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Sexual orientation concealment and mental health: A conceptual and meta-analytic review.

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Pachankis, John E., Mahon, Conor P., Jackson, Skyler D., Fetzner, Benjamin K., Bränström, Richard·2020·Psychological Bulletin

DOI 10.1037/bul0000271PMC PMC8011357

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Abstract

= 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. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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Authors: Pachankis, J. E., Mahon, C. P., Jackson, S. D., Fetzner, B. K., & Bränström, R.
ORCID: Pachankis, John E.
Mahon, Conor P.
Jackson, Skyler D.
Fetzner, Benjamin K.
Bränström, Richard
Venue: Psychological Bulletin
Publisher: American Psychological Association (APA)
Published: 2020-10
Volume: 146
Issue: 10
Pages: 831-871
ISSN: 0033-2909 (ISSN-L)
1939-1455
DOI: 10.1037/bul0000271
PMC: PMC8011357
OpenAlex: W3044954344
Cited by: 433
References: 155
Citations by year: 2026: 59 · 2025: 85 · 2024: 99 · 2023: 76 · 2022: 79 · 2021: 32 · 2020: 3
FWCI: 51.92
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (am, 295 d)
Locations: Psychological Bulletin (publishedVersion, other-oa)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (T32 MH020031)
Topics: Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Social Sciences › Gender Studies › Gender and Feminist Studies
Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
Keywords: concealment of sexual orientation, sexual minority mental health, internalizing problems, depression, anxiety, distress, problematic eating, problematic substance use, stigma, bisexuals, life course
MeSH terms: Sexual and Gender Minorities, Adult, Anxiety, Anxiety Disorders, Mental Disorders, Bisexuality, Confidentiality, Cross-Sectional Studies, Defense Mechanisms, Female, Humans, Male, Risk Factors, Sexual Behavior, Comorbidity, Substance-Related Disorders, Social Stigma

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Sexual orientation concealment and mental health: A conceptual and meta-analytic review.

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