The United States’ lack of any permanent, national paid leave policy makes it the sole outlier among industrialized countries and puts workers’ jobs, economic security, and health at risk—as well as the growth of the nation’s economy overall. And while these negative impacts are felt across the country, this policy gap has affected LGBTQI+ individuals, who often have less access to care from traditional family structures, in particular ways.
Today, nearly 1 in 4 private sector workers lacks even a single paid sick day for themselves or their families, and more than 3 in 4 private sector workers do not have access to paid family leave to cover serious caregiving needs. According to 2020 data, 37 percent of LGBTQI+ workers reported not having access to either paid family or sick leave at their current employer, making LGBTQI+ workers less likely than the general workforce to have access to at least some amount of paid leave for health or caregiving needs. Policymakers must act to create paid leave policies that reflect diverse caregiving relationships to better support workers and meet the needs of LGBTQI+ individuals.
What are “chosen families”?
Chosen families are loved ones people consider family but to whom they may not have a legal or biological relationship. For example, this could include a partner or significant other to whom a person is not legally married; a close friend who is like a sibling; or an older neighbor someone cares for like a grandparent.
According to data from the U.S. Census Bureau, an overwhelming majority of American households (82.2 percent) depart from the traditional nuclear family structure.* In fact, millions of people rely on caregiving from “chosen family,” a support structure that is especially important for LGBTQI+ individuals but often excluded in the government definitions of family that are used to determine access to rights, resources, and benefits, including paid leave policies. New data from the Center for American Progress’ nationally representative survey shed light on the caregiving support systems and role of chosen family for LGBTQI+ adults—and all adults.** These data underscore the significance of chosen family in caregiving arrangements and emphasize the need to adopt inclusive paid leave policies at the state and federal levels.
An overwhelming majority of American households (82.2 percent) depart from the traditional nuclear family structure.
CAP data highlight the importance of chosen family for LGBTQI+ individuals
Too often, LGBTQI+ people face discrimination, stigma, conflict, and rejection by their families of origin. For example, according to CAP’s 2022 survey, 34 percent of LGBTQI+ adults—including 49 percent of transgender or nonbinary adults and 37 percent of LGBTQI+ people of color—reported moving away from their family in order to avoid experiencing discrimination because of their sexual orientation, gender identity, or intersex status. Strained relationships with members of one’s family of origin may lead LGBTQI+ people to rely on chosen family, such as close friends, informal support networks, or partners to whom they are not legally married.
As part of an ongoing effort to better understand caregiving support networks among LGBTQI+ people, CAP’s 2022 survey asked both LGBTQI+ and non-LGBTQI+ respondents, “If you had to take time off work for health-related reasons, who are you most likely to rely on for caretaking support?” Respondents were allowed to select multiple options.
Both LGBTQI+ and non-LGBTQI+ respondents reported that they would rely on biological or legally related family members at similar rates. However, LGBTQI+ people were twice as likely as non-LGBTQI+ people to report that if they had to take time off work for a health-related need they would rely on chosen family members—that is, “close friends who are like family to me” (28 percent compared with 14 percent). Thirty-five percent of transgender adults and 30 percent of LGBTQI+ people of color reported the same.
LGBTQI+ people were also more likely than non-LGBTQI+ people to report that they would rely on a spouse or partner to whom they are “not legally married or legally registered” (29 percent compared with 12 percent). In contrast, non-LGBTQI+ people were significantly more likely than LGBTQI+ people to rely on a spouse or partner to whom they are “legally married or legally registered” (55 percent compared with 30 percent).
Percentage of LGBTQI+ people who reported leaving their families to avoid discrimination based on their sexual orientation, gender identity, or intersex status
Percentage of LGBTQI+ people who have called on chosen family to provide support for a health-related need
Percentage of LGBTQI+ people who have been relied on by chosen family to provide support for a health-related need
Percentage of non-LGBTQI+ people who have called on chosen family to provide support for a health-related need
Percentage of non-LGBTQI+ people who have been called relied on by chosen family to provide support for a health-related need
More broadly, chosen family members are important parts of the support system for all adults, but they are especially critical for LGBTQI+ people. More than half of LGBTQI+ adults (51 percent)—compared with more than 1 in 3 non-LGBTQI+ adults (36 percent)—reported that they have called on chosen family to support them when they had a health-related need. Similarly, nearly half of non-LGBTQI+ people (46 percent) say they have been called on by chosen family to provide support for a health-related need, while LGBTQI+ people were more likely to report the experience at even higher rates (58 percent).
Taken as a whole, these findings suggest that when sick, many adults—especially LGBTQI+ people—would rely on chosen family members for care.
The current state of U.S. leave policies
Today, no federal law guarantees the right to paid leave for caregiving or for any other reason. This puts the United States out of sync with its economic peers: Most countries in the Organization for Economic Cooperation and Development guarantee the right to paid leave to address a family member’s health needs. Lack of paid leave for caregiving drags down the economy by reducing labor force participation by caregivers, presenting challenges to retention, and reducing productivity, among other factors. And the existing federal legislation that provides unpaid leave to covered workers—the Family and Medical Leave Act (FMLA)—does not cover care for unmarried partners or other chosen family members. However, many states and cities have stepped up to enact their own paid family and medical leave and paid sick time laws, which often have inclusive family definitions.
Inclusive family definitions have a strong track record at both the state and federal levels. At the national level, the federal government has allowed its employees to take funeral leave for combat-related deaths of chosen family as far back as the Vietnam War. In 1994, the Federal Employees Family Friendly Leave Act enabled federal employees to use paid sick leave for family caregiving, defining family members broadly as “any individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.” In 2015, an executive order from then-President Barack Obama extended this definition to include certain federal contractors, granting them paid sick and safe time that can, among other uses, be used to care for chosen family members. And in 2020, the Families First Coronavirus Response Act, which temporarily provided emergency paid leave in connection to COVID-19, allowed covered workers to provide care for a broad range of loved ones, including relationships with the need for and an expectation of care.
Many states have also adopted expansive definitions of family, including chosen family, in their paid family and medical leave programs. In 2019, New Jersey became the first state in the nation to allow workers to take up to 12 weeks of paid family leave to care for a chosen family member, expanding protection under its existing law to reach those loved ones. Washington state similarly amended its existing paid family and medical leave law to include “any individual who regularly resides in the employee’s home or where the relationship creates an expectation that the employee care for the person, and that individual depends on the employee for care.” Connecticut followed soon thereafter, covering chosen family members since benefits began in 2022. Chosen family coverage is also included in paid family and medical leave laws in Oregon, where benefits will begin in September 2023, and in Colorado, where benefits will begin in January 2024. Other state paid family and medical leave laws have gone beyond the nuclear family in other ways. For example, nearly all state paid family and medical leave laws cover domestic partners.
Moreover, many states and localities from across the country have included chosen family in their paid sick leave laws. For example, Arizona’s paid sick leave law includes the ability to care for those “whose close association with the employee is the equivalent of a family relationship,” as do local paid sick leave laws in Duluth and St. Paul, Minnesota. Most recently, California amended its existing paid sick leave law, along with its state unpaid family and medical leave law, to include the ability to care for a “designated person” chosen by the employee.
Building from this momentum across the country, in November 2021 the House of Representatives passed a paid leave policy that included coverage for chosen family, as well as a broad list of enumerated family members, as part of President Joe Biden’s Build Back Better package. While this paid leave policy ultimately did not become law, it marked a powerful national commitment to paid leave that includes all families.
Similarly, the Caring for All Families Act—which would amend the FMLA to include chosen family members alongside a number of additional loved ones, such as siblings, grandparents, and adult children—was recently reintroduced in Congress. In addition, the Healthy Families Act would guarantee paid sick leave that includes care for chosen family.
Read about workplace leave in the United States
A 2023 series of factsheets on workplace leave laws dives deep into the state of paid and unpaid sick time in the United States.
Both LGBTQI+ and non-LBGTQI+ people rely on chosen family for care, but these needs are especially pronounced among LGBTQI+ people. To adopt comprehensive, inclusive paid family and medical leave policies requires a definition of family that accurately reflects the diversity of modern families and the realities of care and caregiving today.
Policymakers at the state and federal levels should step up to pass paid family and medical leave and paid sick time laws that ensure the ability to care for all those Americans consider family, while working to expand existing laws to meet the same needs. Comprehensive paid leave is crucial for the health of American families and the strength of the nation’s economy. It is past time for paid leave for all families, however they are built.
* CAP’s calculations are based on tables from the Census Bureau’s Current Population Survey “Families and Living Arrangements: Historical Time Series”: Table HH-1: Households by Type: 1940 to Present and Table FM-1: Families by Presence of Own Children Under 18: 1950 to Present.
** Data are from a nationally representative survey of 1,828 self-identified LGBTQI+ adults and 1,542 self-identified non-LGBTQI+ adults ages 18 and older, jointly conducted from May 27, 2022, to June 23, 2022, by CAP and NORC at the University of Chicago. All in-text comparisons between LGBTQI+ respondents and non-LGBTQI+ respondents are significant at the 0.05 level. More information on the sample and methodology is available here.