Research Article: How many sexual minorities are hidden? Projecting the size of the global closet with implications for policy and public health

Date Published: June 13, 2019

Publisher: Public Library of Science

Author(s): John E. Pachankis, Richard Bränström, Cheng-Shi Shiu.

http://doi.org/10.1371/journal.pone.0218084

Abstract

Because sexual orientation concealment can exact deep mental and physical health costs and dampen the public visibility necessary for advancing equal rights, estimating the proportion of the global sexual minority population that conceals its sexual orientation represents a matter of public health and policy concern. Yet a historic lack of cross-national datasets of sexual minorities has precluded accurate estimates of the size of the global closet. We extrapolated the size of the global closet (i.e., the proportion of the global sexual minority population who conceals its sexual orientation) using a large sample of sexual minorities collected across 28 countries and an objective index of structural stigma (i.e., discriminatory national laws and policies affecting sexual minorities) across 197 countries. We estimate that the majority (83.0%) of sexual minorities around the world conceal their sexual orientation from all or most people and that country-level structural stigma can serve as a useful predictor of the size of each country’s closeted sexual minority population. Our analysis also predicts that eliminating structural stigma would drastically reduce the size of the global closet. Given its costs to individual health and social equality, the closet represents a considerable burden on the global sexual minority population. The present projection suggests that the surest route to improving the wellbeing of sexual minorities worldwide is through reducing structural forms of inequality. Yet, another route to alleviating the personal and societal toll of the closet is to develop public health interventions that sensitively reach the closeted sexual minority population in high-stigma contexts worldwide. An important goal of this projection, which relies on data from Europe, is to spur future research from non-Western countries capable of refining the estimate of the association between structural stigma and sexual orientation concealment using local experiences of both.

Partial Text

Sexual minorities, in particular thos who identify as lesbian, gay, and bisexual (LGB), represent an increasingly visible segment of the global population. Although the meaning and experience of LGB identification is by no means universal now or historically, global human rights discourse increasingly relies on a shared understanding of LGB identification to achieve its goal of advancing the equal rights and protections of sexual minority populations worldwide.[1] Despite the ability of this globalizing discourse to erase indigenous sexual minority cultures,[2] strong evidence from academic observation, local civil society, and international sexual minority rights organizations suggests that this hegemony has taken hold in all world regions.[2–4] Reflecting this fact, intergovernmental bodies, including the United Nations, have as a goal to “stand up for equal rights and fair treatment for lesbian, gay, bisexual, trans, and intersex people everywhere,”[5] under the assumption that these minority identities and their potential to be stigmatized in fact exist everywhere.

Model 1 estimates that the global proportion of the sexual minority population that conceals its sexual orientation from all or most people is 83.0%. The model estimates that sexual minorities in the Middle East and North African (94.8%) and Sub-Saharan African (89.5%) regions are most likely to be closeted whereas those in the Latin American and Caribbean (35.4%) and Northern/Western European (36.5%) region are least likely to be closeted.

Responding to the increasingly prominent assumption that sexual minority identities are similarly legible worldwide and the increasing reliance on this assumption to advance the equal treatment of this population,[1, 5] we set out to estimate one logical corollary of this trend, namely that a proportion of the global sexual minority population will conceal their sexual orientation. Extrapolating from the largest known sample of sexual minority men and women, collected across 28 countries, and an objective index of the country-level structural context surrounding sexual minorities in all world countries, we estimate that the majority of sexual minorities around the world conceal their sexual orientation from all or most family, friends, colleagues, neighbors, and medical providers. Our projection suggests that country-level structural stigma, namely discriminatory laws and policies denying sexual minorities equal rights, can serve as a useful predictor of the size of each country’s closeted sexual minority population. Our projection also suggests that eliminating structural stigma would drastically reduce the size of the global closet.

 

Source:

http://doi.org/10.1371/journal.pone.0218084

 

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