Popkin, PhD
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-827-5121
Email: Ronna.popkin@nih.gov

David Dean, Jr., PhD
National Cancer Institute (NCI)
Telephone: 240-276-7803
Email: Chipper.dean@nih.gov

Heiyoung Park, PhD
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Telephone: 301-594-5032
Email: Parkh1@mail.nih.gov

Bonnie Burgess-Beusse, PhD
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Telephone: 301-594-4726
Email: Bonnie.Burgess-Beusse@nih.gov

Susannah Allison, PhD
Scientific Contact for HIV-related inquiries
National Institute of Mental Health (NIMH)
Telephone: 240-627-3861
Email: Allisonsu@mail.nih.gov

Beshaun Davis, Ph.D.
Scientific Contact for non-HIV-related inquiries
National Institute of Mental Health (NIMH)
Telephone: 301-827-5098
Email: beshaun.davis@nih.gov

Melissa S. Gerald, PhD
National Institute on Aging (NIA)
Telephone: 301-496-3136
Email: Melissa.gerald@nih.gov

Crystal Barksdale, PhD, MPH
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-827-4228
Email: Crystal.Barksdale@nih.gov

Jennifer Alvidrez, PhD
Office of Disease Prevention (ODP)
Telephone: 301-827-0071
Email: Jennifer.Alvidrez@nih.gov

Elizabeth Barr, PhD
Office of Research on Women’s Health (ORWH)
Telephone: 301-402-7895
Email: Elizabeth.Barr@nih.gov

Selina Keryte, MPH
Tribal Health Research Office (THRO)
Telephone: 301-827-5855
Email: Selina.Keryte@nih.gov

Financial/Grants Management Contact(s)

Margaret Young
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-642-4552
Email: Margaret.young@nih.gov

Crystal Wolfrey
National Cancer Institute (NCI)
Telephone: 240-276-6277
Email: Wolfreyc@mail.nih.gov

Erik Edgerton
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Telephone: 301-594-7760
Email: Edgertont@mail.nih.gov

Angela Walters
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Telephone: 301-435-6950
Email: Angela.Walters@nih.gov

Terri Jarosik
National Institute of Mental Health (NIMH)
Telephone: 301-443-3858
Email: Tjarosik@mail.nih.gov

Robin Laney
National Institute on Aging (NIA)
Telephone: 301-496-1473
Email: robin.laney@nih.gov

Priscilla Grant, JD
National Institute on Minority Health and Health Disparities (NIMHD)
Phone: 301-594-8412
E-mail: pg38h@nih.gov