Timing matters: Coming out at school and the risk of depression and anxiety among sexual and gender minority youth in Europe.

Background. Adolescence is a crucial period for sexual identity development and peer relationships. Openly identifying as a sexual or gender minority (SGM) may be an experience charged with anxiety and fear and may come with significant challenges, such as peer rejection, family conflict, and school-based victimization. This cross-national study aimed to evaluate how the timing of coming out at school relates to the risk of being classified as high-risk for depression and anxiety over time. Methods. Data were collected through multiple non-probability sampling methods via online surveys in 13 European countries (Austria, Belgium, Croatia, France, Greece, Ireland, Italy, Latvia, Netherlands, Portugal, Slovenia, Spain, and United Kingdom). The sample included 8,302 SGM students (Mage = 15.86; SD = 1.51). Most of the sample is composed by cisgender girls (38.81%) and boys (16.42%) followed by students identifying as intersex (2.31%), questioning (12.86%), trans boys (10.01%) and girls (2.42%) and other (17.16%). In terms of sexual identity, 30.37% identified as lesbian or gay, 41.65% as bisexual, 0.95% as questioning, 0.63% as heterosexual, and 26.4% selected another sexual identity. Depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2, respectively. Participants were asked about the number of SGM friends, how many family members and friends were aware of the participant’s SGM identity and whether they came out to their classmates at school. Follow-up questions addressed the timing of the first coming out and the perceived reactions at the first coming out. Cox proportional hazards models assessed how time since first coming out school was associated with the hazard ratios (HRs) of being high-risk for depression and anxiety. HR > 1 indicated greater risk with more recent coming out, whereas HR < 1 suggested greater risk with less recent coming out. Results. As shown in Table 1, for each additional year of age at which participants came out at school, their risk of being categorized as high-risk increased by 33% at any given time afterward, meaning that risk was higher for youth who came out more recently. In contrast, the more participants were out to family and friends, the lower their risk of being classified as high-risk, with reductions between 8% and 12%, indicating that greater openness was protective. Additionally, each positive reaction received at the time of first coming out was associated with a 7% reduction in the likelihood of being considered high-risk. Conclusions. This study highlights the complex role of coming out timing in adolescent SGM mental health. Delayed coming out at school is associated with a higher risk of depression and anxiety, whereas greater openness with family and friends and positive initial reactions serve as protective factors. These findings underscore the importance of fostering supportive environments, in schools, families, and peer groups, that encourage safe and affirming disclosure. Interventions aimed at reducing stigma and increasing acceptance could promote the well-being of SGM youth across Europe.