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Introduction <p>Sexual orientation disclosure to parents may have enduring mental health consequences for gay men in China’s Confucian, family-centered context, but long-term evidence is scarce.</p> Methods <p>In a 15-year, three-wave (2009, 2017, 2024) longitudinal matched case–control study, 270 gay men who had voluntarily disclosed to ≥ 1 parent within 12 months before baseline were individually matched on age, education, and residence with 270 non-disclosers. Social support, depression, anxiety, and suicidal ideation were assessed at each wave. Population-averaged generalized estimating equations (GEE) were used to estimate group, time (2009 reference), and group × time effects. Covariate-adjusted models additionally controlled for sociodemographics, anal sexual role, HIV status, and baseline outcomes; controls who disclosed during follow-up were excluded.</p> Results <p>At baseline, the two groups did not differ on any psychosocial outcome. By 2017 and 2024, however, disclosers showed lower social support and higher depression, anxiety, and suicidal ideation than non-disclosers. Population-averaged GEE indicated significant disclosure × time interactions for all outcomes, and joint Wald tests confirmed overall effects (all <i>p</i> ≤ 0.026), which remained robust after covariate adjustment.</p> Conclusions <p>Voluntary sexual orientation disclosure to parents was associated with persistently reduced social support and increased psychological distress over 15 years among Chinese gay men in this historical cohort. These findings reflect the long-term consequences of parental disclosure decisions made in 2009 within a relatively conservative sociocultural and media environment, and their generalizability to younger cohorts disclosing in today’s more digitally connected context should be interpreted with caution.</p> Policy Implications <p>To mitigate these long-term psychosocial harms, policy should prioritize making disclosure safer by reducing family and structural stigma—through parent-focused education and counseling, LGBT-inclusive school climates with audited anti-bullying/anti-discrimination enforcement, LGBTQ-affirming training embedded in health-care accreditation and quality standards, and local anti-discrimination protections across employment, education, and health services coupled with accessible complaint-handling and legal aid.</p>

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A 15-Year Longitudinal Case-Control Study of the Psychosocial Outcomes of Sexual Orientation Disclosure to Parents Among Chinese Gay Men

  • 期刊论文

  • 发表日期：

    2026年3月23日

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  • Yong Yu,
  • Zheng Ren,
  • Wenzhao Huang,
  • Keke Qin

摘要

Introduction

Sexual orientation disclosure to parents may have enduring mental health consequences for gay men in China’s Confucian, family-centered context, but long-term evidence is scarce.

Methods

In a 15-year, three-wave (2009, 2017, 2024) longitudinal matched case–control study, 270 gay men who had voluntarily disclosed to ≥ 1 parent within 12 months before baseline were individually matched on age, education, and residence with 270 non-disclosers. Social support, depression, anxiety, and suicidal ideation were assessed at each wave. Population-averaged generalized estimating equations (GEE) were used to estimate group, time (2009 reference), and group × time effects. Covariate-adjusted models additionally controlled for sociodemographics, anal sexual role, HIV status, and baseline outcomes; controls who disclosed during follow-up were excluded.

Results

At baseline, the two groups did not differ on any psychosocial outcome. By 2017 and 2024, however, disclosers showed lower social support and higher depression, anxiety, and suicidal ideation than non-disclosers. Population-averaged GEE indicated significant disclosure × time interactions for all outcomes, and joint Wald tests confirmed overall effects (all p ≤ 0.026), which remained robust after covariate adjustment.

Conclusions

Voluntary sexual orientation disclosure to parents was associated with persistently reduced social support and increased psychological distress over 15 years among Chinese gay men in this historical cohort. These findings reflect the long-term consequences of parental disclosure decisions made in 2009 within a relatively conservative sociocultural and media environment, and their generalizability to younger cohorts disclosing in today’s more digitally connected context should be interpreted with caution.

Policy Implications

To mitigate these long-term psychosocial harms, policy should prioritize making disclosure safer by reducing family and structural stigma—through parent-focused education and counseling, LGBT-inclusive school climates with audited anti-bullying/anti-discrimination enforcement, LGBTQ-affirming training embedded in health-care accreditation and quality standards, and local anti-discrimination protections across employment, education, and health services coupled with accessible complaint-handling and legal aid.