Mormon parents didn't call me on my birthday

For context I grew up mormon in Texas, served a mission, and then my senior year of college I came out as a lesbian, and then after another year finally left the church. My parents are "liberal" and always said they were allies but were extremely upset when I came out. They said it was more about me leaving the church than being gay, but I'm not sure I believe that. I also came out around the time that my dad was diagnosed with cancer, so they were going through a lot emotionally.

Years later I live in another state, and I barely ever hear from them calling me, I always have to call them. Mu dad is super sick and my mom cares for a kid and is going to school. I am going to therapy with the intention of trying to strengthen our relationship. Whenever we do talk, me initiating the conversation, my mom will tell me she's proud of me and loves me, but this only started after I communicated I don't feel she is proud of me. I told her I wish that she reached out to me more and there hasn't been a whole lot of effort.

On my birthday I texted my parents about something unrelated and after a few messages exchanged back and forth I got a text wishing me happy birthday. I didn't hear anything else for the rest of the day. I did remind my parents of my birthday a week before and my mom did send me something from Amazon which was nice. I just feel like there was no effort put in, and they know that reaching out to me is important to me.

Even though talking to them is uncomfortable, I make an effort to reach out regularly enough, and I always call for birthdays and Mother's and Father's day. I reach out to my dad often and just ask him to call me when he's feeling awake, because he sleeps a lot. He never ever calls me, and also will reject my calls. But my sister just let me know that she talks with him weekly. My dad and I talk every 3 months or so for like 10 mins.

I don't want to cut anyone off, I love them and I will be so sad when my dad passes, I have limited time. I also rely on them somewhat financially for help. But they are hurting me a lot. Not sure what to do.