(PS6-12) Clinical Considerations for Identity-affirming Care: How Age and State Policies Shape the Timing of Coming Out

Abstract Text: LGBTQ+ individuals are discovering and disclosing their identities at increasingly younger ages. The difference in years between discovery and disclosure—referred to as “lag time”—has shortened across generations, which may reflect broader societal acceptance throughout the US (Costa et al., 2022). However, a growing number of states are enacting anti-equality laws (e.g., “Don’t Say Gay” laws), reinforcing structural stigma and undermining progress within these regions. These laws may extend lag time and contribute to negative mental health outcomes (Pachankis et al., 2021). Active concealment of identity on its own is negatively associated with psychological and physical health outcomes (Quinn et al., 2017).

Despite growing research on the link between structural stigma and identity disclosure at the national level, little is known about how state-level policies shape lag-time, particularly across age groups (Pachankis et al., 2021). This study examines how state-level anti-equality laws predict lag time and whether age moderates this relationship. We hypothesize that individuals in states with more anti-equality laws will report longer lag times, with this effect being stronger among older individuals.

A sample of 791 LGBTQ+ adults (18-97 years; Mage = 30.16) reported current age, ages of identity discovery and disclosure, and the US state that they lived in for the longest. Approximately 31% of participants identified as gender minorities (GM), and 93% as sexual minorities (SM). State-level LGBTQ+ policies were indexed using data from the Movement Advancement Project, which quantifies LGBTQ+-related laws and policies at the state level, where higher scores indicate more LGBTQ+ affirming states.

Results show that age was positively associated with lag time for both GM (β = 0.27, p < .001), and SM (β = 0.25, p < .001) individuals, meaning older individuals reported more years between discovery and disclosure. More accepting and affirming LGBTQ+ policies predicted shorter lag times for GM individuals (β = -0.16, p = .024). Age moderated the relationship between anti-equality laws and disclosure timing. Among GM individuals, the delaying effect of these laws became more pronounced with age (β = 0.006, p = .016), whereas the effect diminished with age among SM individuals (β = -0.0024, p = .05).

Findings suggest that the lag time between LGBTQ indviduals’ discovery and disclosure of identity is shorter for younger cohorts. While the increased historical acceptance of LGBTQ+ people may contribute to less prolonged identity concealment, anti-equality laws continue to play a significant role in delaying disclosure, particularly for GM individuals. These findings underscore the impact of structural barriers on disclosure timing, even amid broader societal shifts toward acceptance. Future research should examine how lag time compares across generations, and whether the recent and ongoing rise in anti-equality laws on both the state and federal levels impacts lag time. Understanding the negative effects of anti-equality laws across age groups can better inform targeted clinical interventions and state-level policy reforms mitigating the harmful impact on LGBTQ+ mental health.