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American Journal of Community Psychology

, Volume 29, Issue 1, pp 133–160 | Cite as

The Coming-Out Process and Its Adaptational and Health-Related Associations Among Gay, Lesbian, and Bisexual Youths: Stipulation and Exploration of a Model

  • Margaret Rosario
  • Joyce Hunter
  • Shira Maguen
  • Marya Gwadz
  • Raymond Smith
Article

Abstract

A model is proposed and explored that links the coming-out process to the psychological functioning (i.e., self-esteem and distress) and sexual behaviors of gay, lesbian, and bisexual youths recruited from gay-focused community-based and college organizations in New York City. The coming-out process is multidimensional, consisting, as defined here, of involvement in gay/lesbian activities, attitudes toward homosexuality, comfort with homosexuality, self-disclosure of sexual identity to others, and sexual identity. The coming-out dimensions were related to self-esteem, distress, and unprotected sexual behaviors. In addition, the relations between the coming-out dimensions and unprotected sexual behaviors were explained by psychological functioning. In particular, limited involvement in gay/lesbian activities was associated with more unprotected sex. Negative attitudes toward homosexuality were related directly to more unprotected sex, and they were related indirectly to more unprotected sex by means of increasing emotional distress. These and other findings have implications for designing preventive interventions to increase the youths' psychological functioning and reduce their unprotected sexual behaviors.

coming-out process adaptation sexual behaviors gay, lesbian, and bisexual youths 

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REFERENCES

  1. American Medical Association, Council of Scientific Affairs. (1996). Health care needs of gay men and lesbians in the United States. Journal American Medical Association, 275, 1354–1359.Google Scholar
  2. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorder: DSM-III-R (3rd ed. and Rev.). Washington, DC: Author.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder (4th ed.). Washington, DC: Author.Google Scholar
  4. Berger, B. J., Kolton, S., Zenilman, J. M., Cummings, M. C., Feldman, J., & McCormack, W. M. (1995). Bacterial vaginosis in lesbians: A sexually transmitted disease. Clinical Infectious Diseases, 21, 1402–1405.Google Scholar
  5. Bevier, P. J., Chiasson, M. A., Hefferman, R. T., & Castro, K. G. (1995). Women at a sexually transmitted disease clinic who report same-sex contact: Their HIV seroprevalence and risk behaviors. American Journal of Public Health, 85, 1366–1371.Google Scholar
  6. Cass, V. C. (1979). Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4, 219–235.Google Scholar
  7. Cass, V. C. (1984). Homosexual identity formation: Testing a theoretical model. Journal of Sex Research, 20, 143–167.Google Scholar
  8. Centers for Disease Control and Prevention. (1996). Youth risk behavior surveillance-United States, 1995. Morbidity and Mortality Weekly Report, 45(SS-4), 1–86.Google Scholar
  9. Centers for Disease Control and Prevention. (1997). HIV AIDS Surveillance Report, 9(1), 1–37.Google Scholar
  10. Cole, S. W., Kemeny, M. E., Taylor, S. E., Visscher, B. R., & Fahey, J. L. (1996). Accelerated course of human immunodeficiency virus infection in gay men who conceal their homosexual identity. Psychosomatic Medicine, 58, 219–231.Google Scholar
  11. Coleman, E. (1982). Developmental stages of the coming-out process. In W. Paul, J. D. Weinrich, J. C. Gonsiorek, & M. E. Hotvedt (Eds.), Homosexuality: Social, psychological and biological issues (pp. 150–158). Beverly Hills, CA: Sage.Google Scholar
  12. Comstock, G. D. (1991). Violence against lesbians and gay men. NewYork: Columbia University Press.Google Scholar
  13. Cox, S., & Gallois, C. (1996). Gay and lesbian identity development: A social identity perspective. Journal of Homosexuality, 30, 1–30.Google Scholar
  14. Crowne, D. P., & Marlowe, D. (1964). The approval motive: Studies in evaluative dependence. Westport, CT: Greenwood Press.Google Scholar
  15. D'Augelli, A. R., & Hershberger, S. L. (1993). Lesbian, gay, and bisexual youth in community settings: Personal challenges and mental health problems. American Journal of Community Psychology, 21, 421–448.Google Scholar
  16. Derogatis, L. R. (1993). BSI, Brief Symptom Inventory: Administration, scoring, and procedures manual. Minneapolis, MN: National Computer Systems.Google Scholar
  17. Doll, L. S., Petersen, L. R., White, C. R., Johnson, E. S., Ward, J. W., & The Blood Donor Study Group. (1992). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. The Journal of Sex Research, 29, 1–14.Google Scholar
  18. Einhorn, L., & Polgar, M. (1994). HIV-risk behavior among lesbians and bisexual women. AIDS Education and Prevention, 6, 514–523.Google Scholar
  19. Erikson, E. H. (1950). Childhood and society. New York: Norton.Google Scholar
  20. Erikson, E. H. (1968). Identity: Youth and crisis. New York: Norton.Google Scholar
  21. Faulkner, A. H., & Cranston, K. (1998). Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students. American Journal of Public Health, 88, 262–266.Google Scholar
  22. Garofalo, R., Wolf, R.C., Kessel, S., Palfrey, J., & DuRant, R. H. (1998). The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics, 101, 895–902.Google Scholar
  23. Gonsiorek, J. C., & Rudolph, J. R. (1991). Homosexual identity: Coming out and other developmental events. In J. C. Gonsiorek & J. D. Weinrich (Eds.), Homosexuality: Research implications for public policy (pp. 161–176). Newbury Park, CA: Sage.Google Scholar
  24. Herdt, G., & Boxer, A. (1996). Children of Horizons: How gay and lesbian teens are leading a new way out of the closet. Boston, MA: Beacon.Google Scholar
  25. Hershberger, S. L., & D'Augelli, A. R. (1995). The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths. Developmental Psychology, 31, 65–74.Google Scholar
  26. Hunter, J. (1990). Violence against lesbian and gay male youths. Journal of Interpersonal Violence, 5, 295–300.Google Scholar
  27. Joseph, K. M., Adib, M., Joseph, J. G., & Tal, M. (1991). Gay identity and risky sexual behavior related to the AIDS threat. Journal of Community Health, 16, 287–296.Google Scholar
  28. Kahn, M. J. (1991). Factors affecting the coming out process for lesbians. Journal of Homosexuality, 21, 47–70.Google Scholar
  29. Kitzinger, C., & Wilkinson, S. (1995). Transitions from heterosexuality to lesbianism: The discursive production of lesbian identities. Developmental Psychology, 31, 95–104.Google Scholar
  30. Lemp, G. F., Jones, M., Kellogg, T. A., Nieri, D., & Katz, M. (1995). HIV seroprevalence and risk behaviors among lesbians and bisexual women in San Francisco and Berkeley, California. American Journal of Public Health, 85, 1549–1552.Google Scholar
  31. Levine, H. (1997). A further exploration of the lesbian identity development process and its measurement. Journal of Homosexuality, 34, 67–78.Google Scholar
  32. Lima, G., LoPresto, C. T., Sherman, M. F., & Sobelman, S. A. (1993). The relationship between homophobia and self-esteem in gay males with AIDS. Journal of Homosexuality, 25, 69–76.Google Scholar
  33. Martin A. D., & Hetrick, E. S. (1988). The stigmatization of the gay and lesbian adolescent. Journal of Homosexuality, 15, 163–183.Google Scholar
  34. McDonald, G. J. (1982). Individual differences in the coming out process for gay men: Implications for theoretical models. Journal of Homosexuality, 8, 47–60.Google Scholar
  35. McKirnan, D. J., Stokes, J. P., Doll, L., & Burzette, R. G. (1995). Bisexually active men: Social characteristics and sexual behavior. The Journal of Sex Research, 32, 65–76.Google Scholar
  36. Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36, 38–56.Google Scholar
  37. Meyer-Bahlburg, H. F. L., Ehrhardt, A. A., Exner, T. M., & Gruen, R. S. (1994). Sexual Risk Behavior Assessment Schedule-Youth. Unpublished instrument. HIV Center for Clinical and Behavioral Studies and Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032.Google Scholar
  38. Morris, J. F. (1997). Lesbian coming out as a multidimensional process. Journal of Homosexuality, 33, 1–22.Google Scholar
  39. Nungesser, L. (1983). Homosexual acts, actors, and identities. New York: Praeger.Google Scholar
  40. Offir, J. T., Fisher, J. D., Williams, S. S., & Fisher, W. A. (1993). Reasons for inconsistent AIDSpreventive behaviors among gay men. The Journal of Sex Research, 30, 62–69.Google Scholar
  41. Perkins, D. O., Leserman, J., Murphy, C., & Evans, D. L. (1993). Psychosocial predictors of high-risk sexual behavior among HIV-negative homosexual men. AIDS Education and Prevention, 5, 141–152.Google Scholar
  42. Pilkington, N. W., & D'Augelli, A. R. (1995). Victimization of lesbian, gay, and bisexual youth in community setting. Journal of Community Psychology, 23, 34–56.Google Scholar
  43. Prieur, A. (1990). Norwegian gay men: Reasons for continued practice of unsafe sex. AIDS Education and Prevention, 2, 109–115.Google Scholar
  44. Remafedi, G., Farrow, J. A., & Deisher, R.W. (1991). Risk factors for attempted suicide in gay and bisexual youth. Pediatrics, 87, 869–875.Google Scholar
  45. Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. American Journal of Public Health, 88, 57–60.Google Scholar
  46. Remafedi, G., Resnick, M., Blum, R., & Harris, L. (1992). Demography of sexual orientation in adolescents. Pediatrics, 89, 714–721.Google Scholar
  47. Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., Tabor, J., Beuhring, T., Sieving, R. E., Shew, M., Ireland, M., Bearinger, L. H., & Udry, J. R. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal American Medical Association, 278, 823–832.Google Scholar
  48. Rosario, M., Hunter, J., & Gwadz, M. (1993a). Coming-Out Measure of Involvement in Homosexual Activities. Unpublished instrument. Department of Psychology, The City University of New York-The City College and Graduate Center, 138th Street and Convent Avenue, New York, NY 10031.Google Scholar
  49. Rosario, M., Hunter, J., & Gwadz, M. (1993b). Coming-Out Measure Regarding Self-Disclosure of aGay/Lesbian or Bisexual Identity. Unpublished instrument. Department of Psychology, The City University of New York-The City College and Graduate Center, 138th Street and Convent Avenue, New York, NY 10031.Google Scholar
  50. Rosario, M., Meyer-Bahlburg, H. F. L., Hunter, J., Exner, T. M., Gwadz, M., & Keller, A. M. (1996). Psychosexual development of urban lesbian, gay, and bisexual youths. The Journal of Sex Research, 33, 113–126.Google Scholar
  51. Rosario, M., Rotheram-Borus, M. J., & Reid, H. (1996). Gay-related stress and its correlates among gay and bisexual male adolescents of predominantly Black and Hispanic background. Journal of Community Psychology, 24, 136–159.Google Scholar
  52. Rosenberg, M. (1965). Society and adolescent self-image. Princeton, NJ: Princeton University Press.Google Scholar
  53. Ross, M. W. (1990). Reasons for non-use of condoms by homosexually active men during anal intercourse. International Journal of STD & AIDS, 1, 432–434.Google Scholar
  54. Ross, M. W., & Rosser, B. R. S. (1996). Measurement and correlates of internalized homophobia: A factor analytic study. Journal of Clinical Psychology, 52, 15–21.Google Scholar
  55. Rotheram-Borus, M. J., Hunter, J., & Rosario, M. (1994). Suicidal behavior and gay-related stress among gay and bisexual male adolescent. Journal of Adolescent Research, 9, 498–508.Google Scholar
  56. Rotheram-Borus, M. J., Hunter, J., & Rosario, M. (1995). Coming out as lesbian or gay in the era of AIDS. In G. M. Herek & B. Greene (Eds.), AIDS, identity, and community: The HIV epidemic and lesbians and gay men (pp. 150–168). Thousand Oaks, CA: Sage.Google Scholar
  57. Rotheram-Borus, M. J., Rosario, M., Reid, H., & Koopman, C. (1995). Predicting patterns of sexual acts among homosexual and bisexual youths. American Journal of Psychiatry, 152, 588–595.Google Scholar
  58. Savin-Williams, R. C. (1990). Gay and lesbian youth: Expressions of identity. New York: Hemisphere.Google Scholar
  59. Schneider, S., Farberow, N., & Kruks, G. (1989). Suicidal behavior in adolescent and young adult gay men. Suicide and Life-Threatening Behavior, 19, 381–394.Google Scholar
  60. Seibt, A. C., McAlister, A. L., Freeman, A. C., Krepcho, M. A., Hedrick, A. R., & Wilson, R. (1993). Condom use and sexual identity among men who have sex with men-Dallas 1991. Morbidity and Mortality Weekly Report, 42(7), 13, 14.Google Scholar
  61. Siegel, K., & Epstein, J. A. (1996). Ethnic-racial differences in psychological stress related to gay lifestyle among HIV-positive men. Psychological Reports, 79, 303–312.Google Scholar
  62. Sophie, J. (1986). A critical examination of stage theories of lesbian identity development. Journal of Homosexuality, 12, 39–51.Google Scholar
  63. Stall, R., Barrett, D., Bye, L., Catania, J., Frutchey, C., Henne, J., Lemp, G., & Paul, J. (1992). A comparison of younger and older gay men's HIV risk taking behaviors: The Communication Technologies 1989 Cross-Sectional Survey. Journal of Acquired Immune Deficiency Syndromes, 5, 682–687.Google Scholar
  64. Troiden, R. R. (1988). Homosexual identity development. Journal of Adolescent Health Care, 9, 105–113.Google Scholar
  65. Troiden, R. R. (1989). The formation of homosexual identities. In G. Herdt (Ed.), Gay and lesbian youth (pp. 43–73). New York: Hayworth.Google Scholar
  66. Vincke, J., Bolton, R., Mak, R., & Blank, S. (1993). Coming out and AIDS-related high-risk sexual behavior. Archives of Sexual Behavior, 22, 559–586.Google Scholar
  67. Ziemba-Davis, M., Sanders, S. A., & Reinisch, J. M. (1996). Lesbians' sexual interactions with men: Behavioral bisexuality and risk for sexually transmitted disease (STD) and human immunodeficiency virus (HIV). Women's Health: Research on Gender, Behavior, and Policy, 2, 61–74.Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Margaret Rosario
    • 1
  • Joyce Hunter
    • 2
  • Shira Maguen
    • 3
  • Marya Gwadz
    • 4
  • Raymond Smith
    • 2
  1. 1.The City College and Graduate CenterThe City University of New YorkUSA
  2. 2.New York State Psychiatric InstituteUSA
  3. 3.Georgia State UniversityUSA
  4. 4.University of CaliforniaLos Angeles

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