Unhealthy closets, discriminatory dwellings: The mental health benefits and costs of being open about one's sexual minority status

Soc Sci Med. 2021 Sep:285:114286. doi: 10.1016/j.socscimed.2021.114286. Epub 2021 Jul 30.

Abstract

Rationale: With a concealable stigmatized identity, sexual minorities not only face discrimination but the burden of deciding when to be open about their sexuality. What are the mental health costs and benefits to openness about sexual minority status? On the one hand, openness fosters integration within the LGBTQ + community (yielding downstream benefits), but it also heightens perceptions of discrimination towards oneself and the group at large (yielding downstream costs for mental health).

Objective: Previous research has focused on openness as reflecting either a cost or a benefit to sexual minorities' mental health, resulting in apparent conflict. We propose an integrated view of openness as leading to both costs and benefits that work in tandem to steer mental health.

Methods: In two pre-registered studies with nearly 4000 ethnically diverse, sexual minority participants, we propose a theoretically-driven serial mediation model to test opposing mediating mechanisms that operate on subjective wellbeing and mental health. Specifically, we determine how the relationship between openness about sexual minority status fosters LGBTQ + identity importance, community integration, and perception of discrimination.

Results: Being more (vs. less) open strengthens LGBTQ identity importance, facilitating integration in the LGBTQ + community, which benefits mental health. However, openness and strengthened identity importance simultaneously prompt increased perceptions of discrimination, the burden of which adversely affects mental health. Together these opposing forces explain the weak association between greater openness and mental health - an association that indicates, overall, that openness does have a net benefit for LGBTQ + individuals' mental health.

Conclusions: By identifying opposing mechanisms that underlie the relationship between openness and mental health, we have provided a more integrated perspective on the role that openness plays on sexual minorities' mental health. Openness is associated with stronger group identity importance, greater community integration, and heightened perception that the group (and self) face discrimination.

Keywords: Concealment; LGBT; Mental health; Sexual minorities; Stigma; Wellbeing.

MeSH terms

  • Cost-Benefit Analysis
  • Humans
  • Mental Health*
  • Sexual Behavior
  • Sexual and Gender Minorities*
  • Sexuality