In 1979, Cass articulated the process that many LGBTQ individuals have in the struggle to embrace themselves while transforming stigma. While there are many models attempting to explain the coming out process for people, I feel Cass nails it on the head. Here briefly are the stages:

Stage 1 - Identity Confusion This is when people start to recognize their sexuality may differ from the larger populous. There is a greater risk for drug/alcohol use occurring at this stage due to the conflictual feelings people may face. In addition, much of the history of the LGBTQ population has centered on the acceptance people find in bars - which may lead to greater risks of addiction.

Stage Two: Identity Comparison This is the stage where people are recognizing that their sexually is, in fact, LGBTQ and are attempting to find meaning and peace in this fact but may vaciliate between I am/I am not different. This stage can encompass a great deal of pain and vulnerability. Substance use disorders are prevalent in this stage.

Stage Three: Identity Tolerance Identity Tolerance, people begin to notice the feelings they have towards same-sex feelings are probably not going away and the need for acceptance starts. People can still feel very isolated and alienated. At this stage, a person may seek out others in the community to find some sense of peace.

Stage Four: Identity Acceptance The Identity Acceptance stage is characterized by increasing contacts with others identifying as LGBTQ. Normalizing experiences at this stage is common - many begin to socialize in bars leading to greater risks for addiction. The person can find some relief at this stage, however - feeling not so isolated and starting to recognize there are others who have similiar experiences as them.

Stage Five: Identity Pride People now understand the injustice with homophobia and discrimination and set out against it. There is a tendancy to become very angry with the world and see things as “gay or straight”. Many people become involved in activist activities but can completely reject supportive heterosexual people who may be potential support to the person. This is where you’ll see the Ani flags flying (thanks, Sarah).

Stage Six: Identity Synthesis This stage encompasses a sense of peace. A person’s identity is no longer consumed by the definition of LGBTQ. The person starts to realize this aspect is an important part of the self but not the only self.
In stage six, Identity Synthesis, an awareness develops that the dichotomy of “them and us” is not valid. Addiction may be significant at this point due to many years of heavy drug/alcohol use.

Why are these stages important? It helps us understand where we are, what a person might be going through, and the struggle to develop the self when pressured with stigma. These stages may be applicable to many non-predominant populations. Knowledge is power - both for providers and for those who might be wondering what may be occurring within them. Communities can embrace people when you’re ready.

Jill Lehmann-Bauer, MSW