Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities and their norms and supports. Not surprisingly, existing studies of the association between sexual orientation concealment and mental health problems show contradictory associations—from positive to negative to null. This meta-analysis attempts to resolve these contradictions. Across 193 studies (n = 92,236) we find a small positive association between sexual orientation concealment and internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating; ESr = 0.126; 95% CI [0.102, 0.151]) and a small negative association between concealment and substance use problems (ESr = −0.061; 95% CI [−0.096, −0.026]). The association between concealment and internalizing mental health problems was larger for those studies that assessed concealment as lack of open behavior, those conducted recently, and those with younger samples; it was smaller in exclusively bisexual samples. Year of data collection, study location, and sample gender, education, and racial/ethnic composition did not explain between-study heterogeneity. Results extend existing theories of stigma and sexual minority mental health, suggesting potentially distinct stress processes for internalizing problems versus substance use problems, life course fluctuations in the experience of concealment, distinct experiences of concealment for bisexual individuals, and measurement recommendations for future studies. Small overall effects, heavy reliance on cross-sectional designs, relatively few effects for substance use problems, and the necessarily coarse classification of effect moderators in this meta-analysis suggest future needed methodological advances to further understand the mental health of this still-increasingly visible population.

Little research has examined the management of multiple minority identities among lesbian, gay, and bisexual (LGB) people of color, despite a growing theoretical literature on such identity intersections. The present study focused on the intersectional construct of conflicts in allegiances (CIA), defined as perceived incompatibility between one's racial/ethnic and sexual orientation identities. CIA was investigated in relation to experiences of parental heterosexism, racism in LGB communities, outness, and racial/ethnic and sexual orientation group identity. Participants were 124 LGB people of color (main sample) and 124 LGB White people (comparison sample) who completed self-report measures of the main variables as part of a larger survey of same-sex couples. CIA was positively correlated with experiences of racism within LGB communities and perceived heterosexism in one's mother (but not one's father), and negatively correlated with outness to family (but not outness to others in one's everyday life). An interaction was found between racial/ethnic and LGB group identity with respect to behavioral engagement: CIA levels were highest among participants with high racial/ethnic behavioral engagement and low sexual orientation behavioral engagement. Results highlight the role of minority and family contexts in CIA among LGB people of color, and, more broadly, the potential value of studying intersectional variables using quantitative methods. Longitudinal and experimental studies are needed to address questions about direction of influence raised by findings.

Individuals with concealable stigmatized identities face many options regarding whether, when, how, and to whom to conceal or disclose information about their marginalized social status. Numerous studies have examined the psychosocial health consequences of different stigma concealment and disclosure processes, but research in this area is hindered by a relative lack of attention to potential differences among these stigma management variables. The present research investigated the distinctness of stigma management constructs in a population viewed as holding an indiscernible stigmatized identity: lesbian, gay, and bisexual (LGB) university students. In Study 1, the psychometric properties of a 6-item measure assessing recent effortful concealment of sexual orientation were examined in a sample of 353 LGB university students. Exploratory and confirmatory factor analyses in separate subsamples supported the hypothesized single factor structure, and offered preliminary support for the reliability and validity of scores. In Study 2, 301 LGB university students completed an online survey including 3 measures of stigma management: concealment behavior, concealment motivation, and nondisclosure. Also included were measures of psychological health (depression, life satisfaction), negative social identity (self-stigma, acceptance concerns), and positive social identity (membership esteem, identity strength). Each stigma management variable uniquely predicted a different combination of psychosocial variables, supporting the notion that each is a distinct construct. Concealment behavior uniquely predicted psychological health and negative identity variables, concealment motivation uniquely predicted positive and negative identity variables, and nondisclosure uniquely predicted positive identity variables. Implications of these results are discussed in light of literature on management of indiscernible stigmatized identities.

Objectives:We used microlongitudinal methods to examine the prevalence and day-to-day correlates of intersectional experiences (IEs) in a U.S. sample of 131 Black sexual minorities. Method: Participants were 97 gay/lesbian people (74.0%) and 34 bisexuals (26.0%); nearly a third of the sample also identified as queer (32.1%). Most participants identified solely as Black; however, 23 participants (17.6%) indicated at least 1 secondary racial/ethnic identification. Every evening for 1 week, participants reported both negative and positive IEs from the last 24 hr and completed measures of identity conflict, rumination, and affect. Multilevel path analysis was used to test daily relations between IEs and mood-as well as the mediating roles of identity conflict and rumination-at the within-and betweenperson levels, controlling for nonintersectional experiences (e.g., related only to race, related only to sexual orientation, unrelated to identity). Results: Negative IEs (n ϭ 97, 11.4% of total days) were related with identity conflict and negative affect at both levels of analysis and with negative rumination at the within-person level only. Positive IEs (n ϭ 263, 31.0% of total days) predicted positive rumination and positive affect (but not identity conflict) both within and between persons. Many hypothesized indirect paths were supported-for example, identity conflict and rumination mediated the relation between negative IEs and negative affect at the within-person level. Conclusion: Building upon accumulating research linking stigma and health, this study demonstrates that multiple axes of oppression can jointly shape daily events and predict fluctuations in psychological health. What is the public health significance of this article?Whereas most studies of stigma-related stress focus on one type of stigma (e.g., racism) in isolation from others (e.g., homophobia), this study demonstrates that daily events related to both one's race and sexual orientation (i.e., intersectional experiences) are associated with day-to-day changes in Black sexual minorities' psychological well-being. Findings may inform clinical and community interventions aiming to increase the health and resilience of this understudied population.

Writing on the experiences of bisexual-identified people has highlighted the potential complexity of the ongoing process of deciding when and how to present one's sexual orientation identity to others (Rust, 2002). The two studies presented here were designed to contribute basic knowledge regarding self-presentation of sexual orientation among bisexual people. In Study 1, bisexual participants (N = 147) were less likely than their lesbian and gay (LG) peers (N = 191) to present their actual orientation to others, and more likely to present themselves as having a sexual orientation different from their actual orientation. These sexual orientation differences were explained by gender of romantic partner and uncertainty about one's sexual orientation. Sexual orientation differences also emerged in links between self-presentation and outness level. For example, bisexual participants who presented themselves as LG had relatively high everyday outness levels; in contrast, LG participants who presented themselves as bisexual had relatively low everyday outness levels. In Study 2, 240 bisexual women and men indicated their levels of outness as a sexual minority person (potentially including identification as gay, lesbian, queer) and specifically as bisexual. Outness was higher with respect to status as a sexual minority compared to status as bisexual; the magnitude of this difference was predicted by gender of romantic partner and uncertainty about one's sexual orientation. Moreover, even controlling for outness as a sexual minority person, well-being was predicted by outness as bisexual to family members.