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While sexual minorities in South Korea regularly confront social stigma and identity erasure, less is known about how internalized stigma and identity disclosure jointly shape mental health outcomes. This study addresses this gap by employing latent class analysis on a sample of 1,671 lesbian, gay, and bisexual young adults living in South Korea. The findings identify four distinct patterns of internalized homophobia and coming out: self-accepting disclosure, self-accepting concealment, self-negating concealment, and self-negating disclosure. More than half of respondents exhibited seemingly ambivalent patterns—either embracing their sexual identity while remaining closeted, or openly identifying as LGB yet retaining negative self-perceptions. Individuals in the disclosure groups reported higher risks of depressive symptoms and suicidal ideation compared to those in the concealment groups. These risks, however, were partially reduced among those with lower levels of internalized homophobia. The results underscore that in a strongly heteronormative social context, the relationship between internalized stigma and coming out is not adequately captured by a simple linear term; understanding sexual minorities’ mental health therefore requires attention to how these two processes intersect and operate together.