Introduction

Adolescent development is characterized by shifting social relationships (Collins, 1997) and both exploration of and commitment to emerging individual and social identities (Luyckx et al., 2011). For lesbian, gay, bisexual, transgender, asexual, non-binary and other queer or questioning (LGBTQ +) youth, navigating these shifting relationships and identities is further complicated by the decisions about whether, when, and to whom to disclose their, often concealable (Pachankis & Jackson, 2023), sexual or gender identities. When a stigmatized identity or status, such as sexual orientation or gender identity, may be hidden or concealed from others, individuals must navigate decision making around disclosing their stigmatized identity to others and navigate the possible consequences of that disclosure (Pachankis, 2007). Disclosing, or sharing information about, one’s sexual orientation and/or gender identity can have profound implications for the lifelong wellbeing of LGBTQ + populations (Chaudoir & Fisher, 2010; Lick et al., 2013). Consequences of disclosure range from positive, including social support and self-esteem, to negative, including social isolation, distress, and stigma (Chaudoir & Fisher, 2010; Earnshaw, et al., 2024). Although individual studies make it clear that disclosure is an impactful aspect of sexual and gender minority youth development, understand the nuances and diversity in these processes is only possible through bringing together research from multiple studies that can together portray the full developmental process and impact of disclosure. Therefore, the current study provides a comprehensive review and synthesis of the literature that uniquely positions sexual and gender identity disclosure as a complex, developmental process that has consequences for youth mental health and social relationships.

In light of these complexities, this study delves into the intricate social process of disclosure during adolescence, a period marked by changing communication patterns and heightened vulnerability for LGBTQ + youth (Russell & Fish, 2019). Moving forward, this review employs the Disclosure Process Model (DPM) to provide a comprehensive framework for examining disclosure decisions, events, mediating processes, and outcomes (Chaudoir & Fisher, 2010). The decision-making process of when, how, and to whom to disclose becomes a critical aspect of identity development, impacting mental health outcomes. By adopting a developmental focus and synthesizing the literature on both sexual and gender identity disclosure, this study aims to contribute to a more inclusive and nuanced understanding of LGBTQ + youth disclosure experiences, addressing critical gaps in the existing research landscape.

Disclosure of a stigmatized identity is recognized to be a complex and often challenging social process with which individuals, including adults, may struggle (Chaudoir & Fisher, 2010). Yet, LGBTQ + individuals are disclosing at younger ages, including during adolescence, with the average age of first disclosure to family decreasing from age 26 to 17 in recent generations (Bishop et al., 2020). Human development research is paying more attention to sexual minority youth and their lives, which reflects evolving societal values, attitudes, and acceptance regarding LGBTQ + issues and individuals. Significant societal shifts in the acceptance of LGBTQ + issues, along with corresponding legislative and policy changes, opened up previously unimaginable opportunities for sexual minorities to fully participate in society. In tandem with these shifts in society is the observed decline in the average age at which youth come out. Young people who identify as sexual minorities now come out during developmental stages when the majority remain financially and emotionally dependent on family. As disclosure occurs earlier in development, these disclosure processes are now unfolding during a developmental stage when LGBTQ + youth may be more vulnerable to negative disclosure outcomes based on their less developed coping skills and cognitive processing ability (Russell & Fish, 2019). Indeed, adolescence is a period characterized by decreased disclosure of unsupervised activities and behavior to parents (Keijsers & Poulin, 2013), making changes in disclosure a hallmark of communication and development in adolescence. Parent-adolescent research demonstrates that most of what parents know about their adolescence is based on what adolescents voluntarily disclose (Stattin & Kerr, 2000). The convergence of earlier sexual orientation and gender identity disclosure in adolescence thus situates LGBTQ + identity disclosure in a developmental context when navigating changing disclosure and withholding information, at least from parents, is common (Goldstein et al., 2023; Keijsers & Poulin, 2013). Further, because sexual orientation and gender identity may be stigmatized inside and outside the family, LGBTQ + adolescents must navigate disclosure decisions in a variety of other relationships and contexts. Additional key contexts for understanding how LGBTQ + youth experience and navigate stigma include family, school, peer groups, and religion (Goldbach & Gibbs, 2015). In addition, the characteristics of the disclosure recipient, or the person or group of people to whom a person is disclosing, may influence the disclosure (Earnshaw et al., 2019). For example, Lesbian, gay, bisexual, and transgender individuals may disclose their sexual orientation to friends and family but not to coworkers (Quinn & Earnshaw, 2013).

Aligned with transgender theory (Nagoshi & Brzuzy, 2010), for transgender and nonbinary youth, development and eventual disclosure of gender and sexual identities are often inextricably connected, sometimes contributing to multiple, nonlinear disclosure processes over time. Although gender identity and sexual orientation are often framed as two different concepts and identities, many young trans people process both identities together and report these processes as inseparable and intricately interconnected (Hereth et al., 2020). When conceived as separate concepts, a person’s sexual orientation is determined by factors such as their identity, how they define themselves, who they find attractive, and who they have or seek sexual experiences with (Rosario et al., 2006); gender identity is also multifaceted and includes identity, expression (i.e., how one decides to express their gender, such as through clothing and mannerisms), and body (i.e., the variety of choices people make to medically validate their gender identity (Hereth et al., 2020). However, transgender theory explains that gender and sexual identities exist at a dynamic intersection wherein understanding and development of one dimension reciprocally influences change in the other (Nagoshi et al., 2023). For trans and nonbinary adolescents, it can be especially challenging to navigate identity development and disclosure when identity labels and cultural conceptualizations of gender and sexuality are treated as separate and distinct. Although disclosure processes are diverse for trans youth, one qualitative study found that for some trans young people identity development and disclosure was an iterative process that required revisiting labels and identity, and for others it was challenging to understand and describe gender or sexuality without exploring the other first (Hereth et al., 2020). Observing how trans youth navigate the layered understanding of sexual and gender identity together reveals the internal complexity of identity development and the challenges of finding clear ways to communicate this to others.

Disclosure of either sexual and gender identity plays a central role in key theories focused specifically on the wellbeing of LGBTQ + populations. Minority stress theory, introduced by Brooks and expanded on by Meyer (Brooks, 1981; Meyer, 1995) hypothesized that concealment and disclosure of sexual orientation are important to the mental health of LGBTQ + populations. Minority stress theory draws attention to the mental health toll of concealing sexual orientation (e.g., thought suppression, distress), reasons for concealing (e.g., anticipated stigma), and benefits of disclosure (e.g., social support, connection) (Meyer, 2003). Further research among transgender people stresses the importance of disclosure of gender identity for access to gender affirming and appropriate medical care (Hughto et al., 2015). Additional theory recognizes the importance of focusing on disclosure among LGBTQ + youth specifically. The process of identity development and disclosure is particularly central in minority stress models adapted for adolescents, including how sexual and gender identity developmental processes shape the ways in which adolescents experience and cope with minority stressors (Goldbach & Gibbs, 2015). For example, adolescents’ disclosure experiences may be shaped by the extent to which they are sensitized to and have accepted their sexual orientation and/or gender identity prior to disclosure. More recently, a theoretical, developmental model of “the closet,” considers adaptations and growth that occurs before and after LGBTQ + identity disclosure when individuals move out of total isolation when they alone knew of their LGBTQ + identity (e.g., in “the closet”). This developmental model suggests that the closet is shaped by awareness of cultural attitudes toward sexual and gender minorities prior to self-realization of an LGBTQ + identity. Once an individual develops awareness of their sexual or gender identity, they may experience stress due to the shared knowledge of these dominant cultural attitudes, thereby shaping the closet as a period of isolation and stress. Specifically, the model highlights threats to belonging that may shape the experience of the closet and decisions to come out, especially during adolescence. Finally, this model posits a post-closet growth process following initial disclosure which may include meaning making, independence, and social integration (Pachankis & Jackson, 2023). Each of these theories recognizes the complexity of disclosure processes, situates its centrality to understanding LGBTQ + health, and encourages more research in this area.

The Disclosure Process Model (DPM) takes a nuanced approach to characterizing disclosure processes to ultimately understand when and how disclosures of a stigmatized identity are beneficial to the discloser (Chaudoir & Fisher, 2010). In this way, the DPM offers specific insights into disclosure processes as well as explanatory mechanisms through which disclosure and its consequences or downstream outcomes may be connected. The DPM comprised several core components: the decision-making process, the disclosure event, mediating processes, and outcomes. Disclosure starts with a decision-making process, during which the likelihood of disclosure in a particular circumstance is influenced by the disclosure goals. The decision-making process encompasses approach goals (i.e., reasons for) goals such as achieving understanding, forming a stronger relationship, educating others, and avoidant goals (i.e., reasons against) goals such as avoiding social rejection and/or, conflict for disclosure. Determining when disclosure would be advantageous needs to comprehend the disclosure goals, or reasons, that motivate people to disclose. After the decision-making process and when individuals decide to disclose based on their approach and avoidance goals, they explain communicate details to their chosen confidant about the concealable stigmatized identity. The disclosure event spans a verbal exchange of information between a discloser and a disclosure recipient. The DPM focuses on the depth, breadth, duration, and emotional content of the disclosure as well as the reaction of the recipient during the disclosure event. When both the discloser and a confident agree on this information, a disclosure event takes place. For a lot of people in many cases, this disclosure event will be a one-time situation event in which they the discloser talks about their stigmatized identity with their confidant and make it obvious that they are the identity recipient clearly communicates their identity to the confidant. In some cases, however for some, though, it might take longer for the disclosure event to occur a disclosure may span several events and therefore take longer to occur. The DPM further identifies mediating processes think link disclosure events with outcomes. In mediating processes and outcomes DPM determine how disclosure event impact outcomes. Key mediating processes linking disclosure and outcomes may include increases in social support, alleviation of inhibition, and changes in social information. These mediating processes provide a mechanistic explanation for how the disclosure event may indirectly lead to immediate or long-term outcomes at the individual (e.g., psychological, behavioral, health), dyadic (e.g., liking, intimacy, trust), and social contextual (e.g., cultural stigma, norms for disclosure) levels. In addition, individual and contextual moderators such socio-demographic characteristics (e.g., discloser or recipient age, gender identity, sexual orientation, sex, race, and ethnicity) and environmental factors (e.g., cultural beliefs, religion), and are underspecified in the DPM but are highlighted in theory and reviews considering LGBTQ + youth disclosure (Goldbach & Gibbs, 2015; Son & Updegraff, 2023). These moderators may be key factors that shape and guide how disclosure events unfold, what mediating processes are relevant, and what impact disclosure has on intrapersonal and interpersonal outcomes. Altogether, framing disclosure as a process rather than a singular event provides a developmental perspective to LGBTQ + disclosure wherein the full process and its impact on LGBTQ + youth may be considered holistically. This process oriented approach to disclosure and development builds on prior reviews focused on the disclosure event by examining the ways disclosure among LGBTQ + youth is studied within each component of the DPM.

Current Study

The research gaps identified in the current literature on LGBTQ + youth disclosure include the absence of a systematic review that comprehensively evaluates the empirical research in this domain, the lack of an integrated framework that synthesizes various dimensions of the disclosure process (such as decision-making, disclosure events, mediating processes, and outcomes), inadequate evaluation of the methods employed in studying LGBTQ + disclosure processes, and a dearth of research that identifies gaps and outlines future directions for advancing knowledge on LGBTQ + youth disclosure. This study addressed these research gaps. Firstly, the empirical literature on LGBTQ + youth disclosure is systematically reviewed. Secondly, this literature is synthesized using a disclosure process framework, incorporating elements such as decision-making, disclosure events, mediating processes, and outcomes. Thirdly, the methods employed in previous studies are evaluated to provide a critical assessment of the existing research landscape. Lastly, gaps in the literature are identified and future directions for research on LGBTQ + youth disclosure are proposed. Specifically, a developmental lens is applied, considering sexual and gender identity disclosure in adolescence and emerging adulthood, and diverse contexts are addressed by framing the research within the Disclosure Process Model.

Methods

Data Sources

A librarian assisted in searching electronic databases, including PsychINFO, PubMed, Web of Science, Science Direct, Social Services Abstracts, Medline, EBSCO, Gender Watch, and Sociological Abstracts. The search was conducted in May 2023, and articles published before then were included. Search terms used included both disclosure terms (disclosure, coming out, concealment, non-disclosure, and nondisclosure) and LGBTQ + identity terms (sexual minority, gender minority, transgender, LGBTQ + , gay, lesbian, LGBT, LGBTQ, GLBT, homosexual, bisexual, queer, sexual minority, gender minority, sexual orientation, gender identity, nonbinary, non-binary, gender and sexual diverse, men who have sex with men, MSM, women who have sex with women, and WSW). Search terms were searched for separately and in combination (e.g., “disclosure AND LGBTQ + ”).

This systematic review was conducted based on the methods described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for reporting systematic reviews (Tricco et al., 2018). Details of the review were registered on PROSPERO, an international database of prospectively registered systematic reviews. This systematic review did not require IRB review because it relied on available data and did not fit the definition of a human subject. Because no human subjects were in this study, informed consent was not necessary.

Study Selection

Inclusion criteria for the review included studies that: (1) evaluated a section of the Disclosure Process Model (DPM), including the decision-making process (including approach and avoidant goals for disclosure), disclosure event, mediating processes, and/or disclosure outcomes; (2) focused on LGBTQ + participants (i.e., samples were LGBTQ + and/or most participants self-identified as LGBTQ +) disclosing sexual orientation and/or gender identity, (3) included participants aged 26 or younger, (4) were empirical (i.e., quantitative, qualitative, or mixed-methods); and (5) were published in English. Unpublished research, conference presentations, case studies, and theoretical or conceptual papers were not included.

The selected references were imported to a web-based software platform that streamlines the production of systematic reviews (Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia). This software automatically removed duplicates. Two reviewers used the Covidence software to retrieve and evaluate all appropriate published studies. Two reviewers independently screened full-text review. Consensus meetings with all co-authors were held to resolve disagreements regarding inclusion until consensus agreement was reached on all reviewed studies.

Data Extraction

Two authors extracted and inputted data into Covidence. Extracted data included sample size and composition (i.e., sexual orientation, gender identity, age, location), methods, and key results. Additionally, data were extracted to characterize the DPM, including the decision-making process, mediating processes (including disclosures and reactions to disclosures), and outcomes. Although not expressly described as part of the mediating process in DPM, moderating factors that shape the disclosure process were additionally extracted given theory suggesting that the disclosure context may be particularly important to consider for LGBTQ + youth disclosure (Goldbach & Gibbs, 2015; Son & Updegraff, 2023), and to explore whether socio-demographic characteristics shaped disclosure processes.

Risk of Bias Assessment

For the risk of bias assessment, the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used for quantitative studies (National Heart, Lung, and Blood Institute, National Institutes of Health), and the CASP Qualitative Checklist was used for qualitative studies (Long et al., 2020). Both tools/checklists were applied to mixed-methods studies. Two authors evaluated studies for bias based on the NIH Quality Assessment Tool (14 items) and CASP Qualitative Checklist (10 items) independently. Disagreements in ratings were resolved through discussion among all authors until a consensus agreement was reached.

Results

Figure 1 outlines the study selection process according to a PRISMA flowchart. The initial search identified 5,433 articles. Of these, 1,329 duplicates were removed. Next, 4,104 unique titles and abstracts were screened. This screening resulted in a total of 385 articles that were selected for full-text review. Of these 385 articles, 356 articles were excluded based on the exclusion criteria, resulting in 29 articles that met the inclusion criteria. The full-text review revealed that four of the 29 articles meeting inclusion criteria were analyses of the same study dataset (Caba et al., 2022, 2023; McKay & Watson, 2020; Rentería et al., 2022). Table 1 includes key attributes of the articles included in the review.

Fig. 1
figure 1

Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Diagram

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Table 1 Key attributes of articles
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Study and Participant Characteristics

Table 2 provides a summary of study and participant characteristics. The dataset that was used in four articles is included in Table 2 only once (Caba et al., 2022, 2023; McKay & Watson, 2020; Rentería et al., 2022), yielding a study sample size of 26. All articles were published between 2008 and 2023. Of the 26 studies, 17 (65.3%) were conducted in the United States. The remaining nine were conducted in Canada, Australia, China, Malta, the Philippines, and the United Kingdom. Two studies were conducted in multiple countries (i.e., the United States and Canada, and the United States, Canada and Israel).

Table 2 Summary of study and participant characteristics (n = 26)
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Sample sizes ranged from n = 6 to 11,225. Regarding gender identity, all studies included participants who identified as men/boys in their sample, and all articles except two included participants who identified as women/girls. Many studies included trans youth (38.4%) or gender non-binary/non-confirming youth (23.0%). Regarding sexual orientation, over half of studies included participants who identified as bisexual/pansexual (76.9%), gay (76.9%), or lesbian (65.3%). Fewer than half included participants who identified as queer (32.3%), asexual (23.0%) and less than 10% of articles included participants who identified as heterosexual (7.6%), homosexual (7.6%), questioning (7.6%), or same-sex attracted (3.8%). Participant ages ranged from 12 to 26 years old. In just over half of articles (53.8%), samples were predominantly White. Few articles reported samples that were predominantly Asian (11.5%) (D’amico et al., 2015; King, 2008; Wei & Liu, 2019), Latino (11.5%) (Burdick & Nicholus, 2022; Lozano et al., 2021; Russell et al., 2014), or African American (3.8%) (Feinstein et al., 2019).

All articles were published between 2008 and May 2023, with data collection occurring as early as 2004. Among the 26 studies with unique datasets, 42.3% were quantitative, 42.3% were qualitative, and 15.3% were mixed-methods. The majority of studies (88.4%) were cross-sectional, and few were longitudinal studies (Feinstein et al., 2019; Kiekens & Mereish, 2022; Little et al., 2023). Two articles (7.6%) were dyadic, including parents/caregivers and youth (D’Amico & Julien, 2012; Lozano et al., 2021).

Across studies, many different terms and labels were used to describe the diverse sexual orientations and gender identities included across samples. For ease of interpretation, the label LGBTQ + is used when describing results of the studies reviewed. For specific sample descriptions, including sexual orientations and gender identities, see Table 1.

Disclosure Processes Model

Table 3 summarizes components of the DPM and moderators of disclosure processes. The following sections summarize and synthesize the literature reviewed in each of the four components of the DPM as well as moderators of the disclosure. Although all articles evaluated at least part of the DPM (decision-making, disclosure events, mediating processes, outcomes) only one study used the DPM as an explicit guiding framework (Feinstein et al., 2019).

Table 3 Disclosure processes model components and moderators (n = 29)
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Decision-Making Process

More than half of articles (51.7%) highlighted avoidance goals, or reasons against disclosure. These included: sexual and gender minority stigma (e.g., homophobia, heterosexism, heteronormativity), fear and concern of rejection or loss of family financial support, a desire to not offend or make family members feel uncomfortable, shame and guilt, and social isolation (Carpineto et al., 2008; D’Amico & Julien, 2012; Du Bois et al., 2022; King, 2008; Lozano et al., 2021; Mollet, 2023; Sammut et al., 2021). Fear of negative reactions was sometimes based on negative past experiences. For instance, the risk of data leakage when disclosing private information and heteronormative expectations in the health care system can increase the fear of negative reactions from the health care providers. (Burdick & Nicholus, 2022). About a third of articles (34.4%) highlighted approach goals, or reasons for disclosure. These included: a desire to live honestly or authentically, self-protection, identity management, and building a sense of community belonging (Burdick & Nicholus, 2022; Carpineto et al., 2008; Du Bois et al., 2022; Gioia et al., 2021; Little et al., 2023; Lozano et al., 2021; Mollet, 2023; Price & Prosek, 2020; Sammut et al., 2021; Wei & Liu, 2019).

Several articles (17.2%) explored the disclosure decision-making process in general, or whether the decision-making process led to disclosing sexual orientation and gender identity or not. Although these articles did not explicitly describe participants’ goals for disclosure (as framed by the DPM), they did report on associations between the decision-making process and disclosure (Grafsky, 2018; Grafsky et al., 2018; McInroy et al., 2021; Reyes et al., 2023; Toft, 2020). For example, one article reported relationship dynamics and the youth’s expectations of the disclosure outcome are factors that influence the decision of whether or not to disclose (Grafsky, 2018).

Disclosure Event & Mediating Processes

A few articles (24.13%) specifically considered the first experience of disclosure; however, no studies focused exclusively on the first disclosure among LGBTQ + youth. Furthermore, the majority of articles (58.62%) explored disclosure among LGBTQ + youth as a process rather than a singular event, and a few studies (6.89%) even considered disclosure over time.

Regarding reactions to disclosure, many articles reported a mix of positive and negative (41.3%), several reported mostly negative (17.2%), and few reported mostly positive (6.8%). Articles describing mixed reactions to LGBTQ + youth disclosure documented reactions ranging from rejection to unconditional support (Morgan et al., 2022; Roe, 2017). Initial reactions to first disclosures were often characterized as negative, however, responses and reactions from these initial disclosure recipients improved over time (Grafsky, 2018; Lozano et al., 2021; Morgan et al., 2022; Sammut et al., 2021).

Negative reactions to youth disclosure included emotional reactions, such as shock, uncertainty, doubt, disappointment, anger, anxiety, grief, and loss; disbelief, denial, and ignoring the disclosure; attempts to change participants’ sexual orientation; as well as rejection and withdrawal of financial and emotional support (Burdick & Nicholus, 2022; D’Amico & Julien, 2012; D’amico et al., 2015; McInroy et al., 2021; Morgan et al., 2022; Pollitt et al., 2017; Roe, 2017; Sammut et al., 2021). Homophobia, heterosexism, stigma, religion, lack of information, and poor communication were described as profound barriers to positive reactions and support for LGBTQ + youth disclosure (King, 2008; Little et al., 2023; Morgan et al., 2022; Roe, 2017; Sammut et al., 2021).

Positive reactions to youth disclosure included expressions of unconditional love and acceptance; encouragement and affirmation of youth identity; expression of a desire for youth to be happy; openness and involvement; and financial and emotional support including support for the child’s romantic relationships (Carpineto et al., 2008; D’Amico & Julien, 2012; Lozano et al., 2021; Price & Prosek, 2020; Reyes et al., 2023; Roe, 2017). Approximately half (41.3%) of the articles reported that LGBTQ + youth experienced social support following disclosure (Burdick & Nicholus, 2022; Carpineto et al., 2008; Kiekens & Mereish, 2022; King, 2008; Little et al., 2023; Morgan et al., 2022; Pollitt et al., 2017; Price & Prosek, 2020; Reyes et al., 2023; Roe, 2017; Sammut et al., 2021); however, at least one study found no association between outness and social support (Wei & Liu, 2019). Although LGBTQ + youth reported wanting to receive explicit, or verbalized support, most support received was characterized as implicit (e.g., non-verbal expressions, and supportive behaviors) (Lozano et al., 2021; Roe, 2017).

Outcomes

The final component of the DPM, outcomes of disclosure, were reported in the majority of included articles (62.1%). Outcomes may include social support, alleviation of inhibition, and changes in social information. Outcomes could be immediate or long-term outcomes at the individual, dyadic, and social contextual levels. The majority of studies (90%) were cross-sectional; however, retrospective studies provided a valuable perspective by evaluating the long-term outcomes of disclosure. Approximately 20% of articles described long-term outcomes of disclosure (Caba et al., 2022; D’amico et al., 2015; Feinstein et al., 2019; Little et al., 2023; McKay & Watson, 2020; Russell et al., 2014), and an additional 24.1% described short-term or more immediate outcomes (Caba et al., 2023; D’Amico & Julien, 2012; Gioia et al., 2021; Grafsky, 2018; Kiekens & Mereish, 2022; Roe, 2017; Sammut et al., 2021), and 17.2% did not specify whether outcomes were long- or short-term (Lozano et al., 2021; Pollitt et al., 2017; Price & Prosek, 2020; Rentería et al., 2022; Semborski et al., 2022).

Mental health was the most commonly reported disclosure outcome, described by 48.2% of articles. Many articles highlighted favorable mental health outcomes following disclosure. For example, associations were found between disclosure and higher self-esteem, lower depression, positive psychosocial adjustment in young adulthood, positive affect, and wellbeing across social contexts (Caba et al., 2022; Kiekens & Mereish, 2022; Rentería et al., 2022; Russell et al., 2014). In contrast, negative mental health outcomes of disclosure included psychological distress, depression, anxiety, suicidal ideation, self-harm, and negative affect (Caba et al., 2023; Lozano et al., 2021; Sammut et al., 2021; Wei & Liu, 2019). Concealment, or the lack of disclosure, was additionally associated with increased negative affect (Kiekens & Mereish, 2022).

Very few articles (6.8%) reported relationship or interpersonal outcomes. One article found that youth experienced bullying from peers at school and negative reactions from teachers following disclosure (Lozano et al., 2021). Several articles (17%) reported other types of outcomes that were not common across studies. As examples, two articles found that disclosure was associated with negative behavioral health outcomes including alcohol and drug use (Caba et al., 2022; Feinstein et al., 2019). Other articles found disclosure of sexual orientation was linked to conversations about sexual histories and STI and HIV testing (Gioia et al., 2021).

Moderators

Articles identified several moderators of disclosure processes including characteristics of LGBTQ + youth, their disclosure recipients, or their social contexts, that shaped LGBTQ + youth’s disclosure events and experiences. These moderators describe key factors that provide more insight into the broader contexts and relationships integral to LGBTQ + disclosure events.

Identities of LGBTQ + youth that shaped disclosure processes included sexual orientation, gender identity, gender, disability, and housing status. In some studies, youth’s sexual orientation or gender identity moderated disclosure processes. As examples, articles found that bisexual youth, questioning youth, and transgender boys either did not benefit from disclosure to the same extent or were negatively impacted by disclosure in comparison to other LGBTQ + youth (Feinstein et al., 2019; McKay & Watson, 2020; Rentería et al., 2022). Several articles (31.0%) considered how youth’s other identities and socio-demographic characteristics (e.g., age, gender identity, sexual orientation, sex, race, and ethnicity) shaped disclosure processes (Caba et al., 2022, 2023; Carpineto et al., 2008; D’amico et al., 2015; Feinstein et al., 2019; Kiekens & Mereish, 2022; McKay & Watson, 2020; Mollet, 2023; Pollitt et al., 2017). Highlighting the role of gender in disclosure processes, one study found that support from parents following disclosure was more beneficial to young bisexual men than women (Pollitt et al., 2017). Other studies found that ableism shaped the disclosure decisions of disabled LGBTQ + young people (Toft, 2020), and that homeless LGBTQ + youth were more likely to have disclosed to their parents than other family members (Semborski et al., 2022).

Several articles highlighted social-cultural contextual factors that shape disclosure processes for LGBTQ + youth, including culture (6.8%) and religion (6.8%). For example, Hispanic LGBTQ + youth noted that cultural factors including familismo and gender norms (e.g., marianismo, machismo) shaped their disclosure decisions with family, undermining disclosure to fathers and grandparents in particular (Lozano et al., 2021). In another study, youth described Latinx culture as “conservative at times and patriarchal” (p. 1220), leading to fear of disclosure to healthcare providers (Burdick & Nicholus, 2022). Religion was also a barrier to acceptance from Maltese parents following disclosure, with LGBTQ + youth reporting that their parents worried that they would go to hell (Sammut et al., 2021).

The majority of articles (86.20%) considered disclosure recipients, that is people to whom LGBTQ + youth had disclosed or planned to disclose. Many articles focused on LGBTQ + youth disclosure to family specifically, with 41.3% examining disclosure to parents, 13.7% disclosure to siblings, 3.4% disclosure to grandparents, and 34.4% to other family members such as aunts, uncles, cousins, or extended family members (Caba et al., 2023; D’Amico & Julien, 2012; D’amico et al., 2015; Grafsky, 2018; Grafsky et al., 2018; Lozano et al., 2021; McInroy et al., 2021; Morgan et al., 2022; Pollitt et al., 2017; Price & Prosek, 2020; Roe, 2017; Semborski et al., 2022; Wei & Liu, 2019). Regarding other disclosure recipients, 20.6% described disclosure to healthcare providers (Burdick & Nicholus, 2022; Du Bois et al., 2022; Gioia et al., 2021; King, 2008; McInroy et al., 2021; McKay & Watson, 2020), 17.2% to friends (Caba et al., 2023; McInroy et al., 2021; Pollitt et al., 2017; Reyes et al., 2023; Sammut et al., 2021), 17.2% to people at school or college including teachers and students (Caba et al., 2022; King, 2008; McInroy et al., 2021; Russell et al., 2014; Wei & Liu, 2019), 13.7% to people online (King, 2008; McInroy et al., 2021; Mollet, 2023; Semborski et al., 2022), 10.3% to peers (Caba et al., 2022, 2023; Grafsky, 2018), 6.8% to romantic partners (Sammut et al., 2021; Semborski et al., 2022), and 3.4% to a colleague or boss (McInroy et al., 2021).

Results across studies suggest that family is an important social context for LGBTQ + youth disclosure, and that disclosure processes sometimes varied across family members. For example, Hispanic youth disclosed their sexual identity more often to mothers than fathers due to concern about fathers’ reactions (Lozano et al., 2021), and transgender youth reported that fathers struggled with disclosure of gender identity more than mothers (Morgan et al., 2022). Another study found that reactions from mothers and fathers were not different, but their reactions were associated with different consequences. Mothers’ struggles with sexual orientation were associated with distress among youth whereas fathers’ struggles and attempts to control sexual orientation were associated with suicidal thoughts among youth (D’amico et al., 2015).

LGBTQ + youth also highlighted avoidance goals, such as rejection, when considering disclosure to grandparents perceiving that grandparents’ attitudes towards sexual orientation and gender identity are negatively shaped by their culture, age, and historical cohort (Grafsky et al., 2018; Lozano et al., 2021). Yet, one article highlighted that acceptance from grandparents is particularly meaningful for LGBTQ + youth (Grafsky et al., 2018). Disclosure in sibling relationships was described as a unique disclosure context, given that these relationships are characterized by greater equality and less power differential than other family relationships (e.g., parents) (Grafsky et al., 2018). Disclosure to siblings was often followed by greater closeness or connection (Grafsky et al., 2018). Social support from family members following disclosure was further associated with greater overall outness among LGBTQ youth (Little et al., 2023; Reyes et al., 2023).

Several additional key disclosure contexts were identified. Disclosures in healthcare contexts were often accompanied by other conversations about health and wellbeing, including sexual health (Gioia et al., 2021). Stigma was a barrier to LGBTQ + disclosure (King, 2008), and transgender boys reported that it was particularly difficult to disclose to healthcare providers (McKay & Watson, 2020). Many LGBTQ + youth preferred online disclosure, which maximized benefits of disclosure (e.g., improved wellbeing) while minimizing risks (e.g., rejection, discrimination) (McInroy et al., 2021). Several articles compared LGBTQ + youth disclosure across social contexts. For example, one article found that LGBTQ + youth experienced support from teachers at school but rejection from family at home following disclosure (Wei & Liu, 2019).

Risk of Bias

Tables 4 and 5 summarize the risk of bias for individual criterion included in the assessments. Of the fourteen criteria assessed for quantitative studies, three criteria were met by 100% of studies and an additional six were met by more than 50% of studies. Most studies (88.9%) did not include a sample size justification, and many (38.8%) did not report on the participation rate of eligible persons. Of the ten criteria assessed for qualitative studies, three criteria were met by 100% of studies and an additional six were met by more than 50% of studies. Few articles (20%) described the relationship between the researchers and participants. Figure 2 and 3 summarize the total risk of bias scores in studies.

Table 4 Quality Assessment: Quantitative Studies (n = 18) (%)
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Table 5 Quality assessment: qualitative studies (n = 15) (%)
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Fig. 2
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Quantitative Assessment (Total Score)

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Fig. 3
figure 3

Qualitative Assessment (Total Score)

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Discussion

The decreasing age of LGBTQ + identity disclosure and changing social landscape for sexual orientation and gender identity highlight the need to understand how the process of disclosure unfolds for sexual and gender minority youth through review and synthesis of the existing literature. This systematic review of empirical studies of LGBTQ + youth disclosure was theoretically guided by the Disclosure Process Model (DPM) thereby providing an overview of disclosure as a multi-component process in development rather than a singular event. Results suggest that the core components of the DPM were fairly well-studied in relation to LGBTQ + youth disclosure, including the disclosure decision-making process, reactions to the disclosure event, social support following disclosure, and psychosocial outcomes of disclosure. By synthesizing the literature across the components of the DPM, results demonstrate how experiences and benefits of disclosure may be shaped by contexts and disclosure recipient and further reveal what possible outcomes, both positive and negative, may follow disclosure.

Understanding Disclosure Decision Making

Although decreased disclosure of information to parents is typical through adolescence and into emerging adulthood (Goldstein et al., 2023; Keijsers & Poulin, 2013), for LGBTQ + youth decision-making about identity disclosure is further complicated by expectations of stigmatizing response and rejection. Across studies, anticipated stigma, fear of rejection, and other negative reactions were common reasons for avoiding disclosing. Some of these fears of rejection or negative responses could be explained by vicarious trauma—that is, witnessing rejection or mistreatment of other LGBTQ + people (Ramirez & Paz Galupo, 2019)—but at least some youth avoidance is driven directly by their past experiences of rejection (Burdick & Nicholus, 2022). Feeling pressure to continue concealing an identity may continue to force adolescents into isolation, thereby withholding potential opportunities for resource seeking and identity development (Pachankis & Jackson, 2022). Despite growing evidence that, on average, cultural attitudes and environments of acceptance have improved for LGBTQ + youth (Adamczyk & Liao, 2019; Kite et al., 2019), results of the current review demonstrate that anticipation of negative responses was part of decision making from the earliest (e.g., Carpiento et al., 2008; King, 2008) to most recent publications (e.g., Du Bois et al., 2022; Mollet, 2023); thereby highlighting the reality of LGBTQ + youth’s expectations when navigating this high-stress disclosure process as adolescents and emerging adults.

Avoidance goals may be more commonly reported across studies, however, many studies also identified approach goals for disclosure. These studies provide insights for potential target mechanisms both individually and socially for supporting LGBTQ + youth readiness to disclose their LGBTQ + identity to others. In terms of individual motivations for disclosure, studies pointed to desire for authenticity and identity management both of which were identified as positive aspects of being LGBTQ + in studies among gay and lesbian adults (Riggle et al., 2008). By considering disclosure decision-making as a central part of LGBTQ + development, multiple studies together demonstrate that strengths-based aspects of LGBTQ + adulthood begin to develop for youth in adolescence, even preceding identity disclosure. Furthermore, other studies identified building a sense of community as an approach-oriented goal for disclosure. These social approach goals underscore the need for LGBTQ + community connection during adolescence and emerging adulthood when peer relationships outside the family of origin become increasingly significant for all youth (Scholte & Van Aken, 2020). Indeed, social support following disclosure was frequently studied as a key outcome following disclosure events. Together, both individual and social approach goals across studies offer targets for future intervention and youth support resources when equipping LGBTQ + youth to prepare for not only the possible negative reactions to disclosure but also the benefits of disclosure.

Responses to Disclosure

Reactions to LGBTQ + youth identity disclosure events were more complex than a simple binary of support or rejection. In fact, most studies reported that most youth experienced a mix of both negative and positive reactions across different disclosure recipients. The developmental adaptation of the minority stress model for adolescents (Goldbach & Gibbs, 2015) emphasizes the importance of situating LGBTQ + adolescent development across contexts of family, peers, school, and religion wherein attitudes, norms, and resources regarding LGBTQ + identities may be variable. Based on the literature reviewed, LGBTQ + youth are likely to expect a mix of responses from different people and across these different environments. In addition, multiple studies highlight the need to consider disclosure responses as dynamic over time. Some LGBTQ + youth reported experiencing a mix of positive and negative reactions from the same person, noting that these reactions may evolve from negative to positive over time. Framing LGBTQ + identity disclosure as a dynamic process that evolves overtime rather than a singular event may more accurately represent the ways youth describe their experiences and the reactions of others.

LGBTQ + youth development is, at times, framed in terms of improving from negative to positive over time (e.g., “It Gets Better”; Asakura & Craig, 2014; Savage & Miller, 2012); however, the current review provides evidence that the starting point for LGBTQ + youth identity disclosure is neither a wholly positive nor negative experience, but rather, a complex mixture of both. This evidence has important implications for how LGBTQ + youth disclosure is discussed, researched, and supported through intervention and policy. This body of research makes it abundantly clear that identity disclosure for LGBTQ + youth is a process that includes both positive and negative expectations and reactions that may concurrently exist across contexts and relationships. Supporting youth through this disclosure process requires a holistic view that recognizes youth’s ability to form complex, conflicting expectations around disclosure. Furthermore, intervention or policy designed to help youth navigate disclosure responses should be developmentally attuned to recognize the different needs youth may have following disclosure across contexts (e.g., school versus family) and over time (e.g., time since disclosure, age in development).

The Disclosure Process Model and LGBTQ + Youth Disclosure

Guided by the DPM, this review examined how disclosure is considered as a process by synthesizing research across studies. In the DPM, the disclosure event encompasses both the content of disclosures (e.g., depth, breadth, duration, and emotional content) as well as reactions of disclosure recipients. Although reactions were well-studied in the reviewed literature, the actual content of disclosure events or conversations were rarely addressed. With few exceptions (Mollet, 2023), articles focused on whether or not rather than how disclosures occurred. Given that the DPM theorizes that the disclosure depth, breath, duration and emotional content of play important roles in disclosure recipients’ reactions to disclosures, as well as outcomes of disclosures, future research may further investigate the content of LGBTQ + youth disclosure. In addition to how disclosure occurred and what content was included in the disclosure event, research on LGBTQ + youth disclosure events and recipient reactions may be expanded by future research that take a development approach to examining processes over time that both precede and follow disclosure events. This may include multiple conceptualizations of developmental time such as chronological age, stage of development (early adolescence versus late adolescence), or time since disclosure event (or other important LGBTQ + milestones).

Mediating processes and outcomes of disclosures received mixed attention in the literature. Although social support and mental health outcomes were well-studied outcomes of disclosure, mediating processes including alleviation of inhibition and changes in social information—common mediating processes in the DPM—may provide insight into the psychosocial processes the shift following LGBTQ + disclosure events. Given the developmental timing and importance of information disclosure more generally in adolescence (Stattin & Kerr, 2000), situating LGBTQ + identity disclosure into the broader developmental literature on disclosure and parent–child communication could reveal unique challenges or growth that occur in response to navigating LGBTQ + identity disclosure. To that end, few studies investigated relationship outcomes as mediating processes which are likely central to understanding how disclosure reactions evolve from negative to positive over time.

Where, to Whom, and How of Disclosure

Results of this review additionally suggest that considering contextual and relationship moderators of disclosure processes are important when studying LGBTQ + youth disclosure. Although moderators such as disclosure recipients and contexts are highlighted by theory considering LGBTQ + youth disclosure (Goldbach & Gibbs, 2015; Son & Updegraff, 2023), they are underspecified in the DPM. The majority of articles included in this review considered disclosure recipients and/or contexts, and findings suggest LGBTQ + youth’s goals for disclosures, reactions to disclosures, and outcomes of disclosure are shaped by disclosure recipients and contexts. Consistent with previous work (Son & Updegraff, 2023), the current review found that family members, and especially parents, are particularly important disclosure recipients for LGBTQ + youth. Although research on disclosure to family is dominated by studies of parents, the current review highlights the expanding research that conceptualizes family relationships more broadly to include siblings, cousins, grandparents, aunts, and uncles. From a family systems perspective (Broderick, 1993), disclosure across these multiple recipients presents a complex social group for LGBTQ + youth to navigate multiple disclosure events and decision points as well as potential for varied reactions. Even within a single family of origin, disclosure responses from family members were variable (Morgan et al., 2022).

As theorized (Goldbach & Gibbs, 2015) disclosure recipients in other contexts outside family remain important as well. Disclosure contexts and recipients extended across school, mental and physical healthcare providers, peer and friend groups, and employers and workplaces. The breadth of disclosure represented across studies provides further evidence that identity disclosure remains a major developmental task for LGBTQ + adolescents and emerging adults to navigate. This disclosure process is neither linear nor singular and requires adolescents to make decisions, initiate disclosure events, and navigate responses to disclosure in every major context for development.

Fewer articles focused on macro-level variables, such as cultural beliefs and religion (Burdick & Nicholus, 2022; Lozano et al., 2021; Mollet, 2023); however, the articles that did consider these moderators found them to also shape disclosure processes in important ways. Future research should continue to explore how cultural beliefs and religion shape disclosure processes among LGBTQ + youth, including influence on the response of parents and other family members.

A limited number of articles addressed the aspect of "how" disclosure occurs. Notably, one study emphasized that numerous LGBTQ + youth favor online disclosure, a method that enhances benefits while minimizing associated risks (McInroy et al., 2021). It is crucial for future studies to examine the preferences of LGBTQ + youth in terms of disclosure methods, including considerations of direct versus indirect disclosure and choices between online and offline disclosure of their sexual orientation and gender identity.

Finally, although transgender theory (Nagoshi et al., 2023) and qualitative research (Hereth et al., 2020) demonstrate the interconnectedness of gender and sexuality, reviewed literature did not examine the complex ways transgender youth may navigate multiple, overlapping and integrated processes of sexual and gender identity concurrently. Many studies were inclusive of trans and nonbinary youth, both in studies of cisgender and transgender youth together or studies exclusively of trans youth. Additional theoretical and empirical work is needed to describe and explain the complexity of disclosure processes of trans youth that are unlikely to be unidimensional or universal.

Methodological Approaches to Studying Disclosure

Finally, this review offers insight into the methods that were applied to LGBTQ + youth disclosure research as well as the quality of those methods. LGBTQ + youth disclosure is well-studied with both quantitative and qualitative studies, with fewer mixed-methods studies. Despite evidence that disclosure is a process rather than a singular event, the vast majority of studies in this area, however, were cross-sectional. More longitudinal research is needed to better understand the how the disclosure process, as outlined by components of the DPM, unfolds over time from decision-making to outcomes.

Moreover, although disclosure is a dyadic process involving someone who is sharing and someone who is receiving information, very little dyadic research is conducted on LGBTQ + youth disclosure. Dyadic methods are critically important for better understanding how disclosure recipient characteristics moderate disclosure processes, disclosure responses, and relationship outcomes of disclosure. Finally, although risk of bias was generally low across studies, the bias assessment identified some areas of improvement for LGBTQ + disclosure research such as including sample size justifications in quantitative research and describing relationships between researchers and participants in qualitative research.

Limitations and Future Directions

Results of this review should be interpreted in light of its limitations. The focus was on peer-reviewed published literature; therefore, this review does not include unpublished or ongoing research. There may be additional research on LGBTQ + youth disclosure published outside of the nine databases searched or unassociated with the 28 search terms. Moreover, this review was limited to articles published in English. Reviews that include articles published in other languages may be better suited to interrogate how social-structural environments shape disclosure processes among LGBTQ + youth in non-English speaking regions. Additionally, this review focused on LGBTQ + youth because many LGBTQ + people report coming out or first disclosure in this age period (Bishop et al., 2020; Layland et al., 2023). Reviews that include other ages may provide greater insight into disclosure processes across the lifespan. Future research adopting longitudinal and dyadic methods may provide greater insight into aspects of disclosure processes that remain understudied to date (e.g., disclosure content, mediating processes linking disclosures with outcomes) as well as associations between components of disclosure processes over time. Such research may inform efforts to better support LGBTQ + youth disclosure and wellbeing via intervention and policy change. For example, several interventions exist to support disclosure processes among people living with other concealable stigmatized statuses (Brohan et al., 2014; Mulfinger et al., 2018; Murphy et al., 2011). Such disclosure interventions may likewise benefit LGBTQ + youth. Ultimately, work that seeks to promote positive disclosure experiences among LGBTQ + youth must include intervention and education that reduces bias among potential disclosure recipients to shift the onus of navigating disclosure from the youth alone to peers and adults in the LGBTQ + youth’s social network.

Conclusions

Research on LGBTQ + youth disclosure is changing with a strong focus on the decision-making process (e.g., avoidance and approach goals) and disclosure outcomes (e.g., mental health), less attention on disclosure events (e.g., depth, emotional content), mediating process (e.g., social support), and moderators (e.g., sociodemographic characteristics, culture, and disclosure recipient), and movement away from linear models of development. This review highlights the need for a more comprehensive exploration of LGBTQ + youth disclosure processes, aiming for a holistic understanding. The findings align with theoretical perspectives underscoring the pivotal role of disclosure in LGBTQ + youth well-being. Notably, the emphasis on the social context adds depth to understanding. Future research should address these gaps, exploring understudied aspects like disclosure content and employing longitudinal and dyadic methods. These endeavors are crucial for informing interventions and policies and promoting positive LGBTQ + youth disclosure experiences. In conclusion, this review consolidates current knowledge on LGBTQ + youth disclosure while emphasizing the importance of a broader perspective. By recognizing the multifaceted aspects of disclosure processes, this study contributes to advancing the understanding of LGBTQ + youth disclosure experiences.