Goffman (Stigma: Notes on the management of spoiled identity, Prentice-Hall Inc., Englewood Cliffs, NH, 1963) distinguished stigmatized groups as discredited (with relatively obvious marks such as people of color or gender) or discreditable (without obvious marks, causing stigma to be largely hidden). Like gay men and lesbians, people with various mental illnesses can opt to stay in the closet about these conditions in order to avoid corresponding prejudice and discrimination. In this study, we completed semi-structured interviews with 13 gay men and lesbians in order to better understand the personally perceived consequences that guide the coming out process. This information would, in turn, help us to better comprehend the process of coming out for people with mental illnesses. Interview participants identified specific benefits and costs. Benefits that promote disclosure include acceptance, community, and comfort and happiness. Costs that diminish coming out decisions include shame and conformity as well as harm and discrimination. We then postulated how these consequences might manifest themselves in the disclosure process of people with serious mental illnesses. Finally, implications for stigma management and change were considered.