Sexual Identity Disclosure Research Articles

HIV-related knowledge, risk perception, and minority stressors among South Asian sexual minority men in the United States.

South Asian gay, bisexual, and other men who have sex with men (GBM) in the United States have been persistently overlooked in HIV research and programming. To address this limitation, this article describes their HIV-related knowledge, risk perception, and minority stressors, with a focus on identifying variations between American-born individuals and immigrants. Participants were recruited from April-July 2022 through social media advertising and peer referral and surveyed about their sociodemographic and HIV-related behavioral characteristics. Previously validated scales were used to assess their HIV-related knowledge, risk perception, disclosure of sexual identity, experienced homophobia, and perceived racism within the sexual and gender minority community. Mann-Whitney-Wilcoxon tests were conducted to compare those born in the United States and those born abroad. Of the 112 participants, 26 (23.21%) were American-born individuals and 86 (76.79%) were immigrants. Despite similar levels of sexual risk behaviors, such as having multiple male sex partners, engaging in condomless anal sex, and using alcohol or drugs immediately before or during sex, immigrants had lower levels of HIV-related knowledge (p = .0480) and risk perception (p = .0114) compared to American-born individuals. Immigrants were also less likely to have disclosed their sexual identity to family, friends, and society compared to American-born individuals (p = .0004). No differences were identified with respect to experiences of homophobia (p = .2303) or perceptions of racism (p = .4011). Comprehensive HIV prevention efforts that address the social and cultural norms of South Asian GBM in the United States are needed.

Setting boundaries at work: Development and validation of the Sexual Identity Disclosure Dynamics Scale.

Setting boundaries at work: Development and validation of the Sexual Identity Disclosure Dynamics Scale.

Occupational Health, Psychosocial Risks and Prevention Factors in Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual, and Other Populations: A Narrative Review

Despite advances in legislation and social attitudes, workplace discrimination against sexual and gender minority populations remains prevalent, posing significant psychosocial risks. This study aims to explore the occupational health challenges faced by LGBTQIA+ populations, examining factors of discrimination, support, and prevention strategies. Methods: A narrative review of articles from the Scopus, PubMed, and Web of Science databases was carried out, focusing on studies published between 2011 and 2024. Articles in English, Spanish, and Portuguese were considered. Results: 359 studies were identified, and 11 articles were selected for analysis. The findings reveal pervasive discrimination experienced by LGBTQIA+ workers in the workplace, impacting their mental health and job satisfaction. Factors influencing disclosure of sexual or gender identity at work were identified, including workplace characteristics and anti-discrimination policies. Conclusions: Promoting inclusive and supportive work environments is crucial to the well-being of LGBTQIA+ employees. Recommendations include strengthening anti-discrimination protections, improving education and training on LGBTQIA+ issues, and promoting explicit communication about support and equality. Despite progress, more research is needed to address gaps in understanding and effectively promote the occupational health of sexual and gender minority populations.

Identifying as lesbian, gay, and bisexual at work: atemporal associations between sexual identity disclosure and work team experiences

PurposeAlthough sexual identity disclosure in the workplace can be related to heightened adversity for lesbian, gay or bisexual (LGB) employees, disclosure can also serve as an avenue for LGB employees to attain additional resources. Much of the work done in today’s organizations is done in team-based structures, making it likely that LGB individuals disclose to members of their work teams. However, very limited prior research has examined the associations of sexual identity disclosure within work team experiences. This paper aims to take a first step in addressing this gap in research on the experiences of LGB employees in the workplace.Design/methodology/approachThis study takes a first step toward addressing this gap by examining the associations between LGB identity disclosure and critical team-specific attitudes and behaviors (i.e., trust in team, commitment to team, conflict with team, withdrawal from team) and the atemporal indirect role of perceived LGB identity support from the team through a cross-sectional survey of 159 employees.FindingsResults demonstrated that perceptions of a supportive LGB team climate atemporally mediated the association between disclosure and relevant workplace variables. Specifically, disclosure of sexual identity to one’s work team is directly and indirectly, through perceived identity support, positively associated with trust and commitment toward the team. Furthermore, disclosure was indirectly, through perceived identity support, negatively associated with conflict and withdrawal from the team. Theoretical and practical implications of these findings are discussed.Originality/valueThe results of this study highlight the importance of perceived identity support when individuals disclosure their sexual orientation in a team context.

Out of the Closet, but Not Out of the Woods: The Longitudinal Associations Between Identity Disclosure, Discrimination, and Nonsuicidal Self-Injury Among Sexual Minoritized Young Adults.

Sexual minoritized individuals engage in non-suicidal self-injury (NSSI) at higher rates than their heterosexual peers. Disclosing one's sexual minoritized identity can put one at risk for experiencing discrimination, which is linked to greater engagement in NSSI. However, discrimination has yet to be tested as a mechanism linking sexual identity disclosure to NSSI. Understanding how sexual identity disclosure impacts NSSI has the potential to inform interventions to reduce sexual orientation disparities in NSSI. To address this gap, the current study examined sexual orientation-based discrimination as a mediator of the longitudinal association between sexual identity disclosure and NSSI among 792 sexual minoritized young adults. Higher levels of disclosure at baseline were associated with greater likelihood of NSSI at two-month follow-up via greater discrimination at one-month follow-up, even after controlling for baseline levels of depression and demographic characteristics. The indirect effect became non-significant after controlling for previous levels of discrimination and NSSI. Findings provide partial support for the hypothesis that identity disclosure may precede exposure to discrimination and, in turn, engagement in NSSI. However, identity disclosure does not appear to predict acute increases in discrimination. Future research is encouraged to examine these prospective associations with longer intervals between assessments, as the indirect effect of identity disclosure on NSSI via discrimination may continue to accumulate over time. Findings highlight the need to reduce discrimination following sexual identity disclosure through the implementation of equitable and affirmative practices in school, healthcare, and other settings to improve the well-being of sexual minoritized young adults.

To Tell or Not to Tell: Disclosure Experiences and Perceived Microaggressions Among Adopted Adolescents With Lesbian, Gay, and Heterosexual Parents

There is limited research on stigma experiences and disclosure practices among adolescents who: (a) are adopted, (b) who have LGBTQ+ parents, and (c) who are sexual or gender minorities themselves. At a time when LGBTQ+ identities are both increasingly visible and also publicly debated, we conducted interviews with 50 adolescents ( M age = 14.86 years) in 12 two-father, 20 two-mother, and 18 father/mother families. Following protocols approved by Clark University’s Institutional Review Board and through the frameworks of sexual stigma, microaggressions, and communication privacy management, we used thematic analysis to explore themes of disclosure practices, peer responses to disclosure, and parent responses to sexual and gender identity disclosure. Adolescents described various disclosure decisions around their adoptive status, LGBTQ+ parent family structure, and their own sexual and gender identities, ranging from rare to reactive to proactive disclosure. Such decisions were in some cases shaped by the intersections among participants’ race, gender, and family structure. Participants often selectively disclosed because of concerns related to privacy and negative peer reactions. Many adolescents reported instances of microaggressions from peers around their identities. Parent reactions to their children’s sexual and gender identity disclosure were more complex than peers’ reactions. Findings have implications for therapists and other professionals working with adolescents and their families.

Community and sociodemographic factors associated with disclosure of sexual orientation and comfort in discussing care needs in primary care: Results from the OutLook Study

Lesbian, gay, bisexual, and diverse sexual orientation minorities are disproportionately represented in the prevalence of adverse health conditions, even in Canada, suggested as one of the more progressive countries when it comes to social acceptance and human rights protections. This highlights the inclusion of sexual orientation identity as a point of consideration when providers interact with patients and to consider facilitating sexual orientation identity disclosure when accessing health care. This study explored factors associated with different facets of sexual orientation disclosure to primary care providers. A cross-sectional survey of sexual orientation minority participants, 16 years or older, living, working, or residing in Waterloo Region was distributed ( n = 437). Modified Poisson regression methods modelled (a) comfort sharing sexual orientation with their regular primary care provider (RPCP), (b) disclosure of sexual orientation to their RPCP, and (c) talking to their RPCP about health issues related to their sexual orientation. Increasing outness within one’s social network was consistently significant across all three outcomes of comfort, disclosure, and talking about health issues related to sexual orientation. Self-esteem was also identified as salient in comfort and when talking to providers. The authors also observed significant associations between sexual orientation identity and relationship status variables. Findings highlight important factors to consider in discussing and disclosing sexual orientation identity and associated health issues with health care providers. Implications for practice include training new health care providers and providing opportunities for continued education for established providers to ensure appropriate care is provided based on sexual orientation.

Identity management processes, contextual supports and barriers, and substance use among sexual minority workers: A social cognitive lens.

Sexual minority people report substance use at higher rates than their heterosexual peers. Workplace sexual identity management, defined as the process by which sexual minority persons disclose or conceal their identities at work, may exacerbate substance use under stressful conditions, such as when faced with incivility. However, there is a paucity of research on the relation of the work environment to sexual minority workers' substance use. The present study used the social cognitive career self-management model as a conceptual framework to examine two aspects of the work environment (positive climate and harassment) in relation to the sexual identity management process and substance use of sexual minority workers. Because plurisexual employees (e.g., bisexual or pansexual) often face additional workplace stressors relative to their monosexual sexual minority peers, we also examined the links between plurisexual identity and each component of the self-management model. Participants were 418 full-time sexual minority workers residing in the United States. Results were largely consistent with the self-management model derived in terms of the prediction of sexual identity disclosure in the workplace. Workplace harassment moderated the relationship between identity disclosure and substance use, such that disclosure was linked more strongly to substance use in the context of more frequent harassment experiences. Plurisexuality was negatively related to disclosure self-efficacy, outcome expectations, and level of outness at work. Plurisexual workers also perceived their work climates as less identity-affirming. We consider implications for research and practice, including organizational interventions to minimize sexual minority workers' experience of workplace harassment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Every action has a reaction: A model of coworker reactions to sexual minority employees' identity disclosure

AbstractThe current study examines the predictors and consequences of the ways coworkers react following sexual identity disclosure. We propose that employees may experience different reactions following disclosure depending on their social and sexual identities and that such reactions will impact their job attitudes, well‐being, and subsequent identity concealment. Data were collected from 308 lesbian, gay, bisexual, and pansexual employees using a two‐wave field survey design. Results for the predictors of coworker reactions indicate that employees who identified as Black, transgender/genderqueer, or bisexual/pansexual reported they experienced more unsupportive reactions from their coworkers following the disclosure of their sexual identity as compared to White, cisgender, and gay/lesbian employees. Supplemental analyses further indicate that Black bisexual/pansexual employees experienced the least positive reactions from coworkers as compared to the other referent groups. Results examining the outcomes of coworker reactions demonstrate that positive disclosure reactions are associated with decreased job satisfaction and increased turnover intentions, emotional exhaustion, and subsequent identity concealment, whereas negative disclosure reactions are associated with increased depressive symptoms and emotional exhaustion. Findings demonstrate a need to expand on conceptual and empirical work on identity disclosure to consider coworker reactions and underscore that the disclosure experiences of sexual minority employees are not uniform.

Pride & prejudice: A scoping review of LGBTQ + medical trainee experiences

Purpose LGBTQ + medical trainees experience significant discrimination. These individuals are stigmatized within a hetero- and cis-normative system, resulting in poorer outcomes in mental health and increased stress regarding career trajectory compared with their hetero- and cis-identifying counterparts. However, literature on the barriers experienced during medical training in this marginalized group is limited to small heterogeneous studies. This scoping review collates and explores prominent themes in existing literature on the personal and professional outcomes of LGBTQ + medical trainees. Methods We searched five library databases (SCOPUS, Ovid-Medline, ERIC, PsycINFO and EMBASE) for studies that investigated LGBTQ + medical trainees’ academic, personal, or professional outcomes. Screening and full text review were performed in duplicate, and all authors participated in thematic analysis to determine emerging themes, which were iteratively reviewed to consensus. Results From 1809 records, 45 met inclusion criteria (κ = 0.57). Major themes that emerged in the literature included the prevalence of discrimination and mistreatment faced by LGBTQ + medical trainees from colleagues and superiors, concerns regarding disclosure of sexual and/or gender minority identity, and overall negative impacts on mental health including higher rates of depression, substance use, and suicidal ideation. There was a noted lack of inclusivity in medical education and having an LGBTQ + identity had a large impact on career trajectory. Community with peers and mentors was an important determinant of success and belonging. There was a noteworthy lack of research on intersectionality or positive interventions that improved outcomes for this population. Conclusion This scoping review highlighted important barriers facing LGBTQ + medical trainees, identifying substantial gaps in the existing literature. Research on supportive interventions and predictors of training success is lacking and will be important to foster an inclusive education system. These findings provide critical insights for education leaders and researchers to help create and evaluate inclusive and empowering environments for trainees.

Kept in the Closet: Structural Stigma and the Timing of Sexual Minority Developmental Milestones Across 28 European Countries.

Structural stigma's role in lesbian, gay, and bisexual (LGB) people's attainment of identity development milestones remains unknown. In a sample of 111,498 LGB people (ages 15 to 65+) living across 28 European countries, associations were investigated between structural stigma measured using an objective index of discriminatory country-level laws and policies affecting LGB people and the timing and pacing of LGB self-awareness, coming out, and closet duration, and subgroup differences in these associations. On average, self-awareness occurred at age 14.8 years old (SD = 5.1), coming out occurred at 18.5 years old (SD = 5.7), and the closet was 3.9 years long (SD = 4.9); thereby highlighting adolescence as a key period for sexual identity development and disclosure. Greater structural stigma was associated with higher odds of never coming out, later age of coming out, and longer closet duration. Gender identity, transgender identity, and sexual identity moderated associations between structural stigma and these developmental milestones. Reducing structural stigma can plausibly promote sexual identity development among LGB populations, especially during adolescence when identity related milestones are often attained.

The sexual identity disclosure dilemma for lesbian, gay, and bisexual employees in the Indian workplace

PurposeThe purpose of this paper is to extend the theoretical understanding of the disclosure dilemma experienced by lesbian, gay and bisexual (LGB) employees. The study focuses on examining the factors related to self-disclosure such as co-worker support and fear of disclosure. Further, the study also aims at testing the impact of coworker support on the psychological well-being of LGB employees.Design/methodology/approachThe study adopts a concurrent triangulation research design, which involves a simultaneous collection of quantitative and qualitative data. Using a survey questionnaire, data from 200 LGB employees were collected. Semi-structured interviews were carried out with 10 LGB employees. The qualitative findings were treated as complementary to the relationship tested through the quantitative method.FindingsQuantitative results reveal that co-worker support positively impacts self-disclosure by LGB employees. And the fear of disclosure mediates the relationship between coworker support and self-disclosure. Further, self-disclosure is positively related to psychological well-being. The qualitative study brings insights from the lived experiences around these factors. This research expands knowledge about the factors associated with the disclosure of LGB employees.Originality/valueThe study examines the factors related to the disclosure of sexual identity and the experiences of the dilemma of LGB employees in the workplace. Most of the studies in the context of LGB have adopted a quantitative research design. The current study adopts a mixed methods approach with a concurrent triangulation research design.

Care and Loyalty in the Closet: A review of scholarship on sexual identity disclosure in queer South Asian women

This paper highlights a gap in scholarship on personal and family relationships of British queer South Asian women and queer women of colour. It enables fields of study within queer theory, family sociology and intimate relationships to move beyond Western normative frames when looking at queer individuals and their relationships. Existing research on queer people of colour is limited and, where present, rarely focuses on diasporic British queer South Asian women. This paper looks at the diasporic context and highlights why the South Asian family unit should not be categorised as homophobic. It looks at how notions of ‘coming out’ and ‘the closet’ are Westernised and Eurocentric. It also looks at the use of ‘the closet’ as a shield emanating from a place of care for the family and self. This paper also presents queer women of colour as individuals who are moving beyond a binary of being queer and ostracised from family or as pretending to be straight to remain in their family, asking if this can also be the case for queer South Asians. Finally, throughout this paper, the discussion touches on the concept of ‘chosen families’ and how it may apply to queer South Asian women.

Collaborative construction of the closet (in and out): The affordance of interactivity and gay and lesbian employees’ identity work online

For LGBQ employees, the disclosure and management of sexual identity in the workplace are likely to cause additional identity work. In this paper, we explore how such identity work is undertaken collectively by gays and lesbians on internet forums. Drawing on the literature on discursive identity work and social media affordances, we conduct a netnographic study of two internet forums, and analyse the ways in which these forums enable gay and lesbian employees’ identity work and guide their identity management processes. Overall, our study advances knowledge on sexual identity disclosure and management in three main ways. First, by shifting the focus from the identity disclosure accounts of individual gay and lesbian employees to online peer discussions around the topic, it sheds light on the broader context of identity management beyond the workplace. Second, our findings elucidate particular types of collaborative identity work – consulting, legitimating and questioning identity work – enabled by the affordance of interactivity of internet forums that inform and guide gays and lesbians’ identity management practices in organisations. Third, we identify and elaborate on specific discursive identity threats – the ‘falsehood’, ‘incoherence’, ‘exaggeration’ and ‘outdatedness’ of identity – which gay and lesbian employees are likely to encounter when reflecting on and performing specific identity management strategies, such as concealing or revealing their sexual orientation at work.

Sexual Minority Mothers: A Dyadic Exploration of Stigma, Identity, Support, and Parental Wellbeing

ABSTRACT For all couples, regardless of sexual orientation, transition to parenthood often increases stress, although, according to minority stress theory (MST), same-sex couples often experience additional stressors specifically related to their sexual orientation. In this study of 34 same-sex female couples (68 sexual minority mothers) who conceived their children with the use of sperm donation, we explored the intrapersonal and interpersonal influences of sexuality-related stigma, sexual identity, sexuality disclosure (“outness”), and social support on the wellbeing of each partner among these couples. We found support for MST, although the process worked differently based on the mother’s role. Among the pregnant (gestational) mothers, personal experiences of sexuality related stigma, social support, and sexual identity disclosure were all associated with their individual wellbeing. In contrast, among the non-pregnant (non-gestational) mothers, these associations were more interpersonal in nature. Specifically, the non-gestational mothers’ wellbeing was unrelated to their personal experiences of sexuality stigma but was associated with their partner’s (the gestational mother’s) reports of sexual identity centrality and affirmation and support from friends. In all, we found support for MST, such that greater sexuality stigma was associated with poorer wellbeing, but this relationship functioned differently depending on the mother’s role.

Parent Reactions to Sexual and Gender Identity Disclosure Events in the Deep South

Parental reactions to sexual and gender identity disclosures are known to be related to queer children and adolescents’ mental health and psychosocial adjustment. An improved understanding of how and why parents react how they do, in conjunction with their perceptions of how the coming out process unfolded can inform our understanding of how a young person’s coming out is experienced by parents in the broader context of the family. A clearer understanding is especially important for families located in historically sociopolitically conservative geographic areas because these parents might be at highest risk for a maladaptive reactions to coming out, subjected to homophobic legislation and cultural pressures, and because families from these areas are less represented in the literature. In the current qualitative study, semi-structured interviews were conducted with parents of queer children and adolescents living in the Deep South. Results illuminate a highly heterogenious experience and provide an initial roadmap, via the articulation of a conceptual model, to guide further research with families in this context.

Risk factors associated with alcohol and drug use among bisexual women: A literature review.

Bisexual women report elevated alcohol and drug use compared to other sexual minority women. This review summarized extant research on mechanisms (i.e., coping processes with minority stress and victimization, disclosure of sexual identity, connectedness to lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ +) community, religiosity, and normative perceptions) that may influence alcohol and other drug use among bisexual women. Specifically, bisexual women experience unique sexual discrimination (i.e., binegativity) and are at heightened risk for other forms of victimization and other stressful life events. Given this heightened experience with stress, bisexual women may use alcohol as a maladaptive coping mechanism. Further, disclosure of one's sexual identity may produce opportunities for connecting with the LGBTQ + community, but such openness may increase exposure to discrimination and stigmatization among bisexual women. Findings on religiosity have been mixed, but there is some support that bisexual women may use substances in response to internal conflict between their religious beliefs and sexual identity. Lastly, we found that normative perceptions of other bisexual women's drinking behaviors are strongly tied to their own levels of alcohol use. From a therapeutic perspective, we suggest that practitioners recognize the unique experience of minority stress and teach strategies that lessen internalized stigma and promote healthy psychosocial adjustment among their bisexual clients. Clinicians may also help their clients find sources of support, which may protect them against the use of alcohol and drugs to manage minority-induced stress. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Monosexism as an Additional Dimension of Minority Stress Affecting Mental Health among Bisexual and Pansexual Individuals in Hong Kong: The Role of Gender and Sexual Identity Integration

ABSTRACT Monosexism has been increasingly recognized as a minority stressor uniquely experienced by plurisexual individuals. The present study investigated the effects of monosexist discrimination on mental health and examined the moderating role of gender and sexual identity integration (i.e., negation, authenticity, and disclosure). In a sample of 314 bisexual and pansexual individuals in Hong Kong (73.9% women and 26.1% men), the results showed that monosexist discrimination was associated with higher levels of depression and anxiety symptoms, above and beyond heterosexist discrimination. The association between monosexist discrimination and depression symptoms was stronger among bisexual and pansexual men than women, despite there being no gender differences in vulnerability to monosexist discrimination. Moreover, sexual identity negation, authenticity, and disclosure moderated the associations of monosexist discrimination with depression and anxiety symptoms, such that the associations were not significant among those with more positive integration of sexual identity (i.e., lower levels of sexual identity negation as well as higher levels of sexual identity authenticity and disclosure). This study provides insight into the deleterious impact of monosexism and the protective role of sexual identity integration. Implications for plurisexual-affirming psychological intervention, public policy, and community practice are discussed.

Development and Validation of the Youth Pre-Exposure Prophylaxis (PrEP) Stigma Scale.

To date, there are no established scales to assess PrEP stigma among youth. We validated the Youth PrEP Stigma Scale within the Adolescent Trials Network P3 study (2019-2021). Data from sexual and gender minority youth (16-24 years) who were prescribed PrEP across nine domestic sites were evaluated (N = 235). Descriptive statistics, exploratory factor analysis, and correlation coefficients are reported. Results yielded a three-factor solution (PrEP Disapproval by Others, Enacted PrEP Stigma, and PrEP User Stereotypes) with strong factor loadings and Cronbach's alphas ranging from 0.83 to 0.90, suggesting excellent internal consistency. Correlations between this Scale, anticipated HIV stigma, perceived HIV risk, and disclosure of sexual identity were significant, indicating potential for robust application. Given the persistence of HIV infections among youth, stigma as a barrier to prevention, and expansion of PrEP modalities, the Youth PrEP Stigma Scale could enhance intervention and mechanistic research among youth at elevated risk for HIV acquisition.

Do Ask, Do Tell: Understanding Disclosure of Sexuality and Implications Among MSM Active Duty Service Members.

Men who have sex with men (MSM) account for over half of new diagnoses of human immunodeficiency virus (HIV) every year in the United States, with over one-third of this population being unaware of their HIV status. The U.S. Military requires biannual HIV testing for all service members. Although this may be an appropriate recommendation for the military at large, current health protection agencies suggest more frequent testing for those at increased risk of HIV transmission, such as those in the MSM community. However, more frequent testing for those at higher risk relies heavily on the preliminary step of patient disclosure of sexual practices to health care providers. An exploratory cross-sectional study was conducted in order to gain a better understanding of the relationship between sexual health variables and the disclosure of sexual identity to health care providers by MSM service members. A convenience sample of MSM currently serving in the U.S. military services (N = 354) was used to collect demographic data, sexual health and history, and opinions concerning medical treatment and HIV. Analyses of the data were conducted using univariate analysis and multivariate regression. Men of color were more likely to report a higher degree of sexual identification transparency with their health care providers, which deviates from the civilian population. Pre-exposure prophylaxis (PrEP) uptake was increased among individuals who were more transparent with their health care providers. Findings from this study indicate that feeling more comfortable sharing one's sexual identification with a health care provider results in increased engagement with HIV prevention measures. Potential implications for the Military Health System are the advancement of preventive sexual health screening procedures and the development and revision of policies that promote positive outcomes for gender and sexual minorities.