In some cases, far stronger forces are at work in shaping secret lives. Many gay men and some lesbians marry heterosexual partners before working out their sexual identity, or in defiance of it. The aim is to please parents, to cover their own shame or to become more acceptable to themselves and society at large, said Dr. Richard A. Isay, a psychiatrist at Cornell University who has provided therapy to many closeted gay men.

Very often, he said, these men struggle not to act on their desires, and they begin secret lives in desperation. This eventually forces agonizing decisions about how to live with, or separate from, families they love.