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But in many places around the world, concealment and its stressors are safer than the alternative,” he said. “Concealment takes its toll through the stress of hiding and also because it can keep sexual minorities away from each other and from adequate public health attention. Concealment is associated with depression and anxiety, substance abuse and susceptibility to infectious disease. “Given rapidly increasing acceptance of sexual minorities in some countries, it might be easy to assume that most sexual minorities are out in 2019, but actually, most sexual minority people in the world today are probably not out,” said Pachankis.
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Published in the journal PLOS ONE, the study is believed to be the first attempt to quantify the size of the “global closet” in order to gauge its public health impact. He co-authored the study with Richard Bränström, an associate professor at the Karolinska Institutet in Sweden and research affiliate at Yale. The vast majority of the world’s sexual minority population - an estimated 83 percent of those who identify as lesbian, gay or bisexual - keep their orientation hidden from all or most of the people in their lives, according to a new study by the Yale School of Public Health that could have major implications for global public health.Ĭoncealing one’s sexual orientation can lead to significant mental and physical health issues, increased healthcare costs and a dampening of the public visibility necessary for advancing equal rights, said John Pachankis, Ph.D., associate professor at the Yale School of Public Health.