Identity concealment affects all sexual minority individuals, with potentially complex mental health implications. Concealing a sexual minority identity can simultaneously generate the stress of hiding, protect against the stress of discrimination, and keep one apart from sexual minority communities and their norms and supports. Not surprisingly, existing studies of the association between sexual orientation concealment and mental health problems show contradictory associations-from positive to negative to null. This meta-analysis attempts to resolve these contradictions. Across 193 studies (n = 92,236) we find a small positive association between sexual orientation concealment and internalizing mental health problems (i.e., depression, anxiety, distress, problematic eating; ESr = 0.126; 95% CI [0.102, 0.151]) and a small negative association between concealment and substance use problems (ESr = -0.061; 95% CI [-0.096, -0.026]). The association between concealment and internalizing mental health problems was larger for those studies that assessed concealment as lack of open behavior, those conducted recently, and those with younger samples; it was smaller in exclusively bisexual samples. Year of data collection, study location, and sample gender, education, and racial/ethnic composition did not explain between-study heterogeneity. Results extend existing theories of stigma and sexual minority mental health, suggesting potentially distinct stress processes for internalizing problems versus substance use problems, life course fluctuations in the experience of concealment, distinct experiences of concealment for bisexual individuals, and measurement recommendations for future studies. Small overall effects, heavy reliance on cross-sectional designs, relatively few effects for substance use problems, and the necessarily coarse classification of effect moderators in this meta-analysis suggest future needed methodological advances to further understand the mental health of this still-increasingly visible population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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性取向隐瞒和心理健康：概念和荟萃分析综述。

身份隐藏会影响所有性少数群体，并可能对心理健康产生复杂的影响。隐瞒性少数群体的身份可以同时产生隐藏的压力，防止歧视的压力，并使一个人远离性少数群体及其规范和支持。毫不奇怪，现有的关于隐瞒性取向与心理健康问题之间关系的研究显示出相互矛盾的关联——从积极到消极再到无效。本荟萃分析试图解决这些矛盾。在 193 项研究中（n = 92,236），我们发现性取向隐瞒与内化心理健康问题（即抑郁、焦虑、苦恼、饮食问题；ESr = 0.126；95% CI [0.102, 0.151]）之间存在微小的正相关关系，并且隐瞒与物质使用问题之间存在较小的负相关（ESr = -0.061；95% CI [-0.096，-0.026]）。对于那些将隐瞒评估为缺乏开放行为的研究、最近进行的研究以及样本较年轻的研究，隐瞒与内化心理健康问题之间的关联更大；在纯双性恋样本中，该值较小。数据收集年份、研究地点、样本性别、教育程度和种族/民族构成并不能解释研究间的异质性。结果扩展了现有的耻辱和性少数心理健康理论，表明内化问题与物质使用问题的潜在不同压力过程、隐瞒经历的生命历程波动、双性恋个体的独特隐瞒经历以及未来研究的测量建议。总体影响较小，严重依赖横截面设计，对物质使用问题的影响相对较小，以及本荟萃分析中对影响调节因素的必然粗略分类，表明未来需要方法论上的进步，以进一步了解这一仍然日益明显的心理健康问题人口。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。