Sexual orientation, disclosure, and cardiovascular stress reactivity

Stigma may strain the heart health of lesbian, gay, and bisexual (LGB) individuals. To date, however, LGB-related differences in cardiovascular diagnosis, risk factors, and basal biomarkers are inconsistently reported. Using a laboratory-based stress paradigm, the current study assessed whether cardiovascular stress reactivity differs as a function of sexual orientation and disclosure status ("coming out") in a sample of healthy young LGB and heterosexual adults. Eighty-seven participants aged 18-45 (M = 24.61 ± 0.61 SE) identifying as LGB and heterosexual (47%) were exposed to the Trier Social Stress Test, a well-validated laboratory stressor involving public speaking and mental arithmetic. Throughout a two-hour session, ambulatory recordings for heart rate and blood pressure were collected. Self-report questionnaires were also administered to assess psychosocial and demographic variables. Gay/bisexual men showed higher heart rate and lesbian/bisexual women showed marginally higher mean arterial blood pressure in response to a stressor, compared to sex- and age-matched heterosexuals. No significant differences emerged when comparing LGB individuals who had completely disclosed and those that had not completely disclosed their sexual orientation to family and friends. Compared to heterosexuals, heart rate is higher among gay/bisexual men and blood pressure is marginally higher among lesbian/bisexual women when exposed to a laboratory-based stressor. These preliminary findings contribute to small literature on sexual orientation differences in stress reactive biomarkers that requires further exploration. Lay abstract In response to stress exposure in a laboratory, gay/bisexual men showed higher heart rate than heterosexual men. By contrast, lesbian/bisexual showed a non-significant tendency towards higher blood pressure than heterosexual women. These preliminary findings suggest that the heart health of LGB individuals might be strained by stigma exposure.