There is a lack of research on the association between identity concealment and mental health among sexual and gender minority (SGM) adolescents and how social support may attenuate this association. Furthermore, research typically neglects the day-to-day variability in concealment experiences of SGM adolescents. Therefore, we examined the association between daily sexual orientation and gender identity concealment and positive and negative affect and the moderating role of family and peer support on this association among SGM adolescents. Methods: A 21-day daily diary study among 94 SGM adolescents (mean [M] age ¼ 16.10, standard deviation [SD] ¼ 1.50; 31.9% gender minority; 44.7% youth of color) was conducted. Multilevel regression analyses tested the association between daily concealment and positive and negative affect and a cross-level interaction was used to assess the moderating effects of social supports. Results: Daily concealment was associated with higher negative but not with positive affect. Family support was associated with lower daily negative affect but not with positive affect. Peer support was not significantly associated with negative or positive affect. Moderation results indicated that the association between daily concealment and negative affect was significant for adolescents who reported low or average levels of family support but was no longer significant for adolescents who reported high levels of family support. Discussion: Daily identity concealment was positively associated with negative affect and this association was attenuated by family support. Future research and interventions should target families to improve the lives of SGM adolescents and to help reduce and eliminate mental health disparities.

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Lesbian, gay, and bisexual (LGB) adolescents experience elevated levels of internalizing problems and use more substances than heterosexual adolescents. The minority stress and psychological mediation framework are complementary theoretical frameworks that were developed to explain these disparities. However, limited empirical research has integrated both frameworks to study health disparities between heterosexual and LGB adolescents. This study attempts such an integration, using data from the first five waves (participant age 11-22) of the TRacking Adolescents' Individual Lives Survey (TRAILS), a cohort study of Dutch adolescents (N = 1738; 151 LGB; 54.8% girls). It was tested whether an LGB identity was linked to internalizing problems and substance use through a serial mediation process, in which sexual identity would be associated with peer victimization and negative relationships with parents (first set of mediators, in keeping with the minority stress framework), which in turn would be associated with fear of negative social evaluation and a lack of social support (second set of mediators, in keeping with the psychological mediation framework), and eventually increasing the risk for internalizing problems and elevated levels of substance use. Moreover, it was tested whether the link between minority stress and substance use was mediated by peers' substance use levels, as hypothesized by the psychological mediation framework. Compared to heterosexual participants, LGB participants reported more internalizing problems, smoked more cigarettes, and used more marijuana, but did not consume more alcohol. The relation between sexual identity and internalizing problems was mediated by peer victimization and parental rejection, which is in line with the minority stress framework. No statistically significant support was found for the psychological mediation framework. These findings provide a better understanding of the pathways through which sexual identity disparities in mental wellbeing and substance use come about.