Stigma and disclosure: Implications for coming out of the closet

TLDR

People with psychiatric disorders face costs and benefits when deciding to publicly disclose their conditions. The study explores how insights from the gay and lesbian community’s coming‑out experiences can inform disclosure decisions among people with mental illness. The authors review stage‑based models of coming out—identity confusion, comparison, identity acceptance, immersion, and identity synthesis—and examine how costs such as social avoidance and disapproval and benefits like improved well‑being and relationships influence progression through these stages. The paper concludes by outlining the various levels of disclosure adopted by individuals who choose to come out. Funding was provided by MH62198‑01 from the National Institute of Mental Health.

Abstract

Background: There are costs and benefits for people with psychiatric disorders to decide to disclose publicly these disorders. Aims: The gay and lesbian community has struggled with the same tension and their discoveries about coming out may prove useful for the disclosure concerns of persons with mental illness. Methods: Lessons learned about coming out by the gay and lesbian community include a variety of models that map the stages for successfully coming out; e.g., identity confusion, comparison, identify acceptance, immersion, and identity synthesis. Navigating these stages requires consideration of the costs and benefits of disclosure; we review some of these including social avoidance and disapproval as key costs and improved psychological well-being and interpersonal relations as benefits. Conclusions: The paper ends with a review of levels of disclosure for people who opt to come out. Declaration of interest: This paper was made possible in part by MH62198-01 from the National Institute of Mental Health.