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October 1, 2018

Coming Out LGBT: Full Disclosure to Family Linked to Less Stress Hormone

By Society for Biopsychosocial Science and Medicine

Contact: Peggy Zoccola, PhD

For Release: Immediately

An emotional milestone in the life of every gay, lesbian or bisexual person is coming out to others. With the legalization of gay marriage and increased positive media portrayals of sexual minority adults, surveys show that more young people than ever are choosing to come out openly rather than remain in the closet.

That could be a boon to their health in the long run, suggests a pioneering study on coming out and the stress hormone cortisol published in the October issue of Psychosomatic Medicine, journal of the Society for Biopsychosocial Science and Medicine. But the potential benefit may be limited to those who have more fully disclosed to family members. Despite our heavily peer-oriented culture for teenagers and young adults, it’s feeling able to comfortably talk about your sexual identity with family members (not friends) that appears to be most linked to output of the stress hormone cortisol. “The real stress punch seems to be with the family,” says senior author Peggy Zoccola, PhD, Associate Professor of Psychology at Ohio University, who did the study with coauthor Andrew Manigault, MS.

A high output of stress hormones can impair health and even be life-threatening. So far, there’s been scant research on how aspects of coming out by LGBT adults may affect the release of stress hormones, Zoccola points out. Earlier studies do show that if people who identify as sexual minorities feel more acceptance from their families they have higher self-esteem, lower depression and substance use rates, and are less likely to think about suicide than those who don’t feel accepted by their families.

In the new study, 121 sexual minority adults ages 18 to 35 took an initial survey covering their depression and anxiety levels, sociodemographic factors, and how much social support they felt. (No study participants had psychiatric or endocrine disorders.) They all were asked how out they were to family members, friends and acquaintances, coworkers and fellow congregants or clergy in religious organizations. A seven-point scale ranged from, at one end, definitely knows and openly talked about to, at the other extreme, definitely doesn’t know and never discussed. Participants also told the age at which they disclosed their sexual identity.

Then a random sub-sample of 58 who didn’t differ from the larger group provided saliva samples that showed cortisol levels over seven days at four set times every day. And they also filled out diaries of daily stressors and positive events each evening.

The key finding: The more open they were in disclosing, the lower their cortisol levels, but that was driven by how much they disclosed to family members. Stress hormone release was not related to how out these young adults were to friends, coworkers or contacts in religious groups. Saliva samples weren’t taken during normal working hours, so that might account for the lack of coworker effects, Zoccola speculates.

The younger people were when they came out to siblings, the lower their stress hormones. “This may reflect supportive siblings or being in a family where it’s comfortable to share the truth about your sexual identity,” she says.  In fact, it’s not clear whether disclosure per se lowers cortisol or being in a supportive family enables full disclosure, and it’s the family’s basic support that lowers stress. She intends to follow her study participants, whose average age is 25, to see how their coming out and cortisol patterns may relate to longer-term health.

”For these emerging adults, the family provides a foundation of support,”  notes Zoccola. “If they’re comfortable disclosing to their family, they seem to have a protective stress profile.”


Study Link: https://journals.lww.com/psychosomaticmedicine/Abstract/2018/10000/When_Family_Matters_Most___A_Test_of_the.5.aspx

Faculty Page: https://www.ohio.edu/cas/psychology/contact/profiles.cfm?profile=zoccola

The Society for Biopsychosocial Science and Medicine (APS) (http://www.thesbsm.org),
founded in 1942, is an international multidisciplinary academic society that conducts an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the SBSM is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”

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