08:38am Monday 06 April 2020

Study demonstrates health benefits of coming out of the closet

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.”

The research was published in Psychosomatic Medicine on January 29, 2013. The University of Montreal is officially known as Université de Montréal.

About the researchers

Robert-Paul Juster

  • Doctoral candidate, Integrated Program in Neuroscience, McGill University
  • Research Intern, Centre for Studies on Human Stress, Fernand-Seguin Research Centre at Louis-H. Lafontaine Mental Health University Institute, affiliated with the University of Montreal

Sonia Lupien, PhD

  • Director, Centre for Studies on Human Stress of the Fernand-Seguin Research Centre at Louis-H. Lafontaine Mental Health University Institute, affiliated with the University of Montreal
  • Scientific Director, Fernand-Seguin Research Centre
  • Associate Professor, Psychiatry Department, University of Montreal
  • Senior Investigator Chair on Sex, Gender and Mental Health, Canadian Institute of Gender and Health

Nathan Grant Smith, PhD

  • Assistant professor of Educational and Counselling Psychology, McGill University

About this study
This study was funded by a grant (222055) from the Canadian Institutes of Health Research (CIHR) to Sonia Lupien who holds a Senior Investigator Chair on Gender and Mental Health from the CIHR Institute of Gender and Health (GSC 91039). Robert-Paul Juster held a Doctoral scholarship from the CIHR Institute of Aging (SIA 95402).

Media Contact:
Laurence Robichaud
Media Relations
Centre for Studies on Human Stress at Louis H. Lafontaine Hospital
Tel. : 514 251-4000, ext. 2986 Cell. : 514 235-4036

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