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Coming Out to Siblings and Internalized Sexual Stigma: The Moderating Role
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Coming Out to Siblings and Internalized Sexual

Stigma: The Moderating Role of Gender in a
Sample of Italian Participants

Marco Salvati, Jessica Pistella, Salvatore Ioverno, Fiorenzo Laghi & Roberto
Baiocco

To cite this article: Marco Salvati, Jessica Pistella, Salvatore Ioverno, Fiorenzo Laghi & Roberto
Baiocco (2017): Coming Out to Siblings and Internalized Sexual Stigma: The Moderating
Role of Gender in a Sample of Italian Participants, Journal of GLBT Family Studies, DOI:
10.1080/1550428X.2017.1369916

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 JOURNAL OF GLBT FAMILY STUDIES
https://doi.org/10.1080/1550428X.2017.1369916

Coming Out to Siblings and Internalized Sexual Stigma: The

Moderating Role of Gender in a Sample of Italian
Participants
Marco Salvatia, Jessica Pistellaa, Salvatore Iovernob, Fiorenzo Laghia,
and Roberto Baioccoa
a
Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza
University of Rome, Rome, Italy; bPopulation Research Center (PRC), University of Texas at Austin, Austin,
United States
Downloaded by [151.28.53.114] at 10:28 13 September 2017

ABSTRACT KEYWORDS
Previous research has shown that the act of disclosing sexual Coming out; siblings;
orientation, known as coming out (CO), yields various benefits for internalized sexual stigma;
gay and lesbian (GL) persons. Moreover, some researchers have gender; sexual orientation
found that CO is negatively related to internalized sexual stigma
(ISS). However, most research has focused on CO to parents and a
few studies have examined CO to siblings. The aim of this
research is to deepen the understanding of the role of CO to
siblings in protecting GL persons’ wellbeing. Specifically, the study
used a sample of 201 Italian GL persons to determine whether CO
to siblings predicted lower levels of ISS, and whether gender was
a moderating factor in the relation between ISS and CO to
siblings. About 62% of the sample reported that they had
revealed their sexual orientation to their siblings; 71% and 62%,
respectively, reported that they had disclosed their sexual
orientation to their mother and father. A finding of moderate
regression showed that the effect of CO to siblings on ISS was
moderated by the GL persons’ gender. In particular, CO to siblings
was associated with lower levels of ISS in gay men but not lesbian
women. Research implications and limitations are discussed.

Introduction
The phrase coming out (CO) is generally used to refer to the process by which gay,
lesbian, and bisexual persons (GLB) reveal their sexual orientation to others. CO is
an essential component of GLB persons’ identity formation and integration; it
allows them to develop an authentic and stable sense of self (Rosario, Hunter,
Maguen, Gwadz, & Smith, 2001; Wells & Kline, 1987), and the act is positively
associated with mental health (Cass, 1979; Ragins, 2004). Prior research on CO to
family has mostly concentrated on parental reactions, finding that such reactions
may be protective or risk factors (Baiocco et al., 2015; Costa, Pereira, & Leal, 2013;

CONTACT Roberto Baiocco [email protected]. Department of Social and Developmental

Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
© 2017 Taylor & Francis Group, LLC
 2 M. SALVATI ET AL.

D’Amico, Julien, Tremblay, & Chartrand, 2015) for GLB persons’ wellbeing and
mental health. Siblings have rarely been a focus of CO research (Hilton & Szyman-
ski, 2011, 2014; Huang, Chen, & Ponterotto, 2016).
CO is not a one-time event; rather, it must be performed whenever new sit-
uations and relationships are entered (Mohr & Fassinger, 2000). Beals, Peplau,
and Gable (2009) found that a sample of 84 gay and lesbian people from the
United States of America averaged three disclosure opportunities over the
course of 2 weeks. There are various ways in which GLB persons reveal their
sexual orientation, namely because CO is a specific and individual process
(Russel & Seif, 2001). The act usually consists of direct verbal disclosure, but
it can also consist of written or posted messages addressed to specific persons
or a broad audience. GLB persons can also reveal their sexual orientation in
various indirect ways (Gross, 1999; Herek & Capitanio, 1996). For example,
GLB persons might leave clues for their friends and family or make vague
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allusions to their sexuality to test possible negative reactions from others

(Rule, Ambady, & Hallett, 2009; Rule, Ambady, Adams, & Macrae, 2008). CO
is different from outing—a term generally used to refer to the process by
which an individual who is aware of an GLB person’s sexual orientation
reveals it with or without the GLB person’s consent (Johansson & Percy,
1994).
Findings by D’Augelli (2006) and D’Augelli and Grossman (2001), reported that
only 23% of GLB youths were completely self-disclosed to everyone in their life,
and only 38% were self-disclosed to 75% at least, of the people they knew. To date,
research has studied CO in the workplace (Chrobot-Mason, Button, & DiClementi,
2002; Griffith & Hebl, 2002; Prati & Pietrantoni, 2014; Ward & Winstanley, 2005),
among friends (Baiocco, Laghi, Di Pomponio, & Nigito, 2012), at school (Legate,
Ryan, & Weinstein, 2012), in familiar contexts (Baiocco et al., 2015; D’Amico
et al., 2015), and also in television programs (Baldo, 2014; Malici, 2014). However,
to our knowledge, no studies have compared CO between these contexts.

Variables associated with CO and internalized sexual stigma

Frequency of CO is not consistent within the GLB community. Generally, previous
studies have found no gender differences in the proportion of GLB persons who
have come out to families and friends (Balsam & Mohr, 2007; D’Augelli,
Hershberger, & Pilkington, 1998; Dewaele, Van Houtle, & Vincke, 2014; Grov,
Bimbi, Nan
ın, & Parson, 2006; Hequembourg & Brallier, 2009; Wells & Kline,
1987). However, several studies have found significant differences in CO with
respect to sexual orientation: Bisexual persons are less likely to reveal their sexual
orientation to others, relative to gay and lesbian persons (Balsam & Mohr, 2007;
Pistella, Salvati, Ioverno, Laghi, & Baiocco, 2016; Wandrey, Mosack, & Moore,
2015). A possible explanation for this is that bisexual persons may experience less
social pressure to come out, especially when they are involved in a stable
 JOURNAL OF GLBT FAMILY STUDIES 3

relationship with a different-sex partner (Pistella et al., 2016). Another explanation

is that negative attitudes toward bisexual persons are more prevalent than negative
attitudes toward gay men and lesbians (Eliason, 1997).
Although the decision to come out is always personal, CO to one’s family may
also be facilitated or thwarted by various personal and situational considerations,
such as cultural background (Newman & Muzzonigro, 1993; Schope, 2002). Herek,
Norton, Allen, and Sims (2010) reported that older people are more likely to come
out later than younger people. Further, right-wing conservative political ideology
and religiosity in the family (Newman & Muzzonigro, 1993; Schope, 2002) have
been shown to be negative predictors of CO to family members. Furthermore,
Pistella et al. (2016) showed that GLB persons’ right-wing conservative political
ideology negatively predicts CO to family members, but religious involvement
does not affect CO. In contrast, being involved in a stable relationship
(Heatherington & Lavner, 2008; Savin-Williams & Dub
e, 1998) and having GLB
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persons in one’s social network (Herek, 2007; Tropp & Pettigrew, 2005) have each
been shown to be positive predictors of CO to family members.
Internalized sexual stigma (ISS) describes GLB persons’ self-referred negative
feelings, attitudes, and representations of sexual minorities (Herek, 2000; Lingiardi,
Baiocco, & Nardelli, 2012). It is a measure of society’s negative ideology about GLB
persons—an ideology that is sometimes internalized (Mayfield, 2001). ISS is one of
the three components of the minority stress model (Meyer, 2003), according to
which GLB persons suffer stress simply because they belong to a minority group.
The other two components of this model are: (a) external objective events and con-
ditions, such as discrimination and violence (Slepian, Masicampo, & Ambady,
2014) and (b) the expectation of such events, with corresponding vigilant behavior.
ISS is a significant index of GLB persons’ mental health; that is, higher ISS is more
likely to be associated to lower mental health (Mays & Cochran, 2001; Meyer &
Northidge, 2007), and it may consistently interfere with their relational and
psychological wellbeing (Balsam & Mohr, 2007; Herek, Chopp, & Strohl, 2007;
Meyer, 2003; Riggle, Rostosky, & Horne, 2010). Lingiardi et al. (2012) reported
that gay and lesbian persons with higher levels of ISS present higher levels of social
anxiety, lower connectedness to the GLB community, and more rejecting reactions
to their CO. Further, some researchers have found that ISS correlates significantly
and negatively with CO to parents (Baiocco et al., 2014; Chow & Cheng, 2010;
D’Augelli & Grossman, 2001; Pistella et al., 2016) and friends (Costa et al., 2013;
Lingiardi et al., 2012).

Costs and benefits of CO on mental health and wellbeing

Several studies have revealed that CO is related to various benefits for GLB persons’
mental health, such as better wellbeing, greater work and life satisfactions (Griffith
& Hebl, 2002; La Sala, 2000); higher self-esteem (Henry, 2013; Savin-Williams,
1989); increased coping resources and resilience (Rhoads, 1995); and lower anxiety
 4 M. SALVATI ET AL.

and emotional relief (Monroe, 2000). However, the positive relation between CO
and wellbeing must take into account not only the individual, but also the social
context. In fact, although research has generally reported a positive relation between
self-disclosure and indicators of mental health, other scholars have reported that CO
might be associated with negative consequences, mainly due to the social context
(D’Augelli & Grossman, 2001; Frost, Lehavot, & Meyer, 2013; Herek, 2003; Legate
et al., 2012). A possible explanation of such results might be due to their higher visi-
bility than before. Specifically, negative consequences have been shown to arise from
the greater exposure to rejection from family and friends (Frost et al., 2013), peer
victimization (Bianchi, Piccoli, Zotti, Fasoli, & Carnaghi, 2017) and harassment at
school (Guzzo, Pace, Cascio, Craparo, & Schimmenti, 2014; Savin-Williams, 1994),
and discrimination and prejudice (D’Augelli, Pilkington, & Hershberger, 2002;
Meyer, 2003; Pilkington & D’Augelli, 1995).
CO to family members is a challenging act that can potentially alter family rela-
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tionships; it can also be associated with interparental conflict and parents’ mental
health issues (Connolly, 2005; Willoughby, Doty, & Malik, 2008). Some studies
have revealed that youths who disclose their sexual orientation to their parents
show lower self-acceptance and the presence of risk behaviors (Rosario,
Schrimshaw, & Hunter, 2009), as well as compromised wellbeing (Heatherington
& Lavner, 2008). However, to date, research on GLB persons’ CO to family has
mostly focused on parental reactions (Baiocco et al., 2015; Costa et al., 2013), such
as factors that can facilitate or hinder CO to parents and the positive and negative
consequences of CO to parents (or to family, in general; D’Amico & Julien, 2012;
D’Augelli et al., 1998; Lingiardi et al., 2012, Pistella et al., 2016; Svab & Kuhar,
2014). CO to siblings has rarely been a focus of such research (Hilton & Szymanski,
2011, 2014; Huang et al., 2016).

Research on CO to siblings
Previous research has often focused on the importance of sibling relationships for
mental health (Buist, Dekovic, & Prinzie, 2013), the development of social and
relational competences (Sulloway, 2010), the prevention of behavior problems
(Feinberg, Sakuma, Hostetler, & McHale, 2013), and psychopathology (Natsuaki,
Ge, Reiss, & Neiderhiser, 2009). The sibling relationship is one of the most endur-
ing relationships (Noller, 2005), and brothers and sisters spend a lot of time
together—even more time than children spend with parents (Sanders, 2004). Given
these premises, it seems paradoxical that there have been so few studies on the rela-
tionship between GLB persons and their siblings (Chan, 1989; D’Augelli et al.,
1998; Haxhe & D’Amore, 2014; Huang et al., 2016; Hilton & Szymanski, 2014).
Research on CO has revealed that siblings are often an important part of the CO
process (Hilton & Szymanski, 2011; Jenkins, 2008), possibly because siblings—
unlike friends—share the same family as the GLB person, and—unlike parents—
are often of the same generation (Haxhe, Cerezo, Bergfeld, & Walloch, 2017).
 JOURNAL OF GLBT FAMILY STUDIES 5

A study conducted on a sample of 105 GLB youth aged 14 to 21 years (D’Augelli

et al., 1998) revealed that, among the very few (9%) who had first come out to a
parent, all had come out to their mother. Although 94 participants (89%) had a
sibling, only three had chosen to tell their sister first, whereas no one had told their
brother first. There were no differences between female and male participants in
patterns of CO to siblings; in fact, of those with a sibling, 64% said their sibling
knew of their sexual orientation, 14% said their sibling probably knew or
suspected, and 22% said their sibling did not know (D’Augelli et al., 1998). An
Internet study of 2,000 GLB youths aged 10 to 25 by Savin-Williams (2001)
showed that 49% had first disclosed to their mother and 38% had first disclosed to
their brother or sister.
In Hilton and Szymanski’s (2011) qualitative study, heterosexual siblings
claimed that their relationship with their GLB sibling changed after their GLB
sibling came out. Those who already had a positive relationship described the dis-
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closure as bringing them closer, whereas those who had a negative relationship
reported that the CO exacerbated the difficult relationship (Hilton & Szymanski,
2011). In Haxhe and D’Amore’s (2014) study, most of the GLB participants
claimed it had been easier to disclose to siblings than to parents. The researchers
provided three reasons for this: (a) The participants were emotionally and finan-
cially dependent on their parents, thus they feared getting kicked out of the home,
whereas this fear was not present with their siblings; (b) the participants feared
eliciting their parents’ negative judgment and disappointing them by not meeting
their expectations, whereas this fear was less present toward their siblings, except
in some later born GLB persons toward their elder siblings; and (c) the participants
felt there was a greater risk that they would develop feelings of guilt toward their
parents, relative to their siblings.

This study
To our knowledge, few previous studies have investigated the role of gay and
lesbian (GL) persons’ CO to siblings on their wellbeing (Chan, 1989; Haxhe &
D’Amore, 2014; Haxhe et al., 2017; Huang et al.,Hilton & Szymanski, 2014; Huang
et al., 2016), but this research is the first to investigate the connection between
sibling CO with GL persons’ ISS. Considering that ISS has been shown to be an
index of GL persons’ mental health and wellbeing (Balsam & Mohr, 2007; Herek
et al., 2007; Meyer & Northidge, 2007), this study aimed at filling this gap in the
literature. The goal of the study was to investigate the role of Italian GL persons’
gender and CO to siblings in ISS levels and to investigate whether gender moder-
ates the effect between CO to siblings and ISS.
The study was conducted in Italy, where traditional gender ideology is widespread
and related to the concept of machismo—overconformity to the traditional male gen-
der role (Pacilli, Taurino, Jost, & van der Toorn, 2011; Salvati, Ioverno, Giacomanto-
nio, & Baiocco, 2016). Because of this, gay men face prejudice and discrimination in
 6 M. SALVATI ET AL.

their daily life more often than do lesbian women, and gay men also have higher lev-
els of ISS than do lesbian women, independently, by the fact that they have revealed
their sexual orientation (Bahamondes-Correa, 2016; Herek et al., 2007; Monto &
Supinski, 2014). Moreover previous literature showed no gender differences in GL
people’s choice to reveal their sexual orientation to family, to friends, or to work col-
leagues (Balsam & Mohr, 2007; Dewaele et al., 2014; Wells & Kline, 1987) For these
reasons, we expected that: (a) There would be no differences between gay men and
lesbian women in rates of CO to siblings (D’Augelli et al., 1998; Grov et al., 2006;
Hequembourg & Brallier, 2009); (b) male participants would report higher levels of
ISS than would female participants (Bahamondes-Correa, 2016; Herek et al., 2007;
Monto & Supinski, 2014); (c) GL participants who had come out to siblings would
report lower levels of ISS than would GL participants who had not come out to sib-
lings (Haxhe et al., 2017; Hilton & Szymanski, 2014; Huang et al., 2016); and (d) the
difference in ISS levels between participants who had and had not come out to sib-
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lings would be more accentuated in male participants than in female participants,

because of higher ISS in gay men than lesbians due to widespread traditional gender
ideology (Herek et al., 2007; Pacilli et al., 2011).

Method
Procedures and participants
The original sample consisted of 228 participants who had been recruited through
online advertisements and an Internet-based survey. To meet the inclusion criteria,
participants had to (a) be of Italian nationality, (b) have a gay or lesbian sexual ori-
entation, (c) be 18 to 35 years old, (d) have both parents alive, and (e) have at least
one sibling (a sister or a brother). On the basis of these criteria, 10 participants
were excluded because their sexual orientation was not gay or lesbian (2 bisexuals,
8 heterosexual), 12 were excluded because only their mother or father was alive,
and 5 participants were removed because they did not complete the entire set of
questionnaires. Participation in the study was voluntary and anonymous, and all
respondents answered the same questionnaire, individually (they were given
15–20 min to do so). Informed consent was obtained from all participants. Before
the data collection commenced, the research protocol was approved by the Ethics
Commission of the Department of Developmental and Social Psychology at
Sapienza University of Rome. All procedures performed with human participants
were conducted in accordance with the ethical standards of the institutional
\and/or national research committee and with the 1964 Helsinki declaration and
its later amendments, or comparable ethical standards.
The final sample consisted of 201 Italian participants who self-identified as les-
bian women (N D 108; 53.7%) or gay men (N D 93; 46.3%), with ages ranging
from 18 to 31 (lesbian women: M D 26.7, SD D 4.0; gay men: M D 26.1,
SD D 3.4). The lesbian women and gay men did not differ significantly in age,
t(199) D 1.28, p D .261.
 JOURNAL OF GLBT FAMILY STUDIES 7

Measures
Sociodemographic variables
Baseline sociodemographic variables, such as gender, sexual orientation, age,
and parental situation (having both parents alive versus having one or both
parents deceased or out of contact) were evaluated. The presence of siblings
was investigated by the following question: “Do you have a sister or brother?”.
Participants were asked to report their sexual orientation by indicating one of
three possible responses (1 D lesbian, 2 D gay, 3 D other). In cases where
other was selected, participants had the opportunity to specify their sexual
orientation.

Disclosure of sexual orientation

Each participant was given a list of five items (mother, father, brother/sister,
Downloaded by [151.28.53.114] at 10:28 13 September 2017

friends, and colleagues) and asked to indicate whether each individual or group of
individuals was aware of their sexual orientation. Two possible responses were pro-
vided: “He/she is aware about my sexual orientation” and “He/she is not aware
about my sexual orientation.” Participants who had more than one sibling were
asked to refer to the sibling whom they felt emotionally closest to. We did not ask
participants to list the number and gender of their siblings, because these variables
were not relevant for the purpose of this study. The frequencies of CO are shown
in Table 1.
Measure of Internalized Sexual Stigma for Gay Men and Lesbians—Short
Version (MISS-GL; Lingiardi et al., 2012).
A short version of the MISS-GL was used to measure participants’ internalized
sexual stigma (Pistella et al., 2016). This version of the MISS consists of six items
that measure lesbian and gay persons’ negative attitudes toward homosexuality
and homosexual aspects in themselves. Example items are “I do not believe in love
between lesbian or gay men” and “I would prefer to be heterosexual”. The partici-
pants could answer on a five-point Likert scale from 1 (I disagree) to 5 (I agree). A
mean score of items was calculated, with higher scores indicating greater levels of
ISS. Cronbach’s alpha was .80.

Table 1. Differences between lesbian women and gay men in coming-out.

Self-disclosure of Total Sample Lesbian women Gay men

Sexual Orientation (n D 201) (n D 108) (n D 93) x2

Coming-out to Siblings 124 (61.7%) 68 (63.0%) 56 (57.4%) .160

Coming-out to Father 124 (61.7%) 72 (66.7%) 52 (55.9%) 2.44
Coming-out to Mother 142 (70.6%) 81 (75.0%) 61 (65.6%) 2.13
Coming-out to Friends 182 (90.5%) 105 (97.2%) 77 (82.8%) NA^
Coming-out to Colleagues 128 (63.7%) 71 (65.7%) 57 (61.3%) .48

Note. p < .01. p < .001.^The x2 is not applicable (NA) for those variables with < 20% of cells with expected fre-
quencies < 5. The x2 refers to the difference between lesbian women and gay men. The frequencies refer to the
answer “He/she is aware about my sexual orientation” to the questions.
 8 M. SALVATI ET AL.

Data analysis
To conduct bivariate and multivariate analyses, we used the Statistical Package for
the Social Sciences (SPSS 22.0). Group differences were analyzed using the chi-
square test. Point-biserial (when one variable was continuous and one was dichoto-
mous), Pearson (when both variables were continuous), and phi (when both varia-
bles were dichotomous) coefficient correlations were calculated to examine the
relationships between variables. Moreover, moderate regression analysis was
employed to test the interactive effects of CO to siblings and gender on internalized
sexual stigma (with age, CO to father, CO to mother, and CO to colleagues as
covariate variables).

Results
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Gender differences in CO and correlations among variables

The majority of the sample reported that they had revealed their sexual orientation
to siblings (N D 124; 61.7%); 142 (70.6%) and 124 (61.7%) reported that they had
disclosed their sexual orientation to their mother and father, respectively
(see Table 1). Consistent with the literature, CO to friends was higher (182; 90.5%)
than CO to parents, siblings, and colleagues. A chi-square test detected no signifi-
cant difference between lesbian women and gay men in their CO to siblings,
x2(1,201) D 2.13, p D .14.
Moreover, we analyzed differences in CO to one’s father, mother, friends, and
colleagues between lesbian women and gay men. A chi-square test showed no
significant differences between lesbian women and gay men in CO to their father,
x2(1,201) D 2.44, p D .11, CO to their mother, x2(1,201) D 9.18, p D .02, and CO
to their colleagues, x2(1,201) D .42, p D .51. The x2 was not applicable to CO to
friends (fewer than 20% of the cells had expected frequencies lower than 5).
To deepen our understanding of the frequency of CO to family members, we
calculated a categorical variable of CO to parents and siblings (COPS; 1 D CO to
one parent and no siblings, 2 D CO to both parents and no siblings, 3 D CO to one
parent and siblings, 4 D CO to only siblings, 5 D CO to everyone, and 6 D CO to no
one). Using chi-square analyses (see Table 2), we further examined differences in
gender on frequencies of CO to only parents (to one parent without siblings or to
both parents without siblings), to one parent and siblings, to only siblings, to
everyone, and to no one. A chi-square test detected a nonsignificant difference
between gender and COPS, x2(1,201) D 9.34, p D .09. Specifically, gay men
reported similar frequencies of CO to one parent without siblings (10.8%), CO to
both parents without siblings (9.7%), CO to everyone (37.6%), and CO to no one
(19.4%), compared to lesbian women (who reported frequencies of 6.5%, 13.9%,
50.9%, and 16.7%, respectively).
Table 3 shows correlations among key variables for the overall group of
participants.
 Downloaded by [151.28.53.114] at 10:28 13 September 2017

Table 2. Differences between lesbian women and gay men in the frequencies of coming-out to parents and siblings (COPS).
Frequencies of coming-out to COPS

Differences between CO to One parent Both parents One parent Only No

parents and siblings no siblings no siblings and siblings Everyone siblings one x2 p

Lesbian Women (n D 108) 7 (6.5%) 15 (13.9%) 6 (5.6%) 55 (50.9%) 7 (6.5%) 18 (16.7%)

Gay Men (n D 93) 10 (10.8%) 9 (9.7%) 15 (9.7%) 35 (37.6%) 6 (6.5%) 18 (19.4%) 9.341 .096
Total Sample (n D 201) 17 (8.5%) 24 (11.9%) 21 (10.4%) 90 (44.8%) 13 (6.5%) 36 (17.9%)

Note. p < .05, p < .01. The x2 refers to the difference between lesbian women and gay men. The percentages are in parentheses. Participants rated the dichotomous measure on coming-out to
father, mother, and siblings (1 D He/she is aware about my sexual orientation; 0 D He/she is not aware about my sexual orientation). Thus, we calculated a categorical variable of the coming-out
to parents and siblings in order to examine the frequencies of self-disclosure of their sexual orientation only to parents (one parent no siblings or both parents no siblings), to one parent and sib-
lings, only to siblings, to everyone or no one of them.
JOURNAL OF GLBT FAMILY STUDIES
9
 Downloaded by [151.28.53.114] at 10:28 13 September 2017

10
M. SALVATI ET AL.

Table 3. Correlations [and 95% Confidence Intervals] between coming-out (toward siblings, parents, friends and colleagues), internalized sexual stigma and age of
the participants.
1 2 3 4 5 6 7

1. Age 1 — — — — — —
2. Coming-out to Siblings ¡.03 [¡.15, .10] 1 — — — — —
3. Coming-out to Father .07 [¡.08, .21] .37** [.23, .49] 1 — — — —
**
4. Coming-out to Mother .07 [¡.08, .22] .44 [.30, .56] .59** [.48, .71] 1 — — —
**
5. Coming-out to Friends .08 [¡.06, .22] .23** [.09, .35] .13 [¡.03, .28] .24 [.08, .39] 1 — —
6. Coming-out to Colleagues .15* [.002, .29] .30** [.16, .43] .23** [.08, .37] .33** [.18, .46] .43** [.33, .52] 1 —
7. Internalized Sexual Stigma^ ¡.16** [¡.28, ¡.01] ¡.17* [¡.29, ¡.02] ¡.32** [¡.46, ¡.18] ¡.23** [¡.38, ¡.08] ¡.02 [¡.17, .13] ¡.16** [¡.31, ¡.01] 1

Note. p < .05, p < .01.^High scores indicate high internalized sexual stigma. Internalized Sexual Stigma (ISS) refers to Measure of the Internalized Sexual Stigma for Gay Men and Lesbians (MISS-
GL). Participants rated the dichotomous measure on coming-out to father (1 D He is aware about my sexual orientation; 0 D He is not aware about my sexual orientation), coming-out to mother
(1 D She is aware about my sexual orientation; 0 D She is not aware about my sexual orientation), coming-out to siblings (1 D He/she is aware about my sexual orientation; 0 D He/she is not
aware about my sexual orientation), coming-out to friends (1 D They are aware about my sexual orientation; 0 D They are not aware about my sexual orientation) and coming-out to colleagues
(1 D They are aware about my sexual orientation; 0 D They are not aware about my sexual orientation).
 JOURNAL OF GLBT FAMILY STUDIES 11

ISS and CO to siblings by gender

Finally, we conducted a moderated regression analysis to examine the degree
to which gender differences in CO to siblings predicted ISS levels (see Table 4).
We included covariates to adjust for age, CO to parents, and CO to colleagues.
We did not include CO to friends in the moderated regression analysis
because only 3 lesbian women and 16 gay men had not revealed their sexual
orientation to friends. The results of the moderated regression analysis were
significant, F(1,193) D 6.014, p <.001. As Table 4 shows, there was a signifi-
cant and positive main effect of gender, b D .26, t(193) D 2.94, p D .003,
and, most relevant to the goal of the study, a significant and positive interac-
tion effect of CO to siblings £ gender on ISS, b D ¡.40, t(193) D –2.30,
p D .022. The main effect of CO to siblings was not significant, b D ¡.08,
t(193) D ¡.82, p D .41. With regard to covariate modeled, only CO to father,
b D ¡.37, t(193) D –3.37, p D .001, was associated with ISS, whereas age,
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b D ¡.01, t(193) D –1.72, p D .09, CO to mother, b < .01, t(193) D .04,

p D .96, and CO to colleagues, b D ¡.06, t(193) D ¡.62, p D .53, were unre-
lated to ISS. The adjusted R2 for the whole model was .18.
To further explore the nature of the CO to siblings £ gender interaction effect,
simple slopes analyses were performed (see Figure 1), with adjustments made for
age, CO to parents, and CO to colleagues. Consistent with our hypothesis, the
results revealed that the relationship between CO to siblings and ISS was moder-
ated by gender. For gay men, higher ISS scores were associated with participants
who had not come out to siblings, b D – .28, t(193) D –2.05, p D .04. In contrast,
the relation between ISS and CO to siblings was nonsignificant for lesbian women,
b D .12, t(193) D .93, p D .35. These results confirm that gender was a significant
moderator of this relation, controlling the effects of age, CO to parents, and CO to
colleagues.

Table 4. Internalized sexual stigma* as a function of coming-out to siblings and gender (age, com-
ing-out to father, mother, and colleagues were added as covariates): Results of moderated regres-
sion analysis.
Predictors B SE t p [95% CI] F R2 DR2

Coming-out to siblings (COS) ¡.08 .10 ¡.82 .41 [¡.27, .11]

Gender (G) .26 .09 2.94 .003 [.08, .42]
COS x G ¡.40 .17 –2.30 .022 [¡.74, ¡.06]
Covariate variables:
Age ¡.01 .01 –1.72 .09 [¡.04, .01]
Coming-out to father ¡.37 .11 –3.37 .001 [¡.58, ¡.15]
Coming-out to mother <.01 .12 .04 .96 [¡.23, .25]
Coming-out to colleagues ¡.06 .09 ¡.62 .53 [¡.24, .12]
F-values for all variables and interaction 6.014***
R2 for all variables and interaction .18***
R2 Increase due to interaction .03**

Note. High scores indicate high internalized sexual stigma. p < .01, p < .001. Gender: –0.5 D lesbian women,
0.5 D gay men. Coming-out to siblings: –0.5 D He/she is not aware about my sexual orientation, 0.5 D He/she is
not aware about my sexual orientation.
 12 M. SALVATI ET AL.


Figure 1. Gender as a moderator of coming-out to siblings and internalized sexual stigma (N D

201). Note. High scores indicate high internalized sexual stigma. Age, coming-out to father, mother,
and colleagues were used as covariate variables in the moderation model.
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Discussion
This research aimed at contributing to the growing literature on GL persons’ CO
and, specifically, their CO to siblings. In particular, we analyzed the relationship
between GL persons’ CO to siblings and their levels of ISS. Moreover, we aimed at
deepening the understanding of this relationship by analyzing the potential moder-
ation effect of GL persons’ gender. The study was conducted in Italy, which is a
family-oriented country in which GL persons face constant heterosexism (Pacilli,
Taurino, Jost, & van der Toorn, 2011). In such a stigmatizing context, GL persons
have a greater risk of developing ISS (Baiocco et al., 2014; Bianchi et al., 2017) and
facing difficulties in CO to parents, other family members, friends, and colleagues
(Pistella et al., 2016).
We hypothesized that there would be no differences between lesbian women
and gay men in rates of CO to siblings (Hypothesis 1); moreover, we expected that
gay men would report higher levels of ISS than would lesbian women (Hypothesis
2); we further hypothesized that those who had come out to siblings would report
lower levels of ISS than would those who had not come out to siblings (Hypothesis
3); finally, we expected that the difference in ISS levels between those who had and
had not come out to siblings would be more accentuated in males than in females
(Hypothesis 4).
The findings confirmed our first hypothesis. A chi-square test showed that les-
bian women and gay men did not differ in their CO to siblings; this result is in line
with the findings of previous studies (Baiocco et al., 2015; Balsam & Mohr, 2007;
D’Augelli et al., 1998; Grov et al., 2006). The differences in CO to siblings and CO
to family members, more generally, could be more due to nongender variables,
such as sexual orientation (Pistella et al., 2016), political orientation (Newman &
Muzzonigro, 1993; Schope, 2002), involvement in a stable relationship (Heather-
ington & Lavner, 2008; Pistella et al., 2016), the presence of GLB persons in one’s
 JOURNAL OF GLBT FAMILY STUDIES 13

social network (Herek, 2007; Tropp & Pettigrew, 2005), and ISS (Baiocco et al.,
2014; Chow & Cheng, 2010; D’Augelli & Grossman, 2001).
The second hypothesis, according to which gay men were expected to report
higher levels of ISS than were lesbian women, was also confirmed. Moderate
regression showed that participants’ gender predicted their ISS levels, and this
result is in line with the findings of several previous studies in Italian (Lingiardi
et al., 2012) and international contexts (Herek et al., 2007). This result could be
explained by the fact that, in Italy, traditional gender ideology is widespread and
related to machismo behavior (Pacilli et al., 2011; Salvati, Pistella, Ioverno,
Giacomantonio, & Baiocco, 2017). Specifically, traditional gender differences and
gender ideologies could be more strongly interiorized by gay men than by lesbian
women (Carnaghi, Maass, & Fasoli, 2011; Hunt, Fasoli, Carnaghi, & Cadinu, 2016).
Our third hypothesis was that CO to siblings would have a direct effect on ISS,
independent of the GL person’s gender, but this was not confirmed. However, find-
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ings of moderate regression showed that the effect of CO to siblings on ISS was
moderated by the GL person’s gender, and this confirmed our fourth hypothesis.
Specifically, we expected CO to siblings to have a negative effect on ISS in gay men
but not lesbian women. This result can be interpreted in light of previous studies
on CO and ISS in Italy (Baiocco et al., 2015; Lingiardi et al., 2012). In the Italian
context, gay men face significantly more discrimination and prejudice than do
lesbian women (Inbar, Pizarro, Iyer, & Haidt, 2012), and they might require signif-
icant supportive resources to face such events and perceptions.
Siblings might represent such a resource for GLB persons, in addition to friends,
a supportive social context, a stable sentimental relationship, and GLB contacts.
Previous research has demonstrated the relevance of the sibling relationship for
mental health and psychopathology (Buist et al., 2013; Feinberg et al., 2013;
Natsuaki et al., 2009; Sulloway, 2010). In family-oriented Italy, this relationship
might have even greater relevance. As Hilton and Szymanski (2014) highlighted,
the quality of the sibling relationship might predict heterosexual siblings’
acceptance of their GLB sister or brother. Family stress theory states that during a
time of crisis or stress in the family, such as a sibling’s CO, family resources, such
as cohesion among the family, can lessen the effect of the stressor (McKenry &
Price, 2000; Willoughby, Malik, & Lindahl, 2006). CO to siblings represents a
potential resource that gay men, in particular, might benefit from in terms of a
reduction in ISS. However, siblings and family members do not typically constitute
GLB persons’ first choice of people to come out to (D’Augelli et al., 1998). A sup-
portive and friendly context for CO and other GLB contacts may be sufficient for
lesbian women to reduce their levels of sexual stigma. However, because of the
Italian machist society, these resources may not be sufficient for gay men, for
whom siblings might prove an additional source of discrimination and prejudice.
As Haxhe and D’Amore (2014) and Jenkins (2008) have shown, CO to siblings can
also facilitate CO to parents. Siblings often represent the first CO within the family,
because GLB persons are not emotionally and financially dependent on their
 14 M. SALVATI ET AL.

siblings, they have less fear of disappointing them by not meeting their expecta-
tions, and they feel less at risk of developing feelings of guilt toward their siblings
than their parents.

Limitations
Although this study has various strengths, such as its contribution to deepening
the understanding of the role of CO to siblings in GL persons’ ISS, it nonethe-
less has several limitations. First, with respect to the sampling method, we used
a convenience sample, and most of the participants were recruited online. All
of the participants were Italian, and thus the results cannot be immediately gen-
eralized to other national contexts. The age range was limited to 18 to 31 years,
and this might also limit the generalizability of the results. Another strong
limitation of this study is that it did not explore whether siblings’ gender had a
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moderating effect on GL persons’ ISS. Moreover, we did not ask participants to

indicate the time of their CO to various family members. Thus, we do not
know who first came out to siblings and then to parents, and vice versa. The
time of CO, the number of siblings, and siblings’ birth order could be fruitful
variables to investigate in future studies on CO to family members. Another
limitation centers on the fact that various measures were detected by a single
item with dichotomous answers. Future research should evaluate CO in Italian
contexts using adapted scales. Moreover, future studies could examine other
variables, such as fear and shame relating to CO to siblings and the potential
benefits to GLB persons of a positive relationship with siblings. Including bisex-
ual participants in the sample would enable an analysis of differences between
GL and bisexual persons, which no study has yet done.
We believe that too little attention has been focused on CO to siblings. In our
opinion, this is an important topic that is often ignored, despite its significant
potential for improving and promoting the wellbeing of sexual minorities.

Acknowledgments
We express our sincere gratitude to the gay men and lesbian women who participated in this
study. All authors who contributed significantly to the work have been identified.
We did not have financial support for the conduct of the research and preparation of the
manuscript.

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