'Coming' Out May No Longer Be A Matter Of Popular Debate But Rather A Matter Of Public Health

Main Category: Psychology / Psychiatry
Also Included In: Depression
Article Date: 31 Jan 2013 - 0:00 PST


Lesbians, gays and bisexuals (LGBs) who are out to others have lower stress hormone levels and fewer symptoms of anxiety, depression, and burnout, according to researchers at the Centre for Studies on Human Stress (CSHS) at Louis H. Lafontaine Hospital, affiliated with the University of Montreal. Cortisol is a stress hormone in our body. When chronically strained, cortisol contributes to the 'wear and tear' exerted on multiple biological systems. Taken together, this strain is called "allostatic load". "Our goals were to determine if the mental and physical health of lesbians, gay men and bisexuals differs from heterosexuals and, if so, whether being out of the closet makes a difference. We used measures of psychiatric symptoms, cortisol levels throughout the day, and a battery of over twenty biological markers to assess allostatic load," explained lead author Robert-Paul Juster. "Contrary to our expectations, gay and bisexual men had lower depressive symptoms and allostatic load levels than heterosexual men. Lesbians, gay men, and bisexuals who were out to family and friends had lower levels of psychiatric symptoms and lower morning cortisol levels than those who were still in the closet."

Montrealers of diverse sexual orientations were invited to the laboratory of Dr. Sonia Lupien, Director of the CSHS. Lupien's team recruited eighty-seven men and women, all of whom were around twenty-five years of age. Over the course of several visits, the researchers collected psychological questionnaires, asked participants to provide saliva samples to measure cortisol over two days, and calculated allostatic load indices using results from blood, saliva, and urine samples. "Chronic stress and misbalanced cortisol levels can exert a kind of domino effect on connected biological systems," Lupien said. "By looking at biomarkers like insulin, sugar, cholesterol, blood pressure, adrenalin, and inflammation together, an allostatic load index can be constructed and then used to detect health problems before they occur."

Stigma-related stress might force LGBs to develop coping strategies that make them more effective at managing future stressors. "Coming out of the closet is a major milestone in lives of LGBs that has not been studied extensively using interdisciplinary approaches that assess stress biomarkers" said co-author Dr. Nathan Grant Smith. These exciting findings underline the role self-acceptance and disclosure has on the positive health and wellbeing of LGBs. In turn, this has important implications for ongoing political debates. "Coming out might only be beneficial for health when there are tolerant social policies that facilitate the disclosure process" said Juster. "Societal intolerance during the disclosure process impairs one's self-acceptance that generates increased distress and contributes to mental and physical health problems."

"As the participants of this study enjoy progressive Canadian rights, they may be inherently healthier and hardier," Juster said. "Coming out is no longer a matter of popular debate but a matter of public health. Internationally, societies must endeavour to facilitate this self-acceptance by promoting tolerance, progressing policy, and dispelling stigma for all minorities."

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