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Comer JS, Georgiadis C, Schmarder K, Chen D, Coyne CA, Gudiño OG, Kazantzis N, Langer DA, LeBeau RT, Liu RT, McLean C, Sloan DM, Williams MT, Pachankis JE. Reckoning With Our Past and Righting Our Future: Report From the Behavior Therapy Task Force on Sexual Orientation and Gender Identity/Expression Change Efforts (SOGIECEs). Behav Ther 2024; 55:649-679. [PMID: 38937042 DOI: 10.1016/j.beth.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 05/07/2024] [Accepted: 05/22/2024] [Indexed: 06/29/2024]
Abstract
Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despite evidence linking SOGIECEs with serious iatrogenic effects, and despite support for LGBTQ+-affirmative care alternatives, SOGIECE practices persist. In the 1970s and 1980s, Behavior Therapy published articles testing and/or endorsing SOGIECEs, thereby contributing to their overall development, acceptance, and use. The Behavior Therapy Task Force on SOGIECEs was assembled to conduct a rigorous review of the SOGIECE articles published in Behavior Therapy and to decide whether, and what, formal action(s) should be taken on these articles. This report provides a detailed review of the historic SOGIECE literature published in Behavior Therapy and outlines the Task Force's deliberative and democratic processes resulting in actions to: (1) add prominent advisory information to k = 24 SOGIECE papers in the form of digital "black box" disclaimers that caution readers that the SOGIECE practices tested or described in these papers are inconsistent with modern standards, (2) offset organizational financial benefits from the publication of these papers, and (3) promote LGBTQ+-affirmative practices. SOGIECEs are not the only concerning practices across the field's history, and the pages of today's scientific journals include practices that will be at odds with tomorrow's moral standards and ethical guidelines. This report calls for precautionary measures and editorial safeguards to minimize the future likelihood and impact of problematic published scholarship, including the need to fully include those with relevant lived experiences in all aspects of clinical science and peer review.
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Affiliation(s)
- Jonathan S Comer
- Center for Children and Families, Florida International University.
| | | | - Katie Schmarder
- Center for Children and Families, Florida International University
| | - Diane Chen
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine
| | - Claire A Coyne
- Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine
| | | | - Nikolaos Kazantzis
- Cognitive Behavior Therapy Research Unit, Melbourne, VIC, and Beck Institute for Cognitive Behavior Therapy
| | | | | | - Richard T Liu
- Massachusetts General Hospital and Harvard Medical School
| | - Carmen McLean
- National Center for PTSD Dissemination and Training division, Palo Alto VA Healthcare System, and Stanford University
| | - Denise M Sloan
- National Center for PTSD at VA Boston Healthcare System and Boston University Chobanian and Avedisian School of Medicine
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Salim SM, Anilal L, Prabhakaran A. Sexual Orientation Change Efforts Among LGBT+ People of Kerala: Prevalence, Correlates, and Mental Health Aspects. JOURNAL OF HOMOSEXUALITY 2024; 71:1487-1506. [PMID: 36745044 DOI: 10.1080/00918369.2023.2174473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Sexual Orientation Change Efforts (SOCE) have been reported worldwide and have adverse psychiatric consequences. However, no data are available for India or Kerala. We assessed the prevalence of SOCE, its characteristics, and mental health aspects among LGBT+ individuals in Kerala. This cross-sectional survey used snowball sampling. An online questionnaire collected sociodemographic information and history and characteristics of SOCE. Religiosity and SOCE-associated distress were evaluated using 6-point Likert scales. Patient Health Questionnaire (PHQ-9) screened for depressive symptoms; its ninth question assessed death wishes and self-harm thoughts. Generalized Anxiety Disorder Assessment (GAD-7) screened for anxiety symptoms. Participants' (n = 130) mean age was 26.80 ± 7.12 years. Most common biological sex (63.1%) and gender identity (50.8%) were male, and sexual orientation was gay(42.3%). Prevalence of SOCE was 45.4%. In SOCE group, 39% reported very severe distress. SOCE was most commonly self-prompted (47.5%), performed through psychotherapy (28.8%), and performed by doctors (28.8%). SOCE group had significantly higher religiosity scores (t = 2.61, p = .01). Among cisgender men, 48.48% had SOCE history, against 28.57% among cisgender women (χ2 = 3.19, p = .07). SOCE is highly prevalent among the LGBT+ community in Kerala, with high associated distress. Multi-level approaches are necessary to mitigate this problem.
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Affiliation(s)
- Sreya Mariyam Salim
- Department of Psychiatry, Government Medical College, Thiruvananthapuram, India
| | - Lallchand Anilal
- Department of Psychiatry, Government Medical College, Thiruvananthapuram, India
| | - Anil Prabhakaran
- Department of Psychiatry, Government Medical College, Thiruvananthapuram, India
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Roguski M, Atwool N. Conversion practices in Aotearoa New Zealand: Developing a holistic response to spiritual abuse. PLoS One 2024; 19:e0302163. [PMID: 38691525 PMCID: PMC11062516 DOI: 10.1371/journal.pone.0302163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/27/2024] [Indexed: 05/03/2024] Open
Abstract
Research arising from conversion practices, also known as conversion therapy and sexual orientation and gender identity change efforts, has generally been underpinned by an emancipatory discourse that has evolved to counter harmful practices by evidencing associated harms and estimating prevalence. Little attention, however, has focused on what is required to support survivors, inclusive of those currently or those having previously experienced conversion efforts. Within a context of Aotearoa New Zealand having recently criminalised conversion practices, this study adopted an in-depth qualitative research design, informed by a dual adherence to life history and an empowerment methodology. Twenty-three religious conversion practice survivors, who had experienced religious conversion practices across a range of Christian identified faith settings, were interviewed. Participants had a median age of 34 and the majority identified as New Zealand European, cisgender, and gay. Participant narratives were discursively analysed. Three primary discourses were identified that inform the needed development of interventions and supports: 1) pervasive framing of conversion practices as harm, rather than spiritual abuse, has minimised the impacts of conversion practices. Rather, conceptualising conversion as spiritual abuse positions conversion practices as requiring urgent intervention and ongoing support, inclusive of the development of policy and operational responses; 2) the coercive nature of spiritual abuse needs to be appreciated in terms of spiritual, social, and structural entrapment; 3) the metaphor of a pipeline was enlisted to encapsulate the need for a multidimensional array of interventions to ensure those entrapped within spiritual abuse have a "pipeline to safety". Holistic survivor-centric conversion-related responses to spiritual abuse are required. These need to be informed by an understanding of entrapment and the associated need for holistic responses, inclusive of extraction pathways and support for those entrenched within abusive religious settings, support immediately after leaving abusive environments, and support throughout the survivors' healing journeys.
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Affiliation(s)
- Michael Roguski
- Kaitiaki Research and Evaluation, Wellington, New Zealand
- Victoria University of Wellington, Wellington, New Zealand
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Blosnich JR, Coulter RWS, Henderson ER, Goldbach JT, Meyer IH. Correcting a False Research Narrative: A Commentary on Sullins (2022). ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:885-888. [PMID: 36602658 DOI: 10.1007/s10508-022-02521-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Affiliation(s)
- John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34Th St, Los Angeles, CA, 90089, USA.
| | - Robert W S Coulter
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Emmett R Henderson
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34Th St, Los Angeles, CA, 90089, USA
| | - Jeremy T Goldbach
- Brown School, Washington University of St. Louis, St. Louis, MO, USA
| | - Ilan H Meyer
- The Williams Institute at UCLA School of Law, Los Angeles, CA, USA
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Okafor CN, Brennan-Ing M, Ware D, Haberlen S, Egan JE, Brown AL, Meanley S, Stosor V, Shoptaw S, Friedman MR, Plankey M. Grit is associated with psychological health among older sexual minority men. Aging Ment Health 2023; 27:434-444. [PMID: 35138200 PMCID: PMC9360198 DOI: 10.1080/13607863.2022.2032594] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/17/2022] [Indexed: 01/21/2023]
Abstract
Objectives: Studies have shown that grit-defined as perseverance and passion for achieving one's long-term goals-is associated with improved health outcomes, including lower levels of psychological distress. However, the psychometric properties of the original Grit Scale (Grit-O Scale) has not been validated among sexual minority men (SMM). The present study aimed to validate the Grit-O Scale among a sample of older SMM and assess the relationships between the Grit-O Scale factors and symptoms of psychological distress.Method: We used data from a single visit of participants in the Multicenter AIDS Cohort Study (MACS) Healthy Aging longitudinal study. The sample included 981 older SMM (mean age = 61, SD = 8.5) with and without HIV. We conducted confirmatory factor analysis (CFA) to identify the two factors of the Grit-O Scale: consistency of interest and perseverance of effort. We also conducted a latent profile analysis (LPA) to identify distinct profiles of psychological distress from self-reported scales of depression, anxiety, and perceived stress.Results:The Grit-O Scale showed acceptable reliability estimates for the items with Cronbach's alpha reliability coefficients ranging from 0.77 to 0.82. The CFA identified the two factors of the Grit-O Scale with acceptable model fit (root mean square error of approximation = 0.058 [95% CI = 0.050, 0.067], comparative fit index = 0.95, Tucker-Lewis Index = 0.93, standardized root mean square residual = 0.07). The LPA yielded three mutually exclusive profiles of psychological distress (profile 1: low stress, anxiety, and depression; profile 2: high stress and depression and low anxiety; and profile 3: high stress, anxiety, and depression). In adjusted multinominal logistic regression analysis, we found that both higher levels of consistency of interest and perseverance of effort factors of the Grit-O Scale were significantly associated with decreased odds of being in profiles 2 and 3 compared with being in profile 1.Conclusion: Our findings support the use of the Grit-O Scale among older SMM. Grit factors could explain variability in the negative psychological symptoms among older SMM and warrant further investigation.Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2032594.
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Affiliation(s)
- Chukwuemeka N Okafor
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY, USA
| | - Deanna Ware
- Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA
| | - Sabina Haberlen
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, USA
| | - James E Egan
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andre L Brown
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven Meanley
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Valentina Stosor
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Steven Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA, USA
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael Plankey
- Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA
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6
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AOTA's Societal Statement Denouncing Conversion "Therapy". Am J Occup Ther 2022; 76:23996. [PMID: 36706301 DOI: 10.5014/ajot.2022.76s3010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Occupational therapy practitioners have a role in opposing the harmful, discriminatory practice of conversion "therapy" and protecting LGBTQIA+ people. Occupational therapy practitioners should never participate in or promote the principles of conversion "therapy" practices as part of occupational therapy intervention.
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Ogunbajo A, Oke T, Okanlawon K, Abubakari GM, Oginni O. Religiosity and Conversion Therapy is Associated with Psychosocial Health Problems among Sexual Minority Men (SMM) in Nigeria. JOURNAL OF RELIGION AND HEALTH 2022; 61:3098-3128. [PMID: 34455514 PMCID: PMC11334395 DOI: 10.1007/s10943-021-01400-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 05/25/2023]
Abstract
We investigated the associations between social marginalization, psychosocial health, and religiosity among sexual minority men (SMM) in Nigeria (N = 406). We conducted bivariate and multivariable logistic regression. Factors associated with reporting a history of conversion therapy at a religious institution were: being HIV positive, having depressive symptoms, reporting suicide thoughts, and reporting inability to access medical care. Factors associated with increased odds of agreeing that sex between two men was a sin were: residing in Plateau, being Muslim, and higher levels of internalized homophobia. Our findings support the need for LGBT-affirming religious doctrine, which has implications for the health of LGBT communities.
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Affiliation(s)
- Adedotun Ogunbajo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Temitope Oke
- School of Social Work, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Kehinde Okanlawon
- Institute of Social Studies, Erasmus University, The Hague, Netherlands
| | | | - Olakunle Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun, Nigeria
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Philpot SP, Murphy D, Chan C, Haire B, Fraser D, Grulich AE, Bavinton BR. Switching to Non-daily Pre-exposure Prophylaxis Among Gay and Bisexual Men in Australia: Implications for Improving Knowledge, Safety, and Uptake. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:1979-1988. [PMID: 35730059 DOI: 10.1007/s13178-021-00669-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Preexposure prophylaxis (PrEP) dosing options such as event-driven PrEP hold promise to increase PrEP uptake among gay, bisexual, and queer men (GBQM), but their impacts have not yet been realized and uptake by GBQM suitable for PrEP remains slow in countries where it is only considered an alternative option to daily PrEP. METHODS We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBQM in Australia to understand PrEP dosing behaviors, knowledge, and preferences. RESULTS All participants commenced PrEP daily; 35% had ever switched to non-daily PrEP, mostly taking it event-driven. GBQM who preferred non-daily PrEP had infrequent or predictable sex, were concerned about cost given infrequency of sex, and/or wanted to minimize unnecessary drug exposure. Accurate knowledge of event-driven PrEP was poor. However, reflecting concepts underpinning critical pedagogy, having accurate knowledge was supported by access to consistent messaging across clinical, social, community, and public settings. Several participants who switched to event-driven PrEP had condomless sex events in which they were unable to adhere to pills due to unanticipated sex. CONCLUSIONS AND POLICY IMPLICATIONS Implementation of comprehensive and consistent education about correct dosing for event-driven PrEP across multiple settings is needed to ensure increased uptake and safe use. GBQM require messaging about non-condom based HIV prevention strategies when they cannot access daily or event-driven PrEP.
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Affiliation(s)
| | - Dean Murphy
- The Kirby Institute, UNSW, Sydney, Australia
| | - Curtis Chan
- The Kirby Institute, UNSW, Sydney, Australia
| | | | - Doug Fraser
- The Kirby Institute, UNSW, Sydney, Australia
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Kinitz DJ, Goodyear T, Dromer E, Gesink D, Ferlatte O, Knight R, Salway T. "Conversion Therapy" Experiences in Their Social Contexts: A Qualitative Study of Sexual Orientation and Gender Identity and Expression Change Efforts in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:441-451. [PMID: 34242106 PMCID: PMC9152241 DOI: 10.1177/07067437211030498] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe in what forms, with whom, where, when, and why Canadians experience sexual orientation and gender identity and expression change efforts (SOGIECE). METHODS This qualitative study is grounded in a transformative paradigm. We conducted semi-structured interviews with a purposive sample of 22 adults recruited from across Canada who have experienced "conversion therapy." Directed content analysis was used, employing deductive and inductive coding approaches, to synthesize the findings and address 5 policy-relevant questions. RESULTS What are SOGIECE? Formal and informal methods of SOGIECE were used, including pharmacologic interventions, denial of gender-affirming care, and coaching to repress sexual orientation and/or gender identity and expression. With whom did SOGIECE occur? Practitioners included religious leaders, licenced health-care professionals (e.g., psychiatrists and psychologists), peers, and family members. Where did SOGIECE occur? SOGIECE occurred in 3 predominant settings: faith-based, health care, and social life. When did SOGIECE occur? SOGIECE rarely occurred over a restricted time frame; often, SOGIECE began while participants were adolescents or young adults and continued multiple years under various forms. Others described SOGIECE as a context in which their life was embedded for many years. Why did people attend SOGIECE? Cisheteronormative social and religious expectations taught participants that being non-cisgender or non-heterosexual was incompatible with living a good and respectable life. CONCLUSIONS SOGIECE are not a circumscribed set of practices. Our study shows that SOGIECE are a larger phenomenon that consists of intentional and explicit change efforts as well as heterosexual- and cisgender-dominant social norms expressed and enforced across a wide range of settings and circumstances. This study provides critical context to inform contemporary social and health policy responses to SOGIECE. Policies should account for the overt, covert, and insidious ways that SOGIECE operate in order to effectively promote safety, equity, and health for sexually diverse and gender-diverse people.
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Affiliation(s)
- David J Kinitz
- Social and Behavioural Health Sciences, Dalla Lana School of Public Health, 7938University of Toronto, Ontario, Canada
| | - Trevor Goodyear
- School of Nursing, 8166The University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Elisabeth Dromer
- École de Santé Publique de l'5622Université de Montréal, Québec, Canada.,Centre de Recherche en Santé Publique, 5622Université de Montréal et CIUSS du Centre-Sud-de-l'Île-de-Montréal, Québec, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, 7938University of Toronto, Ontario, Canada
| | - Olivier Ferlatte
- École de Santé Publique de l'5622Université de Montréal, Québec, Canada.,Centre de Recherche en Santé Publique, 5622Université de Montréal et CIUSS du Centre-Sud-de-l'Île-de-Montréal, Québec, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.,Faculty of Medicine, 8166The University of British Columbia, Vancouver, British Columbia, Canada
| | - Travis Salway
- Faculty of Health Sciences, 1763Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
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Goodyear T, Kinitz DJ, Dromer E, Gesink D, Ferlatte O, Knight R, Salway T. "They Want You to Kill Your Inner Queer but Somehow Leave the Human Alive": Delineating the Impacts of Sexual Orientation and Gender Identity and Expression Change Efforts. JOURNAL OF SEX RESEARCH 2022; 59:599-609. [PMID: 33871297 PMCID: PMC8557955 DOI: 10.1080/00224499.2021.1910616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Sexual orientation and gender identity and expression change efforts (SOGIECE) aim to suppress the sexual and gender identities of Two-Spirit, lesbian, gay, bisexual, trans, and other queer (2SLGBTQ+) people. Exposure to SOGIECE is associated with significant psychosocial morbidity. Yet, there is a dearth of knowledge specifying the ways in which these psychosocial impacts are produced and experienced. This qualitative interpretive description study aimed to delineate the impacts of SOGIECE. To do so, we thematically analyzed data from in-depth interviews, conducted between January and July 2020, with 22 people with lived experience of SOGIECE. Study participants indicated that feelings of shame and brokenness related to their sexual and gender identities were deeply implicated in and shaped by experiences with SOGIECE. SOGIECE also had socially isolating effects, which had restricted participants' opportunities for meaningful connection with others, including romantic partners and 2SLGBTQ+ communities. Further, SOGIECE had contributed to experiences of profound emotional distress, mental illness (e.g., anxiety, depression), and suicidality. These findings underscore the need for several responsive policy and programmatic interventions, including legislation to prevent SOGIECE, enhanced sexuality- and gender-related educational efforts with the families and support persons of 2SLGBTQ+ people, and targeted mental health screening and supports for SOGIECE survivors.
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Affiliation(s)
- Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, Canada
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - David J. Kinitz
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elisabeth Dromer
- École de santé publique de l’Université de Montréal, Montreal, Quebec, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Olivier Ferlatte
- École de santé publique de l’Université de Montréal, Montreal, Quebec, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Travis Salway
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Corresponding Author: Travis Salway, PhD, Faculty of Health Sciences, Simon Fraser University, Blusson Hall 10506, 8888 University Drive, Burnaby, British Columbia, Canada, V5A 1S6.
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11
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Forsythe A, Pick C, Tremblay G, Malaviya S, Green A, Sandman K. Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States. JAMA Pediatr 2022; 176:493-501. [PMID: 35254391 PMCID: PMC8902682 DOI: 10.1001/jamapediatrics.2022.0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Sexual orientation and gender identity change efforts (SOGICE), also called conversion therapy, is a discredited practice attempting to convert lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals to be heterosexual and/or cisgender. OBJECTIVES To identify and synthesize evidence on the humanistic and economic consequences of SOGICE among LGBTQ youths in the US. DESIGN, SETTING, AND PARTICIPANTS This study, conducted from December 1, 2020, to February 15, 2021, included a systematic literature review and economic evaluation. The literature review analyzed published evidence on SOGICE among LGBTQ individuals of any age. The economic model evaluated the use of SOGICE vs no intervention, affirmative therapy vs no intervention, and affirmative therapy vs SOGICE to estimate the costs and adverse outcomes for each scenario and to assess the overall US economic burden of SOGICE. Published literature and public sources were used to estimate the number of LGBTQ youths exposed to SOGICE, the types of therapy received, and the associated adverse events (anxiety, severe psychological distress, depression, alcohol or substance abuse, suicide attempts, and fatalities). EXPOSURES SOGICE (licensed or religion-based practitioners) or affirmative therapy (licensed practitioners). MAIN OUTCOMES AND MEASURES Total incremental costs and quality-adjusted life-years (QALYs) vs no intervention and total economic burden of SOGICE. RESULTS Among 28 published studies, which included 190 695 LGBTQ individuals, 12% (range, 7%-23%) of youths experienced SOGICE, initiated at a mean age of 25 years (range, 5-58 years), with a mean (SD) duration of 26 (29) months. At least 2 types of SOGICE were administered to 43% of recipients. Relative to LGBTQ individuals who did not undergo SOGICE, recipients experienced serious psychological distress (47% vs 34%), depression (65% vs 27%), substance abuse (67% vs 50%), and attempted suicide (58% vs 39%). In the economic analysis, over a lifetime horizon with a 3% annual discount rate, the base-case model estimated additional $97 985 lifetime costs per individual, with SOGICE associated with 1.61 QALYs lost vs no intervention; affirmative therapy yielded cost savings of $40 329 with 0.93 QALYs gained vs no intervention. With an estimated 508 892 youths at risk for SOGICE in 2021, the total annual cost of SOGICE is estimated at $650.16 million (2021 US dollars), with associated harms totaling an economic burden of $9.23 billion. CONCLUSIONS AND RELEVANCE This economic evaluation study suggests that there is a high economic burden and high societal costs associated with SOGICE and identifies additional research questions regarding the roles of private and public funding in supporting this harmful practice.
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Affiliation(s)
| | - Casey Pick
- The Trevor Project, West Hollywood, California
| | | | | | - Amy Green
- The Trevor Project, West Hollywood, California
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12
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Meanley S, Choi SK, Thompson AB, Meyers JL, D'Souza G, Adimora AA, Mimiaga MJ, Kempf MC, Konkle-Parker D, Cohen MH, Teplin LA, Murchison L, Rubin LH, Rubtsova AA, Weiss DJ, Aouizerat B, Friedman MR, Plankey MW, Wilson TE. Short-term binge drinking, marijuana, and recreational drug use trajectories in a prospective cohort of people living with HIV at the start of COVID-19 mitigation efforts in the United States. Drug Alcohol Depend 2022; 231:109233. [PMID: 34998247 PMCID: PMC8709730 DOI: 10.1016/j.drugalcdep.2021.109233] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/23/2021] [Accepted: 10/11/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND At the start of the COVID-19 pandemic, HIV experts suggested that an increase in mental health diagnoses and substance use among people living with HIV (PLHIV) may be an unintended consequence of COVID-19 mitigation efforts (e.g., limiting social contact). We evaluated short-term trajectories in binge drinking, marijuana, and recreational drug use in a prospective cohort of PLHIV. METHODS Data (N = 2121 PLHIV) consist of survey responses on substance use behaviors from two pre-COVID-19 (October 2018-September 2019) and one COVID-19-era (April 2020-September 2020) timepoints within the MACS/WIHS Combined Cohort Study (MWCCS). We conducted group-based trajectory models, triangulated with generalized linear mixed models, to assess changes in binge drinking, daily marijuana use, and recreational drug use at the start of the pandemic. Controlling for age and race/ethnicity, we tested whether trajectories differed by sex and early-pandemic depressive symptoms, loneliness, and social support. RESULTS Group-based trajectory models yielded two trajectory groups for binge drinking (none vs. any), marijuana (none/infrequent vs. daily), and recreational drug use (none vs. any). Binge drinking and recreational drug use decreased at the beginning of the pandemic. Generalized linear mixed model supported these trends. Consistent with prior research, male sex and having depressive symptoms early pandemic were positively associated with each substance use outcomes. Social support was inversely associated with recreational drug use. CONCLUSIONS Contrary to hypotheses, problematic substance use behaviors decreased from pre-pandemic to the post-pandemic follow-up in our sample of PLHIV. Ongoing surveillance is needed to assess whether this pattern persists as the pandemic continues.
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Affiliation(s)
- Steven Meanley
- University of Pennsylvania School of Nursing, Department of Family and Community Health, Philadelphia, PA, United States.
| | - Seul Ki Choi
- University of Pennsylvania School of Nursing, Department of Family and Community Health, Philadelphia, PA, United States.
| | - Azure B Thompson
- SUNY Downstate Health Sciences University School of Medicine School of Public Health, Department of Community Health Sciences, Brooklyn, NY, United States.
| | - Jacquelyn L Meyers
- SUNY Downstate Health Sciences University School of Medicine, Department of Psychiatry, Brooklyn, NY, United States.
| | - Gypsyamber D'Souza
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, United States.
| | - Adaora A Adimora
- University of North Carolina School of Medicine, Division of Infectious Diseases, Chapel Hill, NC, United States.
| | - Matthew J Mimiaga
- University of California - Los Angeles Fielding School of Public Health, Department of Epidemiology, Los Angeles, CA, United States.
| | - Mirjam-Colette Kempf
- University of Alabama at Birmingham, School of Nursing, Medicine and Public Health Birmingham, AL, United States.
| | - Deborah Konkle-Parker
- The University of Mississippi Medical Center, Schools of Nursing, Medicine, and Population Health, Jackson, MS, United States.
| | - Mardge H Cohen
- Rush University Department of Medicine and Stroger Hospital of Cook County, Chicago, IL, United States.
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, United States.
| | - Lynn Murchison
- Albert Einstein College of Medicine/Montefiore Medical Center, Division of General Internal Medicine, Bronx, NY, United States.
| | - Leah H Rubin
- Johns Hopkins University School of Public Health, Department of Epidemiology, Baltimore, MD, United States; Johns Hopkins University School of Medicine, Departments of Neurology and Psychiatry and Behavioral Sciences, Baltimore, MD, United States.
| | - Anna A Rubtsova
- Emory University Rollins School of Public Health, Department of Behavioral, Social, Health Education Sciences, Atlanta, GA, United States.
| | - Deborah Jones Weiss
- University of Miami Miller School of Medicine, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
| | - Brad Aouizerat
- New York University College of Dentistry, Department of Oral and Maxillofacial Surgery and Bluestone Center for Clinical Research, New York, NY, United States.
| | - Mackey R Friedman
- University of Pittsburgh Graduate School of Public Health, Department of Infectious Diseases and Microbiology, Pittsburgh, PA, United States.
| | - Michael W Plankey
- Georgetown University Medical Center, Division of Infectious Diseases, Washington, DC, United States.
| | - Tracey E Wilson
- SUNY Downstate Health Sciences University School of Public Health, Department of Community Health Sciences, Brooklyn, NY, United States.
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13
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Salway T, Juwono S, Klassen B, Ferlatte O, Ablona A, Pruden H, Morgan J, Kwag M, Card K, Knight R, Lachowsky NJ. Experiences with sexual orientation and gender identity conversion therapy practices among sexual minority men in Canada, 2019-2020. PLoS One 2021; 16:e0252539. [PMID: 34081740 PMCID: PMC8174694 DOI: 10.1371/journal.pone.0252539] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/15/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND "Conversion therapy" practices (CTP) are organized and sustained efforts to avoid the adoption of non-heterosexual sexual orientations and/or of gender identities not assigned at birth. Few data are available to inform the contemporary prevalence of CTP. The aim of this study is to quantify the prevalence of CTP among Canadian sexual and gender minority men, including details regarding the setting, age of initiation, and duration of CTP exposure. METHODS Sexual and gender minority men, including transmen and non-binary individuals, aged ≥ 15, living in Canada were recruited via social media and networking applications and websites, November 2019-February 2020. Participants provided demographic data and detailed information about their experiences with CTP. RESULTS 21% of respondents (N = 9,214) indicated that they or any person with authority (e.g., parent, caregiver) ever tried to change their sexual orientation or gender identity, and 10% had experienced CTP. CTP experience was highest among non-binary (20%) and transgender respondents (19%), those aged 15-19 years (13%), immigrants (15%), and racial/ethnic minorities (11-22%, with variability by identity). Among the n = 910 participants who experienced CTP, most experienced CTP in religious/faith-based settings (67%) or licensed healthcare provider offices (20%). 72% of those who experienced CTP first attended before the age of 20 years, 24% attended for one year or longer, and 31% attended more than five sessions. INTERPRETATION CTP remains prevalent in Canada and is most prevalent among younger cohorts, transgender people, immigrants, and racial/ethnic minorities. Legislation, policy, and education are needed that target both religious and healthcare settings.
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Affiliation(s)
- Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- * E-mail:
| | - Stephen Juwono
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ben Klassen
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Olivier Ferlatte
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- l’École de santé publique de l’Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche en Santé Publique, Montréal, Québec, Canada
| | - Aidan Ablona
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Harlan Pruden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Jeffrey Morgan
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Kwag
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Kiffer Card
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- University of Victoria, Victoria, British Columbia, Canada
| | - Rod Knight
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan J. Lachowsky
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- University of Victoria, Victoria, British Columbia, Canada
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14
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Meanley S, Haberlen SA, Okafor CN, Brown A, Brennan-Ing M, Ware D, Egan JE, Teplin LA, Bolan RK, Friedman MR, Plankey MW. Lifetime Exposure to Conversion Therapy and Psychosocial Health Among Midlife and Older Adult Men Who Have Sex With Men. THE GERONTOLOGIST 2021; 60:1291-1302. [PMID: 32556123 DOI: 10.1093/geront/gnaa069] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Conversion therapies to minimize same-sex attractions are classified as a dangerous practice by numerous scientific institutions in the United States. These practices may contribute to poor long-term psychosocial health, thereby interrupting processes of healthy aging. Few studies have examined psychosocial differences between persons with and without prior experiences of conversion therapy. We assessed associations between prior conversion therapy experiences and psychosocial health among midlife and older men who have sex with men (MSM; age 40+ years). RESEARCH DESIGN AND METHODS Participants included a multicity sample of MSM (N = 1,156) enrolled in the Multicenter AIDS Cohort Study who completed health surveys (2016-2019) as part of their biannual study visits. Using multivariable regressions, we investigated the associations of prior conversion therapy with current depressive symptoms, internalized homophobia, post-traumatic stress, and cumulative psychosocial conditions. Using a trait-level measure (e.g., life purpose and perseverance), we tested whether resilience moderated these associations. RESULTS The full sample was predominantly non-Hispanic white with a mean age of 62.6 years. Fifteen percent of men (n = 171/1,156) reported prior conversion therapy. In multivariable models, men exposed to conversion therapy were more likely to have depressive symptoms and above-average internalized homophobia. Men exposed to conversion therapy had 2-2.5 times the odds of reporting 1 and ≥2 psychosocial conditions, respectively, compared with those who reported 0 conditions. Resilience did not moderate these associations. DISCUSSION AND IMPLICATIONS Conversion therapies are nonaffirming social stressors for MSM and may compromise critical psychosocial aspects of healthy aging among MSM.
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Affiliation(s)
- Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia.,Research Education Institute for Diverse Scholars, Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut
| | - Sabina A Haberlen
- Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Chukwuemeka N Okafor
- Department of Public Health, Baylor University Robbins College of Health and Human Services, Waco, Texas
| | - Andre Brown
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, New York City, New York
| | - Deanna Ware
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia
| | - James E Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Linda A Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Mackey R Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Michael W Plankey
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia
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15
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De Jesus M, Ware D, Brown AL, Egan JE, Haberlen SA, Palella FJ, Detels R, Friedman MR, Plankey MW. Social-environmental resiliencies protect against loneliness among HIV-Positive and HIV- negative older men who have sex with men: Results from the Multicenter AIDS Cohort Study (MACS). Soc Sci Med 2021; 272:113711. [PMID: 33550066 DOI: 10.1016/j.socscimed.2021.113711] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/17/2020] [Accepted: 01/18/2021] [Indexed: 11/27/2022]
Abstract
RATIONALE Loneliness is associated with negative health outcomes, such as cardiovascular disease, cognitive impairment, dementia, physical functional decline, depression, and increased mortality risk, among HIV- positive and HIV-negative older men who have sex with men (MSM). Given these negative health outcomes, it is imperative to identify factors that minimize loneliness in these vulnerable groups. OBJECTIVE We sought to examine whether social-environmental resiliencies-defined as an individual's level of support, social bonding, and psychological sense of community among gay men-buffer against symptoms of loneliness. METHOD We analyzed longitudinal data from 1,255 older MSM with and without HIV infection, all of whom were enrolled in the Multicenter AIDS Cohort Study (MACS). Using longitudinal latent class analysis (LLCA), we identified three underlying classes (Social Connectors, Non-community Connectors, and Social Isolates) in the social environment of the sample. We assessed the prevalence of loneliness by these latent classes. By lagging social environmental factors over time, we were able to examine the temporal relationships between latent classes and subsequent loneliness. RESULTS Consistent with our hypothesis, multivariate associations revealed that compared to Social Connectors with high levels of social support and social bonding and a strong perceived sense of community among gay men, Social Isolates (Prevalence Ratio (PR): 1.42; 95% CI: 1.08-1.88; p = 0.0120) and Non-community Connectors (PR: 1.34; 95% CI: 1.03-1.75; p = 0.0322) were more likely to experience loneliness after adjustment for covariates and baseline loneliness. There were no differences by HIV status. CONCLUSIONS These longitudinal data allowed us to make causal inferences related to the social environmental resiliencies lowering the odds of loneliness among HIV-positive and HIV-negative older MSM. Developing individual- and community-level tailored interventions for these populations by leveraging social environmental resiliencies is key to reducing loneliness and promoting health.
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Affiliation(s)
- Maria De Jesus
- School of International Service, Center on Health, Risk, and Society, American University, Washington, DC, USA.
| | - Deanna Ware
- Georgetown University Department of Medicine, Washington, DC, USA
| | - Andre L Brown
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - James E Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Sabina A Haberlen
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Frank Joseph Palella
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roger Detels
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - M Reuel Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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16
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Kinitz DJ, Salway T, Dromer E, Giustini D, Ashley F, Goodyear T, Ferlatte O, Kia H, Abramovich A. The scope and nature of sexual orientation and gender identity and expression change efforts: a systematic review protocol. Syst Rev 2021; 10:14. [PMID: 33419475 PMCID: PMC7796537 DOI: 10.1186/s13643-020-01563-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/17/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Sexual orientation and gender identity and expression change efforts (SOGIECE) are a set of scientifically discredited practices that aim to deny and suppress the sexual orientations, gender identities, and/or gender expressions of sexual and gender minorities (SGM). SOGIECE are associated with significant adverse health and social outcomes. SOGIECE continue to be practiced around the world, despite denouncements from professional bodies and survivors, as well as calls for legislative advocacy to prohibit SOGIECE and protect SGM. There are substantial gaps in the availability of consolidated international research to support and refine legislative proposals related to SOGIECE, including those currently underway to enforce bans in Canada and elsewhere. We therefore propose the first systematic review of international data on SOGIECE that will outline the scope and nature of these practices worldwide. Specifically, we aim to estimate how many SGM have been exposed to SOGIECE, which sub-groups of SGM experience higher rates of SOGIECE, and how estimates of SOGIECE vary over time and place. In addition, we aim to describe when, where, how, and under what circumstances SGM are exposed to SOGIECE. METHODS To locate an interdisciplinary swath of papers, nine (9) bibliographic databases will be searched: Medline (OVID), Embase (OVID), PsycInfo and Social Work Abstracts via EBSCO, CINAHL, Web of Science Core Collection, LGBTQ+ Source, and Proquest Dissertations & Theses Global and Sociology Collection (ProQuest). A gold standard search will be developed for Medline and adapted to the other databases. Grey literature will be searched at relevant websites, and reference harvesting will be performed in relevant SOGIECE scientific consensus statements. Two authors will independently screen abstracts/titles, screen full texts, abstract data, and apply risk of bias assessments. A narrative synthesis will be implemented to summarize findings. DISCUSSION This review will address the gap in synthesized data regarding the prevalence of SOGIECE, social correlates of SOGIECE, variations of SOGIECE over time and place, and the circumstances, settings, and time-points of SOGIECE exposure. Findings from this review will directly inform ongoing and new legislative efforts to ban SOGIECE and other interventions that aim to stem SOGIECE practices and support SOGIECE survivors. SYSTEMATIC REVIEW REGISTRATION Registration with PROSPERO can be found under the registration number: CRD42020196393 .
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Affiliation(s)
- David J Kinitz
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall 10506; 8888 University Dr., Burnaby, B.C., V5A 1S6, Canada. .,British Columbia Centre for Disease Control, Vancouver, Canada. .,Centre for Gender and Sexual Health Equity, Vancouver, Canada.
| | - Elisabeth Dromer
- Université de Montréal, Montréal, Canada.,Centre de recherche en santé publique, Montreal, Canada
| | - Dean Giustini
- University of British Columbia Biomedical Branch Library, Vancouver, Canada
| | | | - Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Olivier Ferlatte
- Université de Montréal, Montréal, Canada.,Centre de recherche en santé publique, Montreal, Canada
| | - Hannah Kia
- School of Social Work, The University of British Columbia, Vancouver, Canada
| | - Alex Abramovich
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
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17
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Blosnich JR, Henderson ER, Coulter RWS, Goldbach JT, Meyer IH. Sexual Orientation Change Efforts, Adverse Childhood Experiences, and Suicide Ideation and Attempt Among Sexual Minority Adults, United States, 2016-2018. Am J Public Health 2020; 110:e1-e7. [PMID: 32437277 PMCID: PMC7287530 DOI: 10.2105/ajph.2020.305637] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2020] [Indexed: 11/04/2022]
Abstract
Objectives. To examine how sexual orientation change efforts (SOCE) are associated with suicide morbidity after controlling for adverse childhood experiences (ACEs).Methods. Cross-sectional survey data are from the Generations survey, a nationally representative sample of 1518 nontransgender sexual minority adults recruited between March 28, 2016, and March 30, 2018, in the United States. Self-identified transgender individuals were included in a separate, related TransPop study. We used weighted multiple logistic regression analyses to assess the independent association of SOCE with suicidal ideation and suicide attempt while controlling for demographics and ACEs.Results. Approximately 7% experienced SOCE; of them, 80.8% reported SOCE from a religious leader. After adjusting for demographics and ACEs, sexual minorities exposed to SOCE had nearly twice the odds of lifetime suicidal ideation, 75% increased odds of planning to attempt suicide, and 88% increased odds of a suicide attempt with minor injury compared with sexual minorities who did not experience SOCE.Conclusions. Over the lifetime, sexual minorities who experienced SOCE reported a higher prevalence of suicidal ideation and attempts than did sexual minorities who did not experience SOCE.Public Health Implications. Evidence supports minimizing exposure of sexual minorities to SOCE and providing affirming care with SOCE-exposed sexual minorities. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e7. doi:10.2105/AJPH.2020.305637).
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Affiliation(s)
- John R Blosnich
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. John R. Blosnich is also with the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA. Emmett R. Henderson and Robert W. S. Coulter are with the Center for LGBT Health Research and the Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh. Ilan H. Meyer is with the Williams Institute, School of Law, University of California, Los Angeles
| | - Emmett R Henderson
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. John R. Blosnich is also with the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA. Emmett R. Henderson and Robert W. S. Coulter are with the Center for LGBT Health Research and the Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh. Ilan H. Meyer is with the Williams Institute, School of Law, University of California, Los Angeles
| | - Robert W S Coulter
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. John R. Blosnich is also with the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA. Emmett R. Henderson and Robert W. S. Coulter are with the Center for LGBT Health Research and the Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh. Ilan H. Meyer is with the Williams Institute, School of Law, University of California, Los Angeles
| | - Jeremy T Goldbach
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. John R. Blosnich is also with the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA. Emmett R. Henderson and Robert W. S. Coulter are with the Center for LGBT Health Research and the Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh. Ilan H. Meyer is with the Williams Institute, School of Law, University of California, Los Angeles
| | - Ilan H Meyer
- John R. Blosnich and Jeremy T. Goldbach are with the Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles. John R. Blosnich is also with the Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA. Emmett R. Henderson and Robert W. S. Coulter are with the Center for LGBT Health Research and the Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh. Ilan H. Meyer is with the Williams Institute, School of Law, University of California, Los Angeles
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