(PS8-46) Gender and Sexual Minoritized Identity Disclosure in Mental Healthcare: Roles of Stigma Consciousness, Identity Centrality, and Race

Discrimination and stigmatization contribute to high rates of mental distress among gender and sexual minoritized (GSM) adults, and many seek mental health services. While one’s GSM identity may be relevant to mental healthcare needs, GSM adults report experiencing discrimination and stigmatization in healthcare settings and some avoid disclosing their GSM identity to providers. Despite this, stigma consciousness – the concern that one will be stigmatized based on GSM identity – is associated with increased openness about GSM identity with mental healthcare providers. Identity centrality, the degree to which one sees their GSM identity as central to who they are, may play a pivotal role in how GSM adults perceive a need for mental healthcare providers to know their GSM identity. This study aims to examine if stigma consciousness, identity centrality, discrimination, and relevant demographic factors together relate to GSM identity disclosure to mental healthcare providers.

This study included GSM adults who received mental healthcare (n=114) and completed self-report measures on stigma consciousness, identity centrality, discrimination, demographics, and attitudes toward GSM disclosure with mental healthcare providers. Linear regression analyses were used to determine if stigma consciousness, identity centrality, discrimination, and relevant demographic factors (age, gender, socioeconomic status [SES], education, race), predicted a perceived need for their mental healthcare providers to know their GSM identity. Correlation analyses were used to determine relationships between variables. Higher stigma consciousness (r_s = .59, p < .001), higher identity centrality (r_s = .52, p < .001), fewer years of education (r_s = -.21, p =.02), and higher SES (r_s = -.20, p = .03) correlated with a perceived need for providers to know one’s GSM identity. Stigma consciousness and identity centrality also positively correlated with one another (r_s = .67, p < .001). Regression analyses revealed that higher stigma consciousness (β = .41, p = .004), higher identity centrality (β = .28, p = .015), and belonging to a racially minoritized group (β = .48, p = .022) were associated with a perception that it is necessary for mental health providers to know one’s GSM identity (F_(8,100) = 7.99, p < .001, R² = .39).

Results emphasize that centrality of one’s GSM identity is particularly relevant for disclosure to mental healthcare providers, especially when highly concerned about stigmatization. Belonging to a racially minoritized group is also relevant; it may be that a need for GSM identity disclosure to providers is highly important for those who are greatly concerned about stigmatization and hold both GSM and racially minoritized identities. Clinicians must acknowledge the real potential for discrimination and stigmatization that GSM clients face. Providers should also be aware of contexts and perceptions that may encourage or discourage GSM individuals’ identity disclosure and should work to understand the centrality of clients’ held identities.