For lesbian, gay, and bisexual (LGB) adolescents and young adults, coming out to family members, especially parents, is a major psychological decision and hurdle due to both perceived fears and actual negative consequences. But beyond the literature on factors associated with the decision to come out and parents' initial reactions to the disclosure, empirical studies of what unfolds afterward, and how the family adjusts to the LGB adolescent's identity over time, are sparse and scattered. This article reviews and integrates findings from studies of the individual-, dyadic-, and family-level variables associated with positive outcomes, focusing particularly on relationship variables. Methodological concerns within this body of research are discussed, and research recommendations are offered. A preliminary working model of how families successfully come to terms with coming out is proposed to guide future research that will advance theory and clinical work with LGB youth and their families.