Carey Candrian, a researcher and associate professor of internal medicine at the University of Colorado School of Medicine, calls this phenomenon a “habit of silence.” Candrian’s work focuses on how communication can impact health care outcomes, especially for older LGBTQIA+ adults and their caregivers. “If you grew up in this culture — where you were really trained to stay silent about who you were — of course over the years, if you continue to have these experiences you’re going to continue to stay silent,” Candrian said.