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Dec 17th, 2025•8 min read

Coming Out Anxiety: How Concealing Your Identity Impacts Mental Health

Author
Hailey Perez

For many folks of the LGBTQ community, coming out anxiety is something almost everyone experiences to some degree. Whether you've been out of the closet for two years or are thinking about coming out, it's a pretty universal experience that can take a toll on your mental health.

According to The Trevor Project, 66% of LGBTQ+ young people reported experiencing recent symptoms of anxiety" from their report. That's a pretty staggering statistic and it goes to show just how much of a burden it has on people who are looking to come out, especially young people.

Ahead, we discuss the concept of coming out anxiety, the effect of concealing one's identity on one's overall mental health, widespread LGBTQ+ mental health challenges, some tips for navigating this journey of self discovery and acceptance, and therapy services that are available

What Is Coming Out Anxiety?

Coming out anxiety isn't your standard nerves that you get before perhaps a meeting at work or before a test in school, but actually a more chronic, often debilitating form of anxiety that can keep one stuck with ruminating thoughts questioning who they are as a person and where they belong in society.

Not only is one fully coming to terms with who they are, but also letting loved ones and the rest of the world into a piece of their life that they've hidden for so long.

This anxiety often is brought on by a fear of rejection by loved ones, family members, and society. People are afraid that people will view them differently once they know this part of them although they are still the same person.

In many cases, one's own faith, cultural or even workplace norms may contribute to this anxiety on an internal level because there's this notion that it's "wrong" or "not acceptable" to come out and be queer despite it being a part of who they are at their core — this is known as internalized homophobia. Some people even worry about whether it's "too late" for them to come out or if they fit the stereotypes spelled out by society.

The Hidden Toll of Concealing One’s Identity

As you can imagine, concealing one's identity can have a significant impact on mental health. Think about it — if you're walking around everyday with the emotional burden of secrecy it's bound to get exhausting and can take a toll on your mental health.

For example, a journal article of Psychology Bulletin, showed that hiding one's sexual orientation was strongly correlated to internalizing mental health problems such as anxiety, depression, and disordered eating.

Psychological Stress from Staying Closeted

There are a great deal of LGBTQ+ mental health challenges that individuals in the closet may face from cognitive dissonance to emotional suppression in both the short and long term.

Cognitive dissonance occurs when one has differing views and beliefs that contradict each other. In terms of coming out, one might have a vision in their head of who they "should be" compared to who they actually are. These contradicting views can cause a great deal of tension, stress and discomfort in the coming out process. This is just one of the several mental health effects of hiding identity that individuals may experience on their journey.

Emotional suppression is also a pressing issue for those in the closet as many people don't feel like they have adequate coming out support or people to turn to when they need to vent. As a result, many people internalize their thoughts and feelings as mentioned above which can increase feelings of anxiety, depression and excessive worry.

Additionally, people who have hidden their sexuality have reported decreased feelings of belongingness and sense of community and place which is important for developing positive self-esteem and self-worth.

Physical and Emotional Symptoms to Watch For

It is possible that those struggling with their identity or worrying about coming out of the closet may also experience physical and emotional symptoms. For example, some individuals might notice they are experiencing sleep issues, fatigue, depression, chronic stress, and tearfulness. Additionally, scientists at the Centre for Studies on Human Stress at Louis H. Lafontaine Hospital in Montreal found that staying in the closet can weaken one's whole immune system too so if you find that you get sick often then that could be why.

In some cases, people may turn to alcohol and substances as a way to numb the pain which can be dangerous and warrants professional help.

Not everyone who is in the closet will experience these symptoms but it is possible that this type of anxiety can take a toll on physical and emotional health so it's important to keep a watchful eye on it.

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The Mental Health Effects of Internalized Stigma

According to the International Journal of Environmental Research and Public Health, internalized stigma is defined as when people reinforce stereotypes whether that's pertinent to race and ethnicity, health status, or in this case gender and sexual orientation. With internalized stigma, one may believe that they are "abnormal" or something is inherently wrong with them if they don't fit in the mold that was outlined for them by society. This can oftentimes be seen in people who stay in the closet because they are ashamed and fearful of not fitting in the box that they put themselves in.

With this in mind, this internalized shame, or when speaking about LGBTQ+ mental health challenges, internalized homophobia, can greatly impact levels of anxiety, depression, and emotional regulation.

The Power of Coming Out — But Only When It's Safe

Coming out can be an empowering experience. However, you want to make sure it is safe for you. Not everyone is in a situation where it is safe to come out, whether that's with friends, family, work or their environment.

Coming Out Is Not a Cure

Coming out initially, whether that's to a therapist, friend, family member or someone else you know, may provide you with a great sense of relief. You no longer have to stay quiet about this part of yourself and you can now live a more authentic life.

That said, coming out usually isn't a one and done process. It typically happens on several occasions when you meet someone new or go to a new place or perhaps you may find that you can't be out in certain places for your own safety and comfort.

Speaking of safety and comfort, timing and environment matter because you want to make sure you have coming out support and are surrounded by people who will more than likely accept you for who you are with open arms. In the same vein, you want to make sure you're in an environment where it's appropriate to disclose this aspect of yourself.

Safety First: When It’s Okay to Wait

Your safety needs to be your top priority when coming out. If you're living in an environment where your safety could be at risk if you come out, then you'll want to wait. If you are dependent on others for your shelter and other essentials, then you will want to wait until you can be fully independent in the event of the worst scenario. If you don't want to wait, then you'll want to make sure you have supportive people in your corner who can be there for you during the time you need to get back on your feet.

Aside from making sure you're physically safe, you need to make sure you're equipped to handle the responses (both positive and negative) of those around you when you come out to them. It's likely that some people will be positive and supportive, however, it is probable that some will have some pushback.

This is something you can work on in therapy about how to build inner resilience first so you are prepared to handle whatever reactions come your way from those around you.

How Therapy Helps You Navigate Identity and Anxiety

If you’re looking for help with the coming out process, then you may want to consider therapy. Finding a platform that has LGBTQ+ affirming therapists is important since you want a therapist who can validate your experience in a safe and non-judgmental environment or even help you explore your identity if you’re unsure while offering quality care.

Having a therapists' support coming out can make a huge difference in giving you the insights, resources and the courage to come out. And since they aren't friends or family members, they aren't biased and can serve as a sounding board without you feeling the need to hold back your real thoughts, feelings and emotions.

Here at Octave we have highly skilled therapists who offer in LGBTQ+ affirming therapy and specialize in different modalities that can be helpful including cognitive behavioral therapy (CBT), expressive art and narrative therapy just to name a few. Our therapists are trained to listen and validate with a compassionate and empathetic ear while working with you to be the best version of yourself.

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Support and Resources for the Journey Ahead

At the end of the day, coming out is a personal journey and has to be done on your own timeline and when you feel safe. Here are some resources to help: