Abstract
Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals often experience challenges pertaining to disclosure of their sexual orientation to others, or "coming out." Coming out can be stressful and significantly impact an individual's mental health, confidence, and safety due to factors including family and friends support, religion, environment, and finances. This study explored the lived experiences of LGBTQ+ adult individuals coming out, including experiences of ambiguous loss (AL).
Methods: This mixed-methods, IRB-approved study included 429 LGBTQ+ identifying individuals who completed an online anonymous survey about their coming out experience. We utilized virtual and social media platforms, and snowball sampling. A deductive codebook was developed and the data were coded by two researchers to ensure inter rater reliability. Ambiguous Loss theory was used as a framework to guide the findings.
Results: From the data of 429 participants, three major themes emerged: (1) Psychosocial safety (fear of being disowned, shunned, or abandoned); (2) Anxiety, depression, emotional strain, and shame; and (3) Authenticity, self-discovery, and the liberation. Results of this study indicate that individuals had an overwhelming fear of being rejected by their family, friends, and employers. Religious beliefs (n = 254), financial concerns (n = 107), and living in a heteronormative society were major factors in individuals' fear of loss. Although participants identified many challenges, stressors, and losses during the coming out process, most (n = 379) reported that disclosing their sexual orientation improved their health and mental well-being.
Discussion: The findings of this study indicate a need to assess and offer support for ambiguous loss as individuals navigate the challenges of coming out and learn to cope with losses associated with heteronormativity and homophobia. Nurses can use this research to gain a deeper understanding of the interpersonal complexities experienced by LGBTQ+ people who disclose their sexuality. Understanding the impact of ambiguous loss in this context will enable nurses and the interdisciplinary team to provide empathetic care and appropriate resources, support, and guidance needed by the LGBTQ+ population to "come out" safely and confidently.
Notes
References:
1.) Boss, P. (2007). Ambiguous loss theory: Challenges for scholars and practitioners. Family Relations, 56(2), 105–111. https://doi.org/10.1111/j.1741-3729.2007.00444.x
2.) Boss, P. (2016). The context and process of theory development: The story of ambiguous loss. Journal of Family Theory & Review, 8(3), 269–286. https://doi.org/10.1111/jftr.12152
3.) Charak, R., Cano-Gonzalez, I., Ronzon-Tirado, R., Schmitz, R. M., Tabler, J., Karsberg, S., Flores, A., & Ford, J. D. (2023). LGBTQ+ identity-related abuse during childhood and associations with depression and suicide behavior: Role of adulthood cisheterosexism and expressive suppression. Child Abuse & Neglect, 145, 106433. https://doi.org/10.1016/j.chiabu.2023.106433
4.) Drydakis, N. (2022). Social rejection, family acceptance, economic recession, and physical and mental health of sexual minorities. Sexuality Research and Social Policy, 19(3), 1318–1340. https://doi.org/10.1007/s13178-021-00640-4
5.) Pollitt, A. M., Fish, J. N., & Watson, R. J. (2023). Measurement equivalence of family acceptance/rejection among sexual and gender minority youth by disclosure status. Journal of Family Psychology, 37(2), 195–202. https://doi.org/10.1037/fam0001056
6.) Ramm, A., Astudillo, P., Venegas, D., Dinamarca, C., & Salinas, V. (2024). ‘It would be a problem for the family’: Queerness, family honour and familism in Chile. Culture, Health & Sexuality, 1–14. https://doi.org/10.1080/13691058.2023.2300642
7.) Rosati, F., Pistella, J., Nappa, M. R., & Baiocco, R. (2020). The coming-out process in family, social, and religious contexts among young, middle, and older italian lgbq+ adults. Frontiers in Psychology, 11, 617217. https://doi.org/10.3389/fpsyg.2020.617217
8.) Rostosky, S. S., Richardson, M. T., McCurry, S. K., & Riggle, E. D. B. (2022). LGBTQ individuals’ lived experiences of hypervigilance. Psychology of Sexual Orientation and Gender Diversity, 9(3), 358–369. https://doi.org/10.1037/sgd0000474
Sigma Membership
Beta Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Health Equity or Social Determinants of Health, Stress and Coping, Interprofessional, Interdisciplinary, LGBTQ+
Recommended Citation
Rabins, Maya; Koch, Amie; Brennan-Cook, Jill; and Jackson, Gillian, "Embracing Identity: Unmasking Challenges in LGBTQ+ Disclosure Journey" (2025). International Nursing Research Congress (INRC). 179.
https://www.sigmarepository.org/inrc/2025/presentations_2025/179
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Embracing Identity: Unmasking Challenges in LGBTQ+ Disclosure Journey
Seattle, Washington, USA
Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals often experience challenges pertaining to disclosure of their sexual orientation to others, or "coming out." Coming out can be stressful and significantly impact an individual's mental health, confidence, and safety due to factors including family and friends support, religion, environment, and finances. This study explored the lived experiences of LGBTQ+ adult individuals coming out, including experiences of ambiguous loss (AL).
Methods: This mixed-methods, IRB-approved study included 429 LGBTQ+ identifying individuals who completed an online anonymous survey about their coming out experience. We utilized virtual and social media platforms, and snowball sampling. A deductive codebook was developed and the data were coded by two researchers to ensure inter rater reliability. Ambiguous Loss theory was used as a framework to guide the findings.
Results: From the data of 429 participants, three major themes emerged: (1) Psychosocial safety (fear of being disowned, shunned, or abandoned); (2) Anxiety, depression, emotional strain, and shame; and (3) Authenticity, self-discovery, and the liberation. Results of this study indicate that individuals had an overwhelming fear of being rejected by their family, friends, and employers. Religious beliefs (n = 254), financial concerns (n = 107), and living in a heteronormative society were major factors in individuals' fear of loss. Although participants identified many challenges, stressors, and losses during the coming out process, most (n = 379) reported that disclosing their sexual orientation improved their health and mental well-being.
Discussion: The findings of this study indicate a need to assess and offer support for ambiguous loss as individuals navigate the challenges of coming out and learn to cope with losses associated with heteronormativity and homophobia. Nurses can use this research to gain a deeper understanding of the interpersonal complexities experienced by LGBTQ+ people who disclose their sexuality. Understanding the impact of ambiguous loss in this context will enable nurses and the interdisciplinary team to provide empathetic care and appropriate resources, support, and guidance needed by the LGBTQ+ population to "come out" safely and confidently.
Description
In a mixed-methods study, 429 LBGTQ+ identifying individuals shared their experiences of disclosing their sexual orientation, or “coming out”, which highlighted the effects on participants’ mental health and associated ambiguous losses. The results from this study enable nurses to provide empathetic care and appropriate resources, support, and guidance needed to support LGBTQ+ individuals to come out safely with minimal losses.