LGBTQ+ health: Coming out has powerful benefits

Authenticity is one of the most powerful prescriptions for health. When people can be seen, heard and supported, the body responds. Stress lessens, immunity strengthens and healing begins.”

Coming out is not merely a social or emotional milestone. It is a profound act of self-care. As an openly gay physician practicing for more than 40 years in the LGBTQ+ space, I have seen how authenticity and health are deeply connected.

The journey toward living openly is not without challenge, but it can be life-changing in ways that reach far beyond identity. The health implications of staying closeted, the impact stress can play and the essential role of supportive environments in fostering healing and a sense of well-being are all crucial for individuals and families alike.

The health risks of staying in the closet

The closet is a toxic place. The constant need to censor oneself, change pronouns, hide relationships and suppress aspects of one’s identity can take a real toll on both mental and physical health. Fear of judgement and discrimination can lead those concealing parts of themselves to withhold critical information from their doctors, sometimes resulting in missed screenings, misdiagnoses and untreated conditions.

When a person’s true identity is hidden, the body carries the burden. Increased or elevated stress hormones, poor sleep and anxiety can contribute to physical problems such as ulcers, high blood pressure and heart disease.

This continued concealment also keeps the body in a constant state of alertness. Persistent fight-or-flight mode can, over time, create significant harm to both physical and emotional health. It can weaken the immune system, making the body more vulnerable to illness, and contribute to inflammation. These are not abstract connections. They are real and measurable consequences of chronic stress and fear.

Minority stress and overcoming it

LGBTQ+ individuals experience the ongoing strain caused by stigma, prejudice and discrimination. This chronic stress can contribute to poor mental health, substance abuse and chronic disease. It is not identity that impacts an individual’s health, rather, it is the social environment that forces them to navigate secrecy and fear.

Families, friends and communities play an essential role in breaking that cycle. Every act of acceptance and affirmation helps protect against harmful health effects and builds emotional resilience.

Why supportive spaces are important

When people come out in supportive environments, their relief is visible. Anxiety is replaced by a sense of calm, shoulders relax, breathing slows and healing begins. In fact, supportive families and friends do more than reduce stress. They help open doors to better health care for their loved ones.

Concurrently, LGBTQ+ individuals are more likely to speak honestly with health care providers, and address problems they may have ignored. Being able to openly share one’s truth with one's healthcare provider can alter the whole experience of health care. Misdiagnoses can disappear as the hidden stress of concealment is gone. Inclusion itself can be a form of medicine.

In cases where this level of support does not exist, it is vital that LGBTQ+ people find places where it does and form communities of choice that are supportive. Allowing others to create a toxic environment will only increase unhealthy stress.

Navigating health care conversations

Health conditions do not change after coming out. They simply become better understood and more effectively treated because conversations happen without judgement and fear. Sensitive providers learn to ask open-ended questions that create a path to feeling safe to give honest answers. For instance, instead of asking, “Are you sexually active?” — which can easily be construed as asking "are you promiscuous,” — I might ask instead, “Have you ever had sex? If so, with men, women or both?” These questions are not about labels. They are about ensuring proper, inclusive care.

Patients can also advocate for themselves when making appointments by asking whether the provider has experience working with LGBTQ+ patients or with individuals living with HIV. Transparency and trust go hand in hand.

The major misconception about coming out is that it is a single moment. In reality, it’s a lifelong process. People will often make assumptions about how others perceive them, and living openly will often mean challenging those assumptions. As individuals begin to live more openly, family and friends can offer support not only in spiritual ways, but also in ways that promote one’s health. Some tips for doing that include:

• Help find LGBTQ-friendly health care providers
• Support routine medical care and mental health check-ins
• Offer to accompany your loved one to appointments
• Promote healthy routines
• Listen without judgement

Authenticity is one of the most powerful prescriptions for health. When people can be seen, heard and supported, the body responds. Stress lessens, immunity strengthens and healing begins.

Coming out, when met with love and understanding, is more than a declaration of identity. It is an act of self-preservation and a path toward lifelong well-being.

Editor’s note: Howard Grossman, MD is medical director for Spectrum Medical Care Center in Phoenix. Please submit comments at yourvalley.net/letters or email them to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.