By Amanda Gardner
MONDAY, June 20, 2011 (Health.com) — The level of support that people perceive in their surroundings when they come out as lesbian, gay, or bisexual (LGB) is closely related to their mental health and overall well-being, and this may mean that coming out to some people (but not others) is less psychologically damaging than has been believed, a new study suggests.
People who reveal their sexual orientation to friends, family, or coworkers whom they consider tolerant and supportive tend to be less depressed, angry, and insecure in those social contexts than their peers who come out in less accepting or outright hostile environments, according to the study, which was published in the June 20 issue of Social Psychological and Personality Science.
"It makes sense theoretically," says Stephen Russell, PhD, a professor of family studies and human development at the University of Arizona, in Tucson, who was not involved in the study but has researched health risks among gay and lesbian adolescents. "People come out in places where they feel supported and they do better in terms of more self-esteem and less depression. That's encouraging."
The study findings aren't entirely surprising, but they do add a new wrinkle to the research on the health implications of coming out.
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Previous studies have found that concealing one's sexual orientation can have consequences for both mental and physical health. (For instance, HIV has been shown to progress faster in closeted versus out individuals.) At the same time, the process of coming out can be fraught with conflict, fear, and distress.
"Coming out is a period of vulnerability for LGBT people—particularly youth," Russell says. "Some respectable studies are showing, for example, that the risk for self-harm and suicide appears to be highest in the window around the period of coming out to key family members."
By focusing on the level of support LGB individuals feel, the study helps explain how coming out might be both good and bad for mental health, depending on the context. The findings suggest that the same individual who feels more self-assured and less depressed and angry being out in a supportive environment may experience distress in a less supportive environment.
In fact, the study found that people who were selectively out—who were more out with friends and family than with coworkers, say—were no more or less depressed, angry, or content than people who concealed their sexual orientation less.
"We looked at whether people who were more out in some settings and less in others had worse overall well-being. They did not," says Richard Ryan, Ph.D., a coauthor of the study and a professor of psychology at the University of Rochester Medical Center, in New York. "The evidence did not suggest that being selectively out was necessarily detrimental."
Next page: Survey sample may not be representative
Ryan and his colleagues surveyed 161 people between the ages of 18 and 65 who were recruited through LGB-oriented online discussion boards and social-networking sites. The group of participants was roughly evenly split between those who identified as gay, lesbian, and bisexual.
The participants anonymously answered questions about how out they were, the level of support they felt, and their well-being in five different contexts: with family, among friends, at work, at school, and in their religious community. Nearly 9 in 10 participants were out with friends, and two-thirds were out to family. Only about half were out at school or work, however, and just 31% were out in their religious community.
The percentage of out individuals in each context varied in step with the perceived support of the community, not surprisingly, and the levels of depression and anger among out individuals were highest in less-supportive contexts. "We sampled very important contexts in people's lives and found much better results in places which let people be who they are," Ryan says.
The study has some key shortcomings. It was relatively small, and the participants aren't necessarily representative of LGB people as a whole. Because they were recruited from LGB websites, the participants may be more comfortable than most with their sexual orientation, the researchers say.
Still, the findings highlight the importance of supportive environments on the health and well-being of LGB individuals, says Jeffrey T. Parsons, PhD, a professor of psychology at Hunter College, in New York City.
"I think this really puts pressure on institutions and organizations, whether those are educational institutions likes schools and colleges or workplace environments, to make sure that policies and supportive environments are in place for people to feel that it is going to be a supportive environment to come out," Parsons says.