Act of coming out associated with better health for LGB adults

A comprehensive new study led by Boston University School of Public Health (BUSPH) researcher Emily Rothman shows that two-thirds of lesbian, gay and bisexual adults in a representative Massachusetts sample reported receiving positive support from their parents after coming out to them. Their incidence of mental health and substance abuse problems was significantly lower than those who did not receive support, the authors reported.

Overall, three-quarters of lesbian, gay and bisexual adults in Massachusetts reported having come out to their parents, typically when they were about 25 years old, the study found.

The response to their coming out led to different health outcomes, according to the researchers. Gay and bisexual males whose parents did not support them, for example, had six to seven times the odds of serious depression and binge drinking, while lesbian and bisexual females had five times the odds of developing serious depression, and 11 times the odds of illicit drug use.

In the study, published in the Journal of Homosexuality, Rothman and colleagues surveyed 5,658 adults ages 18-64 years old in Massachusetts using a statewide surveillance system. They explored whether coming out-and the reaction that it received -was associated with better or worse adult health. The authors controlled for factors including age, race, education level and health insurance status, in order to focus as narrowly as possible on the association between coming out and adult health status.

"These results do not surprise me at all," said Nicole Sullivan, a 22-year-old student at Bunker Hill Community College who came out as bisexual when she was 19 years old. "I struggled with mental health and drug problems during my adolescence, and I know that some of it is because I didn't feel accepted at home. I am really grateful that I had cousins who supported me, and it's because of them that I was able to get healthy."

The authors found that the act of coming out (instead of remaining "closeted") was generally associated with better health for lesbian and bisexual women, but that this was not similarly true for gay and bisexual men.

"It's possible that the stress of not disclosing your sexuality to your parents affects men and women differently," explained Rothman, an associate professor of community health sciences. "In general, gay and bisexual men may be able to conduct their sexual lives apart from their parents with less stress. On the other hand, it's also possible that this was an artifact of our particular sample."

Rothman added: "Given the high rates of suicide and self-harm among lesbian, gay and bisexual (LGB) youth--and the high costs of treating mental-health and substance-abuse disorders-it's critical that we understand what we can do to promote better health for LGB kids."

In the study, the authors propose that a low-cost but potentially far-reaching strategy to improve LGB youth health would be for national academies of pediatric medicine to develop and disseminate guidelines or recommendations that would encourage pediatricians to provide all parents of adolescents with tips for supporting children if they come out as lesbian, gay or bisexual.

"The way that parents treat their LGB children when they come out is an important public health topic that has received too little attention to date," Rothman said. "Our message is that parents should take note: The way we treat our LGB children, even from before the time they disclose their sexual orientation status, may have a long-term, significant impact on their health and ability to handle life's challenges."