Research on the effects of concealing a stigmatized identity on health outcomes is remarkably mixed, with results showing both health costs and benefits to concealing. This chapter reviews the literature and presents a framework for conceptualizing the moderators and mediators of the concealment–health relationship. It is proposed that people who reveal their stigmatized identity within supportive environments reap health benefits, whereas those living in more hostile environments benefit by greater concealment. However, if concealment leads to greater cognitive burden, then negative health outcomes can occur. If people do disclose their stigmatized identity, the confidants they choose, the level of social support received, and the negativity of the reactions will all influence the relationship between disclosure and health outcomes. Future research is needed to clarify which variables are most important for health and to examine differences between identity types and environments.