142nd APHA Annual Meeting and Exposition

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Mental health correlates of sexual orientation concealment and disclosure in the California Quality of Life Survey

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 1:00 PM - 1:15 PM

John Pachankis, Ph.D. , Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
Susan D. Cochran, Ph.D., M.S. , Department of Epidemiology/Department of Statistics, UCLA Fielding School of Public Health, Los Angeles, CA
Vickie Mays, Ph.D., MSPH , Department of Psychology and Fielding School of Public Health Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
Background: Sexual orientation concealment may afford escape from stigma exposure, but also poses its own psychological toll.  Coming out alleviates the mental burden of concealment but also invites the stress of navigating a new public identity.  Population-based mental health surveys that include both “in” and “out” sexual minorities provide an ideal opportunity to investigate these competing implications for mental health.

Methods: Sexual minority participants in the California Quality of Life Survey (n = 2,014) indicated whether they had disclosed their sexual orientation and, if so, the age at which this occurred. Diagnoses of major depressive disorder and generalized anxiety disorder were derived from the Composite International Diagnostic Interview Short Form (CIDI-SF).

Results: Closeted men (n = 90) were significantly less likely to be classified as depressed than out men (n = 980; OR = .41 95% CI: .17-.99).  The opposite effect was found for closeted (n = 52), compared to out (n = 892), women, although not significantly so.  Recently out men were significantly more likely to be diagnosed with generalized anxiety disorder than men who had been out for longer (OR = .18; 95% CI: .08-.44).  Recently out women were less likely to be depressed than women who had been out longer (OR = 1.91; 95% CI: .94-3.89). 

Conclusions: These findings document the mental health correlates of sexual orientation concealment and disclosure in a population-based sample.  Results will be discussed in terms of the unique experiences of sexual minority men and women both in and out of the closet.

Learning Areas:

Diversity and culture
Epidemiology
Social and behavioral sciences

Learning Objectives:
Describe the use of a large population-based survey of mental health among sexual minorities to determine the mental health correlates of sexual orientation concealment and disclosure. Compare the unique experiences that sexual minority men and women face when concealing and disclosing their sexual orientation.

Keyword(s): Lesbian, Gay, Bisexual and Transgender (LGBT), Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator or co-investigator of multiple federally funded grants focusing on the health and mental health of LGBT individuals. I have published 20 peer reviewed journals on LGBT health, serve on the editorial board of three respected professional journals, and have served as a reviewer for over 30 peer-reviewed journals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5177.0: Mental health and substance use among LGBT communities