Stigma consciousness, the expectation of prejudice and discrimination, has been associated with negative psychological outcomes for lesbians. This research examined the moderating role of social constraints or difficulty lesbians experience in talking with others about sexual orientation-related issues. One hundred five, predominantly out, lesbians completed measures of stigma consciousness, social constraints, lesbian-related stress, intrusive thoughts, internalized homophobia, negative mood, and physical symptoms. For lesbians who were high (but not low) in social constraints, stigma consciousness was positively associated with intrusive thoughts, internalized homophobia, and physical symptoms. These results add to the literature on the negative consequences of social constraints by suggesting that constraints in combination with high stress that is not necessarily traumatic (i.e., stigma consciousness) are associated with the most negative outcomes.