“I can’t stop thinking about it”: The mental and behavioral health correlates of disclosure rumination among sexual minorities.

Among sexual minority individuals (SMs), concealment of one’s sexual identity has been associated with adverse mental and behavioral health outcomes, though the mechanisms underlying this association remain underexamined. The present research examined a novel mechanism linking higher sexual identity concealment to poorer mental health and a greater likelihood of using substances to cope with stress. Specifically, disclosure rumination (i.e., the extent to which participants felt fixated on disclosure experiences, including feeling overwhelmed by thinking about disclosing their identity to others) was examined with survey items adapted from prior brooding rumination scales. As hypothesized, SMs (N = 362) who concealed their identity to a greater extent spent more time ruminating about disclosure, contributing to poorer self-reported mental health and a greater likelihood of substance use coping in our cross-sectional mediation analyses. Additional moderation analyses suggest that these associations were more pronounced for SMs who experience greater sexual orientation-based discrimination. Interventions to reduce disclosure rumination among SMs are suggested to combat SM’s mental health and substance use disparities. Sexual minority individuals who conceal their sexual orientation are at greater risk of developing mental and behavioral health disorders compared to their less concealed counterparts. The present research suggests that disclosure rumination (i.e., a fixation on thinking about the act of identity disclosure) is an underexamined mechanism underlying the adverse consequences of sexual orientation concealment. Efforts to reduce stress surrounding disclosure, for example, by reframing cognitions toward pondering about positive rather than negative outcomes of disclosure, may be a fruitful avenue to improve the mental and behavioral health of concealed sexual minority individuals, perhaps especially among those in more supportive environments.