A recent study showed that for LGBT people, the act of "coming out of the closet" and opening up to friends and family resulted in better health outcomes by reducing the effects of stress on the body. According to a report published Tuesday in the journal Psychosomatic Medicine, people who come out have lower levels of the stress hormones and suffer from fewer instances of depression, burnout and anxiety than their peers who are not open about their orientation.

Researchers at Canada's Center for the Study of Human Stress (CSHS) at Louis H. Lafontaine Hospital in Montreal found that LGBT people who were open with the people around them had a lower "allostatic load" than people who were not. Allostatic load is the strain and wear and tear inflicted on the body's systems caused by the stress hormone cortisol.

"Our goals were to determine if the mental and physical health of lesbians, gay men and bisexuals differs from heterosexuals and, if so, whether being out of the closet makes a difference. We used measures of psychiatric symptoms, cortisol levels throughout the day, and a battery of over twenty biological markers to assess allostatic load," said the study's lead author Robert-Paul Juster.

"Contrary to our expectations," he continued, "gay and bisexual men had lower depressive symptoms and allostatic load levels than heterosexual men. Lesbians, gay men, and bisexuals who were out to family and friends had lower levels of psychiatric symptoms and lower morning cortisol levels than those who were still in the closet."

Researchers studied a diverse group of 85 volunteers around the age of 25 who represented a range of sexual and gender orientations. CSHS director Dr. Sonia Lupien's laboratory directed the study, which, over the course of several visits, administered multiple questionnaires, as well as tests of the subjects' saliva, blood and urine to detect cortisol and establish allostatic load levels.

"Chronic stress and misbalanced cortisol levels can exert a kind of domino effect on connected biological systems," explained Lupien. "By looking at biomarkers like insulin, sugar, cholesterol, blood pressure, adrenalin, and inflammation together, an allostatic load index can be constructed and then used to detect health problems before they occur."

Study co-author Dr. Nathan Grant Smith said, "Coming out of the closet is a major milestone in lives of LGBs that has not been studied extensively using interdisciplinary approaches that assess stress biomarkers."

Lead author Juster pointed out that these findings are true for LGBT people who live in a socially tolerant culture like Canada, but that people trying to come out in rigidly conservative or dogmatically religious cultures will have different outcomes.

"Coming out might only be beneficial for health when there are tolerant social policies that facilitate the disclosure process," he said. "Societal intolerance during the disclosure process impairs one's self-acceptance that generates increased distress and contributes to mental and physical health problems."

"Coming out is no longer a matter of popular debate but a matter of public health," he concluded. "Internationally, societies must endeavour to facilitate this self-acceptance by promoting tolerance, progressing policy, and dispelling stigma for all minorities."

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