Sexual Orientation and Disclosure in Relation to Psychiatric Symptoms, Diurnal Cortisol, and Allostatic Load

Abstract

Lesbian, gay, and bisexual (LGB) individuals-particularly those who have not disclosed their sexual orientation-are believed to experience increased chronic stress in comparison with heterosexuals. This interdisciplinary study assessed whether psychiatric symptoms (self-rated anxiety, depression, and burnout), stress hormone profiles (diurnal cortisol), and physiological dysregulations (allostatic load [AL]) would differ for a) LGBs versus heterosexuals and b) disclosed LGBs versus nondisclosed LGBs. The study included 87 healthy participants (mean [SD] age=24.6 [0.6] years; LGB n=46, 43% women; and heterosexual n=41, 49% women). Diurnal cortisol sampled at five time points was averaged for 2 days. AL indices were based on an algorithm incorporating 21 biomarkers representing neuroendocrine, immune/inflammatory, metabolic, and cardiovascular functioning. Psychological measures were assessed with well-validated questionnaires. Between-group results revealed no significant differences in symptoms of anxiety and burnout, nor among diurnal cortisol levels between sexual orientations. By contrast, gay/bisexual men unexpectedly had lower depressive symptoms (p=.003) and AL levels (p=.043) compared with heterosexual men. Within-group results revealed that disclosed LGBs had fewer psychiatric symptoms (p values<0.01) and lower cortisol levels +30 minutes upon awakening (p=.004) compared with nondisclosed LGBs. Disclosure was not significantly related to AL levels. LGBs did not manifest more stress-related problems than did heterosexuals. Life transitions like disclosing to one's family and friends may be protective against psychopathologies and hyperactive cortisol awakening responses. Our novel findings underline the roles disclosure processes have on positive health and well-being for sexual minorities.