Bicultural and biracial individuals (those who identify either with two cultures or two races) are often denied membership in the groups with which they identify, an experience referred to as identity denial. The present studies used an experimental design to test the effects of identity denial on physiological and self‐reported stress, and naturalistic behavioral responses in a controlled laboratory setting for both bicultural (Study 1; N = 126) and biracial (Study 2; N = 119) individuals. The results suggest that compared to an identity‐irrelevant denial, bicultural participants who were denied their American identity and Minority/White biracial individuals who were denied their White identity reported greater stress and were more likely to verbally reassert their identity. Bicultural participants also demonstrated slower cortisol recovery compared to those in the identity‐irrelevant denial condition. The results are the first to highlight the negative physical health consequences of identity denial using an experimental design for both bicultural and biracial populations, underscoring the necessity to promote belongingness and acceptance.

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Although numerous reviews suggest the detrimental influence of healthcare identity threat (i.e., expectations and the experience of identity-based devaluation) on stigmatized group members’ experiences in healthcare settings, no experimental research has examined identity safety cues (i.e., identity-relevant cues that signal protection from identity-based devaluation) in healthcare settings. The present 2 studies manipulated the presence or absence of 2 commonly studied identity safety cues on a healthcare provider’s brochure (i.e., racial minority representation and diversity statements) and assessed Black and Latinx participants’ perceptions of the provider (i.e., the provider’s racial bias and cultural competency) and expectations of a visit at that provider’s office. Across the 2 studies, Black and Latinx participants (Ntotal = 407) reported greater perceptions of the provider’s cultural competence and significantly lower perceptions of the provider’s racial bias when the provider signaled having racially diverse clientele compared to all White clientele. Further, participants anticipated having greater comfort and treatment quality when providers had racially diverse clientele. Providers’ diversity statements did not have a significant influence on perceptions of providers or anticipated visit quality. Future research should explore how identity safety cues in healthcare settings can influence intentions to visit healthcare providers and consequent health outcomes of Black and Latinx Americans.

A vast literature examines the role of contextual cues in signaling identity safety for stigmatized group members in potentially threatening contexts. Yet, to date, a striking lack of research has utilized this literature to improve stigmatized populations' experiences in health care settings. This review discusses how identity cues embedded in medical contexts may signal safety or potential threat to varied stigmatized group members, including those with visible or concealable stigmas. We propose that identity safety cues have the potential to improve patientϪprovider communication and comfort and, moreover, rates of health care utilization and adherence to medical suggestions. We discuss factors that may promote or hinder the efficacy of such cues and the relative power of different identity safety cues in past research. Finally, we review limitations of the cue implementation approach and describe suggestions for implementation within medical contexts. What is the significance of this article for the general public?Varied stigmatized group members, for example, people who are overweight, those with chronic illnesses, and racial and sexual minorities, utilize health care services at lower rates and often have poorer physical and mental health than do their majority counterparts. Extending the psychological literature on identity safety cues to the medical context may improve stigmatized group members' health care utilization, visit satisfaction, adherence, and subsequent health.

The present work experimentally examines how identity cues that signal minority inclusion contribute to sexual minorities’ (SM) healthcare visit expectations. We find that minority representation cues reduced SM’s ( N = 188) expectations of a healthcare provider’s bias and increased perceived provider cultural competency which was, in turn, associated with lower anticipated identity-based devaluation and greater sexual orientation disclosure comfort. Providers’ diversity-valuing statements had mixed effects highlighting the importance of more concrete indicators of inclusion in this context. This work suggests that a lack of identity safety cues in healthcare settings may contribute to disparate health outcomes for sexual minority populations.