No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
“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
The Journal of Sex Research
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.
... "For example, the government established state-sponsored conversion therapy programs, publicly caned lesbians and enforced draconian laws on LGBTQ people." [58] 2 (6%) [26,58] Religious [33,37,39,42,45,47,53,59,63] Support groups "Therapy and support groups were described as the first places in which participants could speak honestly" [29] 8 (23%) [29,37,43,47,51,59,63,64] Content courtesy of Springer Nature, terms of use apply. Rights reserved. ...
... [51] 3 (9%) [14,48,51] Other religious community members (unspecified or varied roles) "Individual counseling or mentoring through a church, ministry program, or friend ranked second highest at 77 percent (23/30)." [68] 13 (37%) [4,5,26,29,31,32,40,42,45,51,60,68,72] Other religious institutions (unspecified) ...
... Three studies reported the means and ranges (denoted in parentheses) of participants' duration of SOGIECE experiences: 2 years (2 months-9 years) [28]; 4.3 years (1 month-30 years) [34]; 4.73 years (< 1 year-9 years) [45]. Three additional studies reported ranges only: 6 months-6 years [63]; 6 months-5.5 years [64]; 3 months-1 + years [78]. ...
Purpose of Review
This study analyzes literature on sexual orientation and gender identity or expression change efforts (SOGIECE) settings, perpetrators, methods, and timing of exposure to inform and improve the effectiveness of SOGIECE prevention efforts.
Recent Findings
We identified 41 unique studies conducted in 14 countries during 2000–2024. Primary categories of SOGIECE perpetrators included (1) clinicians/healthcare settings (secular), (2) other public bodies, (3) religious, (4) social circles, and (5) “troubled teen industry.” The most common SOGIECE modalities were gender role enforcement (66%), prayer (59%), group-based practices (53% of studies), individual secular counseling (41%), removing demons (41%), religious/pastoral counseling (38%), sexual abstinence (38%), encouragement of heterosexual relationships (38%), and aversion therapies (34%). Among 6,164 participants, 60% were < 18 when they were first exposed to SOGIECE. On average, participants experienced SOGIECE for 2–5 years, with some attending SOGIECE for 10 + years.
Summary
Contemporary SOGIECE are diverse in their approaches and settings, necessitating multifaceted prevention strategies, including educational and regulatory interventions to address SOGIECE not immediately recognizable as such. More resources are required for SGM who may experience prolonged exposure to SOGIECE.
... Gender identity change efforts (GICE), which seek to alter a transgender and/or nonbinary person's gender identity to be a cisgender identity, have been found to cause psychological and relational trauma (Del Río-González et al., 2021;Goodyear et al., 2022;Green et al., 2020;Heiden-Rootes et al., 2022;Turban et al., 2020). However, these practices continue to be used by therapists, and there are multiple states in the United States that do not have legal restrictions on the practice of GICE, leaving transgender and nonbinary people, especially transgender and nonbinary youth, at risk of being harmed (Green et al., 2020;Kinitz et al., 2022;Turban et al., 2019). ...
... The literature that does exist focuses on the harm and ineffectiveness of GICE or on exploring transgender and nonbinary individuals' experiences with religion and religious communities. In terms of the harm caused by GICE, Goodyear et al. (2022) found in their qualitative study that experiencing GICE negatively impacted transgender and nonbinary individuals' abilities to form romantic relationships and led to a sense of isolation. Other researchers have documented the link between exposure to GICE and increased suicidal ideation and psychological distress (Heiden-Rootes et al., 2022;Turban et al., 2020). ...
... Results from this study align with the literature that documents the harm caused by GICE, as well as the ineffectiveness of GICE (Conine et al., 2022;Dromer et al., 2022;Heiden-Rootes et al., 2022;Goodyear et al., 2022;Turban et al., 2020). The participants highlighted their own lived experiences of working with individuals who have experienced GICE and shared examples of the harm they have seen in these individuals that mirrored what is documented in the scholarly literature. ...
Given the religious groundings that support the practice of gender identity change efforts (GICE), we sought to explore the beliefs of Christian religious leaders about this practice and their understanding of marginalized gender identities. Nineteen religious leaders mainly from diverse Mainline Christian Protestant traditions were interviewed. Queer theory‐informed thematic analysis revealed two themes related to participants' beliefs about transgender and nonbinary identities: (1) Transgender and nonbinary identities are normative and authentic and (2) God created gender diversity. The analyses also highlighted two themes reflecting the pastors' beliefs about GICE: (1) GICE is harmful and (2) Therapy should affirm transgender and nonbinary identities. Finally, the thematic analysis exploring participants' messages for couple and family therapists could be organized into two themes: (1) Christian religious beliefs do not justify the use of GICE and (2) Therapists should be helpful and not harmful. Implications for couple and family therapists are also discussed.
... 4 Our interdisciplinary research team has studied SOGIECE and their impacts at length. [1][2][3]5,6 Informed by this work, and in line with contemporary legislative bans, 4 we denounce SOGIECE due to their ethical implications and evidence on the lack of benefits (e.g., mental health gains, ''effectiveness'') and significant psychosocial harms, including suicidality (encompassing suicidal thoughts and suicide attempts). ...
... times the risk of having ever experienced suicide ideation, along with 2.49 (95% CI: 2.07-2.99) times the risk of having ever attempted suicide compared with those without exposure to SOGIECE. 1 Findings of this nature are substantiated in other quantitative analyses, [12][13][14] qualitative studies, 6,15,16 and knowledge syntheses. 17 Together, this literature offers clear and compelling evidence of SOGIECE's suiciderelated and broader health and social harms. ...
... Internalization of failure with respect to changing something as deep and personal as identity-particularly when this identity is marginalized-can reasonably also contribute to suicidality (O). 6,23,24 Considering suicidogenic factors such as M1 and M2, the minimal sufficient adjustment set for estimating the total effect of E on O includes not only pre-SOGIECE suicidality (C3) but also a measure (or proxy) of external sources of cisheterosexism (C1) that will likely exert an effect on suicidality before and after SOGIECE. This adjustment could help to elucidate the structural nature of these issues and may also shed light on how circular or episodic sequelae between minority stressors, suicidality, and SOGIECE interact across the life course. ...
Sexual orientation and gender identity and expression change efforts (SOGIECE) aim to deny or suppress nonheterosexual and transgender identities. SOGIECE, including "conversion practices," are controversial and remain prevalent despite contemporary legislative bans and denouncement of these harmful practices from numerous health profession organizations. Recent work has questioned the validity of epidemiological studies associating SOGIECE with suicidal thoughts and suicide attempts. This perspective article addresses such critiques, arguing that the balance of available evidence indicates SOGIECE contribute to suicidality, while proposing methods to better account for structural context and the multitude of factors that may explain both SOGIECE attendance and suicidality.
... Here, it is vital to consider the different forms of social stigma and marginalising forces that manifest in sexual minority men's lives including ostracism, targeted violence and internalised homonegativity -all of which impact intimate relationships (Guschlbauer et al. 2019;Meyer 2003;Šević, Ivanković, and Štulhofer 2016). Encompassing many of the aforementioned challenges, minority stress research consistently highlights heightened risk for depression and suicidality amongst sexual minority men (Goodyear et al. 2022;Green, Price, and Dorison 2022) as interlocking with social isolation and/or intimate relationship distress and disruption (Guschlbauer et al. 2019;Šević, Ivanković, and Štulhofer 2016). ...
... Although this desire for legitimacy in sexual minority men's relationships may assimilate homonormative practices that idealise monogamy (van Eeden-Moorefield et al. 2012), some participants defended these desires as valid and vital for connecting with their intimate partners and other significant people in their lives. Many sexual minority men navigate the marginalisation of their identities, behaviours and relationships, as previously reported (Arreola et al. 2015;Goodyear et al. 2022;Guschlbauer et al. 2019;Šević, Ivanković, and Štulhofer 2016), and marginalising processes can indeed threaten emotional intimacy. While Elizur and Mintzer (2003) assert that by securing connections to family, friends and communities important social supports are garnered, the current study findings confirm work by Conner (2023) and Hart et al. (2023) that there are locale specific challenges for racialised and/or immigrant men. ...
Emotional intimacy is key to intimate partner relationship quality and satisfaction. For sexual minority men, queer and feminist theorists consistently link emotional intimacy to diverse sexual practices and partnership dynamics formulated within the relationship. This Photovoice study adds to those insights by drawing on individual photovoice interviews with 16 sexual minority men to describe participant's experiences of, and strategies for emotional intimacy in their intimate relationships. Analysis revealed three distinct yet entwined themes: (i) embracing vulnerabilities to drive self-acceptance; (ii) building relationality with partners; and (iii) securing connections with family, friends and community. By embracing vulnerabilities to drive self-acceptance, participants spoke to embodied courage and autonomy as key components for addressing wide-ranging emotional intimacy challenges in their relationships. In theme two, building relationality with partners, participants described how empathy, trust and reciprocity underpinned collaborative work to foster emotional intimacy. Lastly, in securing connections with family, friends and community, acceptance and inclusion were key to participants' sense of belonging and legitimacy which aided their emotional intimacy with partners. The findings provide guidance for tailored programmatic efforts to assist sexual minority men build intimate relationships.
... These diagnoses make minor semantic changes-namely, the removal of explicitly naming queerness as a mental disorder-but continue to reproduce the same pathological understandings about queerness as their predecessors Wyatt-Nichol, 2014). Scholars also refer to the intensified practising of conversion therapies after the removal of homosexuality from the DSM-II (Goodyear et al., 2022) and their ongoing prevalence worldwide (particularly targeting non-cisgender people) as another example of the continuation of harmful psychiatric practice (Ashley, 2022;Goodyear et al., 2022;Pilling, 2022;. Furthermore, it has been noted that although being diagnosed with gender dysphoria enables access to life-saving treatment for non-cisgender people, it remains a pathological reading of queerness that leaves queers dependent on psychiatry Pilling, 2022). ...
... These diagnoses make minor semantic changes-namely, the removal of explicitly naming queerness as a mental disorder-but continue to reproduce the same pathological understandings about queerness as their predecessors Wyatt-Nichol, 2014). Scholars also refer to the intensified practising of conversion therapies after the removal of homosexuality from the DSM-II (Goodyear et al., 2022) and their ongoing prevalence worldwide (particularly targeting non-cisgender people) as another example of the continuation of harmful psychiatric practice (Ashley, 2022;Goodyear et al., 2022;Pilling, 2022;. Furthermore, it has been noted that although being diagnosed with gender dysphoria enables access to life-saving treatment for non-cisgender people, it remains a pathological reading of queerness that leaves queers dependent on psychiatry Pilling, 2022). ...
Guest edited by Associate Professor Bruce M. Z. Cohen (Waipapa Taumata Rau), the topic of this special issue of New Zealand Sociology is 'Theorising Mental Health'. Consisting of an introduction, seven research articles and two book reviews, the issue offers novel, innovative and critical questioning and analysis in the mental health space. The special issue not only adds significantly to sociological scholarship on mental health in New Zealand Sociology but also centrally showcases scholarship of local emerging and early career researchers.
... Scholars have found that GICE and SOCE are ineffective in that these efforts do not create the change in identities that they claim to Dehlin et al., 2015;Serovich et al., 2008). Moreover, the outcomes associated with these change efforts include increased depression, anxiety, suicidal ideation, substance abuse, and self-harming behaviors, as well as significant harm to family and romantic relationships (e.g., Goodyear et al., 2022;Green et al., 2020;Ryan et al., 2020;Turban et al., 2020). Despite the plethora of research documenting the ineffectiveness and harm caused by GICE and SOCE, these change efforts continue to be practiced, and are primarily practiced in religious settings by those with conservative and/or fundamentalist religious affiliations or orientations (e.g., Bradshaw et al., 2015;Dehlin et al., 2015;Drescher, 2015). ...
... Beyond adding statements to their codes of ethics, scholars have also suggested that mental health associations advocate for legislative efforts to render SOCE and GICE illegal for any clients; to educate their membership (at all levels from trainees to long-term clinicians) about the research documenting the harm caused by these practices; and to examine the research published supporting SOCE and GICE in the associations' scholarly journals that may need to be retracted based on methodological or ethical concerns (Conine et al., 2022;Cramer et al., 2008;Gamboni et al., 2018). Other scholars have argued for the importance of providing education to the public to help parents and other loved ones recognize the danger of seeking GICE and SOCE and to provide information about how to affirmatively support their LGBTQ family members (Goodyear et al., 2022;Ryan et al., 2020). Although a small group of scholars have provided a few recommendations for mental health associations, no one has explored what steps therapists would like to see their professional organizations take to address these problematic practices. ...
This study explored the steps or actions that therapists would like to see professional mental health associations take concerning gender identity change efforts (GICE) and sexual orientation change efforts (SOCE; also referred to as conversion therapy). Data were collected from 177 therapists utilizing an open-ended question from an online survey. A queer theory informed thematic analysis of the data revealed four themes tied to actions that professional mental health organizations can engage in, ranging from (a) acknowledging the unethicality of GICE and SOCE, (b) intervening to cease the current practice of GICE and SOCE, (c) preventing GICE and SOCE from being practiced in the future, and (d) engaging in transformation efforts to create change at systemic levels (e.g., policy, laws, organizations) to affirm lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities.
... For example, a study of a large sample of lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents and young adults found that exposure to SOCE and GICE was linked to more than twice the likelihood of attempting suicide compared to a sample of LGBTQ individuals with no exposure to change efforts (Green et al., 2020). Additionally, Goodyear et al., (2021) found that survivors of SOCE and GICE reported feelings of shame and isolation, which impacted their ability to form relationships with romantic partners and fellow LGBTQ persons. Other scholars have focused on the harm that SOCE and GICE can do to family relationships, particularly when parents force or coerce an adolescent to attend change effort services (Ryan et al., 2020). ...
... Some of the participants espoused that these practices were designed to force all individuals to adhere to heterosexuality and cisgender norms and stigmatize anyone who does not align with dominant groups. Further, many of the MFTs in this study tied their understanding of systems of (e.g., Goodyear et al., 2021), which reflects some of participants' rationales for the AAMFT to ban these practices because they cause harm in multiple aspects of LGBTQ people's lives. ...
This study sought to explore the beliefs of marriage and family therapists (MFTs) about why sexual orientation change efforts (SOCE; i.e., conversion therapy) and gender identity change efforts (GICE) should be labeled as unethical in the American Association of Marriage and Family Therapy (AAMFT) Code of Ethics. Utilizing an online survey, this study collected data from 208 clinicians with a range of therapeutic experiences and social location identities. Participants responded to open-ended questions, which were analyzed using thematic analysis. The analysis revealed four themes describing why MFTs support GICE and SOCE being labeled as unethical in the AAMFT Code of Ethics: (1) Does not fit the values/roles of being an MFT; (2) Does not fit the ethics of being an MFT; (3) Is harmful and ineffective; and (4) AAMFT has an ethical imperative. Finally, a fifth theme emerged representing the responses from three participants who felt that SOCE and GICE may be ethical practices. Implications for therapists and MFT training programs are discussed.
... Additionally, the sample in the current analysis is limited to TNB persons living in the U.S., which constricts the generalizability of our findings to TNB persons living elsewhere. Considering that TNB persons living outside of the US experience similarly hostile socio-political environments (Chiam et al., 2019;ILGA Europe, 2023) and are exposed to GICE (Bishop, 2019; Goodyear et al., 2022), the importance of further research that accounts for experiences of TNB persons living outside the US cannot be overstated. ...
Introduction: Transgender and nonbinary (TNB) persons’ healthcare experiences and related transition decisions have received increasing attention in recent years. Growing literature indicates gender non-affirming practices, such as gender identity conversion efforts (GICE), are harmful for the wellbeing of TNB persons. Yet, how exposure to GICE is linked to transition related decisions among TNB persons remains unexplored. This study examines links between GICE and TNB persons’ transition decisions and identity exploration, using a conceptual framework that distinguishes adaptive transition decisions (e.g. transition interruptions due to interpersonal coercion) from identity-related transition decisions.
Methods: This study is a secondary data analysis of the 2015 U.S. Transgender Survey
(N=27,630). Multinomial logistic regression was conducted to examine the relationship
between GICE and transition decisions among TNB persons while controlling for demographic covariates.
Results: Overall, 13.5% of TNB participants experienced GICE. Participants interrupted their transition due to interpersonal coercion (4.9%), structural factors (2.0%), and identity-related factors (0.4%). Participants with GICE exposure were more likely to report interrupting their transition due to interpersonal coercion than not interrupting their transition. However, GICE-exposed participants did not have a higher chance of identity-related transition interruptions than no interruptions.
Conclusions: These findings point to a potentially harmful role GICE may play in the transitiondecisions of TNB persons. Our analysis adds to evidence indicating the need for banning GICE and calls for a more nuanced understanding, recognition, and respect for TNB persons’ non-linear transitioning trajectories. Otherwise, we risk vilifying gender-affirming practices and pathologizing adaptive transitioning decisions of TNB persons.
... As a large proportion of 2S/LGBTQ+ people have survived SOGIECE Goodyear et al. 2022Goodyear et al. , 2023, we call on all levels of government to fund support services that address the needs of those with this experience. Moreover, we recommend that provinces and territories work with community agencies already serving sexual and gender minority groups to ensure that supports are provided using appropriately tailored trauma-informed and 2S/LGBTQ+ affirming approaches. ...
Two-Spirit, lesbian, gay, bisexual, transgender, queer and other sexual and gender minority (2S/LGBTQ+) populations continue to experience profound health disparities. In this article, we prioritize five issues in 2S/LGBTQ+ health equity and discuss policy interventions to address disparities in each area: (1) poverty in 2S/LGBTQ+ communities; (2) Two-Spirit mental health; (3) health equity issues in migrant and racialized LGBTQ+ populations; (4) challenges in implementing bans on conversion therapy; and (5) the evolving context of gender-affirming care. Multi-level policy interventions, including those in healthcare-adjacent contexts such as housing and immigration, will be critical to address the structural undercurrents driving health inequities for 2S/LGBTQ+ populations. Recognizing growing complexity and political volatility in the lives of 2S/LGBTQ+ people across Canada, we challenge healthcare policy actors to recognize the breadth of structural barriers to 2S/LGBTQ+ health equity issues and act with urgency in this area.
... Reasons for detransitioning are complex, not always due to SOGI fluidity and often comprise a combination of social, psychological and medical factors (Expósito-Campos et al. 2023). On their own, support for SOGI exploration is positive and SOGI-conversion efforts, as Kia et al. (2024) point out, are associated with isolation, anxiety, depression and suicidality (Goodyear et al. 2022;Salway et al. Affirming Everyone in the Rainbow: Is Gender-Affirming Healthcare "Gay Conversion Therapy?" 2020). ...
Many young people today embrace gender-diverse identities, with adolescents and young adults comprising the largest and fastest-growing demographic of gender-affirming healthcare seekers. Simultaneously, gender-affirming healthcare for this demographic has been debated, and restrictions have been introduced in many jurisdictions. Within this politically charged climate, some journalists, cultural commentators, gender clinicians and politicians have leveraged rhetorical claims that gender-affirming healthcare comprises a new form of “gay conversion therapy.” In this commentary, we explore the extent to which empirical evidence supports or contradicts this discourse as a real phenomenon. While we conclude that gender-affirming healthcare is not gay conversion therapy, we also draw attention to opportunities to enrich gender-affirming healthcare by embracing the complexity of sexuality and gender.
... Conversion efforts are not a phenomenon unique to the U.S., however, as its use has been documented across the globe. Currently, the practice is only banned in six nations (i.e., Brazil, Canada, Ecuador, Germany, Malta, and Taiwan) (Bishop, 2019;Goodyear et al., 2022;Hauser, 2022). The use of conversion efforts in China, India, South Africa, the UK, and Russia among many others has been well documented (Bishop, 2019;King, 2015). ...
Introduction
Gender identity change efforts (GICE) aim to change one’s gender identity to be congruent with sex assigned at birth. Practicing conversion efforts with minors is outlawed for licensed professionals in many U.S. jurisdictions, yet it remains legal in many other jurisdictions and for religious counselors. Literature remains scant but points to a harmful role GICE may play in the lives of transgender and nonbinary (TNB) persons. We examine how GICE is associated with mental and physical wellbeing and proximal minority stressors among TNB persons.
Methods
Using the U.S. TransPop online survey data (2016–2018) collected from 271 TNB adults, we conducted multivariate regression models examining the association between GICE exposure and psychological distress (Kessler-6), past 30-day physical and mental health, healthcare-related stigma anticipation, and proximal stressors (i.e., negative future expectation, nondisclosure of gender identity, and internalized transphobia). Covariates included race, age, gender identity, education level, census poverty level, and sexual orientation.
Results
The average participant was 39 years old and identified as a transgender woman (44%) and white (69%). TNB participants with GICE exposure, on average, reported 4 points (0–23) higher psychological distress levels and 8.1 additional days with poor mental health over the past 30 days. Significantly higher healthcare stigma fears and negative expectation were also observed among GICE-exposed participants.
Conclusions
Findings indicate poorer mental wellbeing among GICE-exposed TNB persons who also report more healthcare-related stigma fears and negative future expectation.
Policy Implications
Considering the relationship between GICE exposure and poor mental wellbeing, our findings give further credence to efforts aimed at outlawing GICE.
... By subjecting these young people to SOGICE, they are being put at risk for numerous health problems. SOGICE increases risks for depression, anxiety, self-hate, shame, guilt, isolation, suicidality, lower life satisfaction, relationship difficulties, drug use, less social support, and other serious mental health problems (e.g., Flentje et al., 2014;Goodyear et al., 2022;Higbee et al., 2022;Ryan et al., 2020;Salway et al., 2020;Shidlo & Schroeder, 2002). In fact, scholars have shown that exposure to SOGICE increases the risk of attempting suicide by 55% and doubles the risk that a young transgender person will run away from home (Campbell & Rodgers, 2023). ...
Sexual orientation and gender identity change efforts (SOGICE) remains a threat to LGBTQ + young people throughout many parts of the USA, increasing risks for many mental health problems, including suicidal behaviors. Little research, though, has examined the strategies activists use to ban licensed professionals (e.g., social workers) from practicing SOGICE. The present study, therefore, involved semi-structured interviews with 15 LGBTQ + individuals affiliated with a grassroots organization focused on banning SOGICE in one Southern state in the USA. Thematic analysis generated six themes: knowledge is power, empathy and communication, utilizing media platforms, professional development, awareness of diversity, and growth areas. Findings suggest LGBTQ + grassroots activism organizations should focus on educating members and volunteers about SOGICE, history, and the legislative process, strengthen empathy-related skills, amplify their voices through media platforms, provide opportunities for job skill development, and foster inclusive environments. Social workers can use these findings to strengthen activism-related skills among LGBTQ + individuals interested in becoming activists to ban SOGICE in Southern states.
... They also acknowledged the same criticisms apply to Blosnich et al.'s original study, suggesting the need for better research to more definitively understand the SOCE-suicide association. Being exposed to SOCE has also been described as socially isolating due to being restricted from meaningful connection with similar others, romantic partners, and LGBQ+-affirming communities (Goodyear et al., 2022). Researchers have posited the negative sequelae of SOCE, such as depression, can last far into the future and become long-term inhibitors of emotional health (Meanley et al., 2020). ...
We analyzed a socio-politically diverse sample (N = 1,412) of cisgender adults who reported experiencing or having experienced same-sex attractions to compare the degree of depression and flourishing between three statuses of sexual orientation change efforts (SOCE): No SOCE (n = 329), Ongoing SOCE (n = 326), and Ended SOCE (n = 757). ANCOVA results controlling for age indicated that the participants with Ongoing SOCE reported greater depression and less flourishing than participants in either the group with No SOCE or who had Ended SOCE, who had similar health outcomes, with small effect sizes. However, consideration of scale norms and structure suggested these group differences may not be interpretively meaningful. Chi-square analysis with medium effect size indicated that participants rejecting an LGBQ+ identity were disproportionately found in the group with Ongoing SOCE while over 60% of LGBQ+-identified participants reported having ended their SOCE. Overall, 11%–21% (88–159/757) of participants reported either always having or developing enough other-sex sexual attraction to enjoy other-sex sexual behavior. Nineteen participants who did not pursue SOCE also reported this change. Duration of SOCE was not associated with health outcomes and the number of years elapsed following SOCE was not correlated with health outcomes after controlling for age. Finally, we did not find evidence that the age of onset of SOCE (as a minor or an adult) was related to participant reports of depression or flourishing. We conclude by discussing possible reasons for why these findings are somewhat counter to established narratives.
... The reality isthat it is diverse SOGIESC individuals that face elevated risksoften shaped by homophobic and/or transphobic beliefs. Violence and stigma against LGBTQIA þ populations are explicitly evidenced in "conversion" practices commonly known as conversion therapy, which although banned in a handful of countries, continue to this day (Goodyear et al., 2022;Trispiotis and Purshouse, 2022). The UK Government in 2021 initially excluded transgender people from their proposal on banning conversion therapy (Mind, 2022), deliberately ostracising people who are transgender from this legislation and selectively deciding who is entitled to protection. ...
Purpose
The purpose of this article is to draw attention to how harmful and inaccurate discourses pertaining to disaster responsibility is produced, the negative implications such narratives pose and the role of the media in the ways in which discourses about queerness and disaster are reported.
Design/methodology/approach
Throughout this paper, the authors detail examples of media reporting on discourses relating to people with diverse sexual orientation, gender identity, gender expression and sex characteristics (SOGIESC) being blamed and held responsible for disasters across the world. The authors examine the value of such reporting as well as describing the harm blame narratives have on queer people and communities.
Findings
There is little value in reporting on accounts of people publicly declaring that people with diverse SOGIESC are to blame for disaster. More sensitivity is needed around publishing on blame discourses pertaining to already marginalised communities.
Originality/value
This article contributes to the developing scholarship on lesbian, gay, bisexual, transgender, queer, intersex, agender, asexual and aromantic individuals, plus other gender identities and sexual orientations (LGBTQIA+/SOGIESC) and disasters by detailing the harm of blame discourses as well as drawing attention to how the media have a role to play in averting from unintentionally providing a platform for hate speech and ultimately enhancing prejudice against people with diverse SOGIESC.
... 51 This quantitative data is consistent with the accounts of individuals reporting exposure to trans conversion practices. 52 Sociologist Karl Bryant stated that trans conversion practices "made me feel that I was wrong, that something about me at my core was bad, and instilled in me a sense of shame that stayed with me for a long time afterward." 53 His testimony resonates with the work of Robert Wallace and Hershel Russell, who explain that attempts to alter or prevent transitude or gender non-conformity can disrupt attachment and identity-formation processes, leading to shame and depression. ...
Transgender conversion practices involve attempts to alter, discourage, or suppress a person’s gender identity and/or desired gender presentation, including by delaying or preventing gender transition. Proponents of the practices have argued that they should be allowed until proven to be harmful. Drawing on the notion of expressive equality, I argue that conversion practices are prima facie unethical because they do not fulfill a legitimate clinical purpose and conflict with the self-understanding of trans communities.
... I engaged in research to explore and understand conversion therapy in Canada throughout my doctoral studies with a team of health science researchers. Extrapolating from the definition provided above, one can imagine the negative consequences of conversion therapy; it instills shame, isolates people from family and community, and is destructive to people's mental health and wellbeing, often resulting in suicidality (Goodyear et al., 2022). The specific project that I draw from is a qualitative study of people's experience of conversion therapy in Canada that collected data through in-depth interviews. ...
In response to decades-long exclusionary practices, academic institutions are now recruiting early career researchers (ECRs) from systemically marginalized populations who specialize in equity-related research. As a result, these ECRs are likely to conduct research within their communities on topics that have personal relevance—insider research. Methodological training for insider research places an emphasis on methods, such as reflexivity, to ensure rigor; however, the emotional and psychological impacts of these research methods on the researcher are seldom discussed. Therefore, I use analytic autoethnography to illustrate the embodied impacts of conducting insider research using an example of personal relevance and argue that methodological practices require an embodied reflexivity that centers the researcher and the impacts the research has on them. This paradoxically rewarding and taxing work necessitates changes in methodological training and practice, institutional support, and an openness to innovation when calling for equity, diversity, and inclusion in the academy.
... 503). Goodyear et al. (2021) argue that "the impacts of [SOCE] are predominately negative and severe, to the point of being life threatening." (p. ...
Background. Sullins, Rosik, and Santero (2021) evaluated a convenience sample of 125 men who had undergone sexual orientation change efforts (SOCE) and they made their data available for independent analysis.
Methods: Data from Sullins et al. (2021) were reanalyzed in ten new ways. Several new typologies and variables were created. Paired sample t-tests, correlations, regression analyses, repeated measures analyses with time x group interactions, and chi-square tests were used to evaluate ten novel hypotheses.
Results: Using parametric statistics, we found similar results to Sullins et al. (2021) where they had used nonparametric statistics. Regression analyses found that lower initial SSI and higher SSB predicted more change. Using a new typology for marital status, it was found that those who became engaged/got married during SOCE had the largest gains in OSB compared to other categories of marital status. Using the typology of change, it was found that some men who became stronger for SSA, SSI, and SSB nevertheless reported high levels of helpfulness for SOCE. Harms from SOCE seem to be minimal compared to the positives reported for young adults. SOCE effectiveness did not appear to change with time since therapy, lending less support to a recall bias argument. Congruence between SSA and SSI, may, in some cases, reduce the apparent effectiveness of SOCE
Conclusion: While the sample’s results cannot be generalized outside of highly religious men with initially higher levels of SSA and SSB than SSI, these results differ from many contemporary assertions that SOCE cannot ever be effective and is inherently harmful, or that SSA is inherently immutable. Therefore, calls to ban SOCE legally appear to be founded upon incomplete or inaccurate data and thus premature, while more higher quality research is yet needed regarding SOCE.
... 1,2 More than 50 health professional organizations -including the Canadian Psychiatric Association and American Medical Association -have issued consensus statements denouncing conversion therapy, owing to substantial empirical evidence that these practices are ineffective and associated with poor health outcomes, notably including suicide ideation and attempts. [3][4][5][6][7] Despite these denouncements, conversion therapy continues to occur in Canada, in both licensed and unlicensed practice settings, affecting as many as 10% of Two-Spirit, lesbian, gay, bisexual, transgender and queer (2SLGBTQ+) people. 8 The recent passage by the federal Parliament of Bill C-4, banning conversion therapy, creates a new opportunity for synergy between medicine and the law, protecting the rights and health of 2SLGBTQ+ people in Canada. ...
... LGBTQ2 communities 23 , future studies should aim to sample using broader recruitment mechanisms. ...
Background: "Conversion therapy" practices (CTP) refer to a heterogeneous set of treatments and activities that share the common goal of suppressing, "repairing," or otherwise preventing expressions of transgender, lesbian, gay, bisexual, or queer identities. This study aimed to elicit details from those with direct experience and assess concordance between CTP experiences and the definition of CTP included in federal legislation aiming to deter CTP.
Methods: We conducted an anonymous online survey of adults (>18 years) in Canada between August 18 and December 2, 2020. Participants were recruited through social media, CTP survivor networks, and word-of-mouth.
Results: Of 51 respondents with direct experience of CTP, 16 were transgender, 34 were cisgender. Most respondents lived in Alberta, British Columbia, Ontario, or Quebec. 49% experienced CTP in a licensed healthcare provider office, 45% at a faith-based organization, and 36% at an unlicensed counselor office (categories not mutually exclusive). Age at first CTP experience ranged from 2 to 44 years of age (mean: 17.8 years; median: 17 years). Respondents experienced CTP for <1 year to 33 years (mean: 4.6 years; median: 2 years). Fifty percent of those with direct experience of CTP indicated that the proposed legislative definition of CTP did not fully encompass their personal experience.
Interpretation: Results from this Canadian survey of adults with experience of CTP indicate that legislative attempts to ban CTP must be expanded (e.g., to include adults and practices that do not concord with previously drafted definitions) and paired with other prevention efforts.
Little research exists on the prevalence of conversion therapy practices (CTP) and sexual orientation and gender identity, and expression change efforts (SOGIECE) among Two-Spirit and lesbian, gay, bisexual, transgender (trans), queer, intersex, and asexual people as well as other sexual and gender minorities (2S/LGBTQIA+) youth in Canada. This study aims to quantify the prevalence of CTP and SOGIECE among 2S/LGBTQIA+ youth in Canada, including policy-relevant details regarding setting, age of initiation, and duration of CTP exposure. 2S/LGBTQIA+ youth, 15–24 years old, in Canada were recruited through social media and 2S/LGBTQIA+ organizations from November 2021 to January 2022. Respondents provided demographic data and detailed quantitative information about their experiences with CTP and SOGIECE. Of respondents ( N = 2,960), 7.7% experienced CTP, 7.4% were at risk of CTP, and 65.8% reported exposure to SOGIECE. CTP experience was highest among respondents who were men, gay/homosexual, transgender, intersex, Arab, South Asian, Southeast Asian, Pacific Islanders, and living in the province of Manitoba. Among the respondents who experienced CTP ( n = 203), most did so with a certified health professional or a religious organization. Almost half of the respondents experienced their last CTP over three years prior to participation in this study, and 37.1% experienced CTP between the ages of 15 and 19 years old. The current study provides evidence that CTP and SOGIECE remain prevalent among 2S/LGBTQIA+ youth. Education and policy efforts are needed to target school, religious, and healthcare settings.
Background: Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change, deny, or discourage their sexual orientation, gender identity, and/or gender expression. This study aims to investigate the prevalence of CTPs across Canadian provinces and territories and identify whether CTP bans reduce the prevalence of CTPs. Methods: We collected 119 CTPs from 31 adults (18+) in Canada who have direct experience with CTPs, know people who have gone to CTPs, or know of conversion therapy practitioners using a 2020 anonymous online survey. Mapping analysis was conducted using ArcGIS Online. CTP prevalence was compared between provinces/territories with and without bans using chi-square tests. Results: Three provinces and eleven municipalities had CTP bans. The prevalence of CTPs in provinces/territories with bans was 2.34 per 1,000,000 population (95% CI 1.65, 3.31). The prevalence of CTPs in provinces/territories without bans was 4.13 per 1,000,000 population (95% CI 3.32, 5.14). Accounting for the underlying population, provinces/territories with the highest prevalence of CTPs per 1,000,000 population were New Brunswick (6.69), Nova Scotia (6.50), and Saskatchewan (6.37). Conclusions: Findings suggest only 55% of Canadians were protected under CTP bans. The prevalence of CTPs in provinces/territories without bans was 1.76 times greater than provinces/territories with bans. CTPs are occurring in most provinces/territories, with higher prevalence in the west and the Atlantic. These findings and continued efforts to monitor CTP prevalence can help inform policymakers and legislators as society is increasingly acknowledging CTPs as a threat to the health and well-being of LGBTQ2S+ people.
This is a collection of preprint and publicly available drafts of an exchange of studies and commentaries that took place in the Archives of Sexual Behavior on the question whether sexual orientation change efforts induce higher risk of suicidal behavior.
Background: Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change, deny, or discourage their sexual orientation, gender identity, and/or gender expression. This study aims to investigate the prevalence of CTPs across Canadian provinces and territories and identify whether CTP bans reduce the prevalence of CTPs. Methods: We collected 119 CTPs from 31 adults (18+) in Canada who have direct experience with CTPs, know people who have gone to CTPs, or know of conversion therapy practitioners using a 2020 anonymous online survey. Mapping analysis was conducted using ArcGIS Online. CTP prevalence was compared between provinces/territories with and without bans using chi-square tests. Results: Three provinces and eleven municipalities had CTP bans. The prevalence of CTPs in provinces/territories with bans was 2.34 per 1,000,000 population (95% CI 1.65, 3.31). The prevalence of CTPs in provinces/territories without bans was 4.13 per 1,000,000 population (95% CI 3.32, 5.14). Accounting for the underlying population, provinces/territories with the highest prevalence of CTPs per 1,000,000 population were New Brunswick (6.69), Nova Scotia (6.50), and Saskatchewan (6.37). Conclusions: Findings suggest only 55% of Canadians were protected under CTP bans. The prevalence of CTPs in provinces/territories without bans was 1.76 times greater than provinces/territories with bans. CTPs are occurring in most provinces/territories, with higher prevalence in the west and the Atlantic. These findings and continued efforts to monitor CTP prevalence can help inform policymakers and legislators as society is increasingly acknowledging CTPs as a threat to the health and well-being of LGBTQ2S+ people.
Every year thousands of young people are sent to therapeutic boarding schools (TBS) in the USA. TBS are residential programmes that combine educational classes and group therapy in self-contained facilities that operate year-round. The programmes are part of a wider 'troubled teen industry' that seeks to reform young people perceived as having mental health and/or substance misuse problems. Interviews were conducted with former TBS students about their experiences as youth inside these facilities. The research was undertaken from a survivor-researcher approach and was conducted by a former TBS student with former students. This article will focus on the experiences of two LGBTQþ former students who were subjected to conversion therapy in TBS. The case studies will describe conversion practices that pressure people to change or suppress their sexual orientation, gender identity or gender expression. Conversion therapy manifested in overt and covert forms that resulted in lasting psychological trauma. The case studies highlight the impacts of conversion therapy as epi-stemic injustice and the ways in which the former students adapted to and resisted institutional harm. Implications for practice include the importance for social workers to understand conversion therapy as a dynamic, evolving and potentially subtle practice.
This booklet presents all the elements of the published exchange between Blosnich et al. and Sullins over the question whether sexual orientation change efforts increase the risk of suicide. All elements are published, peer-reviewed articles, presented here in chronological order, by point and counterpoint, to facilitate following the arguments and counter-arguments in full.
Conversion therapy practices (CTPs) are discredited efforts that target lesbian, gay, bisexual, trans, queer, Two-Spirit, or other (LGBTQ2S+) people and seek to change, deny, or discourage their sexual orientation, gender identity, and/or gender expression. This study aims to investigate the prevalence of CTPs across Canadian provinces and territories and identify whether CTP bans are associated with decreasing prevalence. We analyzed 119 CTPs reported from 31 adults (18+) in Canada who have direct experience with CTPs, know people who have gone to CTPs, or know of conversion therapy practitioners by using a 2020 anonymous online survey. Mapping analysis was conducted using ArcGIS Online. CTP prevalence was compared between provinces/territories with and without bans using chi-square tests. We found 3 provinces and 11 municipalities had CTP bans. The prevalence of CTPs in provinces/territories with a ban is 2.34 per 1,000,000 population (95% CI 1.65, 3.31). The prevalence of CTPs in provinces/territories without a ban is 4.13 per 1,000,000 population (95% CI 3.32, 5.14). Accounting for the underlying population, provinces/territories with the highest prevalence of CTPs are New Brunswick (6.69), Nova Scotia (6.50), and Saskatchewan (6.37). Findings suggest only 55% of Canadians are protected under CTP bans. The prevalence of CTPs in provinces/territories without a ban is 1.76 times greater than in provinces/territories with a ban. CTPs are occurring in most provinces/territories, with higher prevalence in the west and the Atlantic. Findings will help inform policymakers and legislators as they are increasingly acknowledging CTPs as a threat to the health and well-being of LGBTQ2S+ people.
Sexual orientation and gender identity and expression change efforts (SOGIECE)—often referred to as conversion therapy—are practices that aim to change, deny, or suppress non-cisnormative gender expressions and gender identities and non-heteronormative sexual orientations. SOGIECE are ineffective and associated with negative biopsychosocial consequences. This qualitative interpretive description study explores how individuals who have experienced SOGIECE recover from these practices. We conducted in-depth interviews with 20 Canadian adults who have experienced SOGIECE. Using thematic analysis, we derived three interrelated themes pertaining to participants’ recovery from SOGIECE: 1) rebuilding social support and finding strength in lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and LGBTQ + -affirming communities; 2) overcoming SOGIECE through affirming therapy and healthcare support; and 3) managing SOGIECE instigators. Based on these findings, we offer recommendations to facilitate the recovery process of people who experience SOGIECE, including enhancing access to LGBTQ + -affirming spaces and mental healthcare.
Suicide capability is theorised to facilitate the movement from suicidal ideation to suicide attempt. Three types of contributors are posited to comprise suicide capability: acquired, dispositional, and practical. Despite suicide capability being critical in the movement from ideation-to-attempt, there has been no systematic synthesis of empirical evidence relating to suicide capability that would enable further development and refinement of the concept. This study sought to address this synthesis gap. A scoping review was conducted on suicide capability studies published January 2005 to January 2022. Eleven electronic databases and grey literature sources were searched returning 5,212 potential studies. After exclusion criteria application, 90 studies were included for final analysis. Results synthesis followed a textual narrative approach allocating studies based on contributors of suicide capability. Most studies focused on investigating only one factor within contributors. Painful and provocative events appear to contribute to acquired capability more so than fearlessness about death. Whilst emerging evidence for dispositional and practical contributors is promising, the small number of studies prevents further conclusions from being drawn. An unexpected additional cognitive contributor was identified. The focus of a single factor from most studies and the limited number of studies on contributors other than acquired capability limits the theoretical development and practical application of suicide capability knowledge. Given that suicide is a complex and multifaceted behaviour, future research that incorporates a combination of contributors is more likely to advance our understandings of suicide capability.
Sexual and gender minorities (SGMs) navigate systems of oppression that reify cisgender and heterosexual norms (cisheteronormativity) while developing their identities. ‘Conversion therapy’ represents a particularly prominent and harmful threat in this landscape. We explore how SGM who experienced conversion therapy develop their identities to understand antecedents to mental health struggles in this population. In-depth interviews were conducted with 22 people in Canada. A ‘master narratives’ framework combined with Polkinghorne’s narrative analysis were used to explore individual-structural relations that affect identity in settings where cisheteronormative master narratives are amplified (i.e., conversion therapy). We present research findings through a creative non-fiction, which includes learning cisheteronormative master narratives; internalizing master narratives; feeling broken and searching for alternatives; and embracing self-love amidst pain. The amplification of master narratives through conversion therapy leads to conflict and delays in adopting a coherent identity. Health professionals should enact institutional practices that affirm SGM and thereby deemphasize cisheteronormativity.
Religion-based LGBTQA + conversion practices frame all people as potential heterosexuals whose gender aligns with their birth sex (in a cisgender binary model of male and female sexes). Deviation from this heterosexual cisgender social identity model is cast as curable ‘sexual brokenness’. However, research shows conversion practices are harmful, and particularly associated with increased experiences of abuse, mental health diagnoses, and suicidality. This paper explores their contribution to the particular harms of moral injury and religious trauma, drawing firstly on the foundational moral injury literature to offer a unique conceptual framework of spiritual harm and moral injury, and secondly on a rare qualitative 2016–2021 study of the spiritual harms reported in semi-structured interviews of 42 survivors of LGBTQA + change and suppression practices in Australia. The paper examines the survivors' support needs around the nature and extent of religious trauma and moral injury, to inform services working towards supporting their recovery from such experiences and their resolution of conflicts deeply bound in their sense of self and belonging. It argues that impairment of conversion survivors' relationships with religious communities, and religious self-concepts, point to the need for additional improvements in pastoral practice.
Conversion therapies are practices that attempt to change an individuals’ same-sex attractions through psychotherapeutic and aversive therapeutic techniques. Conversion therapies were developed based on homophobic beliefs that same-sex attractions are a mental illness. We sought to describe the prevalence and characteristics of conversion therapy experienced among middle-aged and older men who have sex with men in the USA. Given associations of homophobic stigma and HIV risk, we hypothesized that HIV-positive men would report higher odds of conversion therapy compared to HIV-negative men. We analyzed data from 1237 middle-aged and older men who have sex with men (MSM) enrolled in the Multicenter AIDS Cohort Study. Among participants, 17.7% reported lifetime conversion therapy, of which the average start of therapy age was 22.67 (sd = 10.56) years, 25.8% reported therapy durations of 6+ months, 37.7% reported session frequencies 1+ session per week, and 35.9% indicated that undergoing therapy was either a little or not at all their decision. We observed no statistically significant association between reporting lifetime conversion therapy and HIV status. Future efforts should continue to assess the magnitude of harm conversion therapies imposed on MSM’s health across the life course as well as test potential, indirect associations that may link these practices to HIV.
In their fervor to fix homsexual, practitioners of sexual conversion therapies have often overlooked or completely dismissed the possible psychological and social side effects of such treatments. Sexual Conversion Therapy: Ethical, Clinical, and Research Perspectives works to counterbalance the clinical and ethical omissions of overzealous therapists who have focused on efficacy and outcome at the expense of their patients'self-esteem. Sexual Conversion Therapy features first-person accounts of patients and clinicians, including psychotherapists who themselves have undergone treatments ranging from psychoanalysis to religious faith healing to aversion behavior conditioning and even electroshock therapy. In addition to examining the history and ethics of conversion therapy, the book presents empirical data on current practice and recovery processes for survivors of failed conversion attempts.
Therapy meant to change someone's sexual orientation, or reorientation therapy, is still in practice despite statements from the major mental health organizations of its potential for harm. This qualitative study used an inductive content analysis strategy (Patton, 2002) to examine the experiences of thirty-eight individuals (31 males and seven females) who have been through a total of 113 episodes of reorientation therapy and currently identify as gay or lesbian. Religious beliefs were frequently cited as the reason for seeking reorientation therapy. Frequently endorsed themes of helpful components of reorientation therapy included connecting with others and feeling accepted. Harmful aspects of reorientation therapy included experiences of shame and negative impacts on mental health. Common reasons for identifying as LGB after the therapy included self-acceptance and coming to believe that sexual orientation change was not possible. The findings of this study were consistent with recommendations by the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009), which concluded that helpful aspects of reorientation therapy could be achieved through affirmative treatment methods while avoiding potential harms that may be associated with reorientation therapy. Limitations of the findings, including a small, self-selected sample, are discussed.
Purposeful sampling is widely used in qualitative research for the identification and selection of information-rich cases related to the phenomenon of interest. Although there are several different purposeful sampling strategies, criterion sampling appears to be used most commonly in implementation research. However, combining sampling strategies may be more appropriate to the aims of implementation research and more consistent with recent developments in quantitative methods. This paper reviews the principles and practice of purposeful sampling in implementation research, summarizes types and categories of purposeful sampling strategies and provides a set of recommendations for use of single strategy or multistage strategy designs, particularly for state implementation research.
The American Psychological Association's (APA's) as well as other professional organizations' (e.g., American Psychiatric Association) removal of homosexuality as a mental disorder represented a paradigmatic shift in thinking about exual orientation. Since then, APA (2000)2.
American Psychiatric Association. 2000 . Position statement on attempts to change sexual orientation (conversion and reparative therapies). . American Journal of Psychiatry , 157 : 1719 – 1721 . [PubMed], [Web of Science ®], [CSA]View all references disseminated guidelines for working with lesbian, gay, and bisexual (LGB) clients, and a variety of scholars and researchers alike have advocated affirmative therapeutic interventions with LGB individuals. Despite these efforts, the controversy over treating individuals with LGB orientations using nonaffirmative techniques continues. In this discussion, the limited evidence regarding the efficacy and effects of conversion therapy is surveyed, particularly in the context of empirically supported treatment criteria summarized by Division 12 (clinical psychology) of the APA. Authors then consider the resulting ethical considerations in performing conversion therapy and propose alternative uses of affirmative therapy on the basis of ethical standards defined by APA. Finally, options for treating LGB individuals who are coming to terms with their sexual orientations are discussed.
This article examines narratives of gay men and lesbians who participated in conversion therapies and/or ex-gay ministries in order to change their sexual orientation to that of heterosexual. Data for this study were gathered through an analysis of the stories of 14 people, published in a document titled Finally Free, who describe their negative experiences with conversion therapy through ex-gay ministries. Analysis of the data revealed seven common psychosocial issues faced by gay men and lesbians who turned to conversion therapy in an attempt to become heterosexual. These issues provide knowledge for social workers' intervention with gay men and lesbians seeking healing and personal growth after participating in conversion therapy and ex-gay ministries.
What motivates individuals to pursue conversion therapy and ex-gay groups? How do they perceive its harmfulness and helpfulness? In this study, 202 consumers of sexual orientation conversion interventions were interviewed to answer these questions. The results indicated that a majority failed to change sexual orientation, and many reported that they associated harm with conversion interventions. A minority reported feeling helped, although not necessarily with their original goal of changing sexual orientation. A developmental model that describes the various pathways of individuals who attempt to change their sexual orientation is presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.
This study describes stress as derived from minority status and explores its effect on psychological distress in gay men. The concept of minority stress is based on the premise that gay people in a heterosexist society are subjected to chronic stress related to their stigmatization. Minority stressors were conceptualized as: internalized homophobia, which relates to gay men's direction of societal negative attitudes toward the self; stigma, which relates to expectations of rejection and discrimination; and actual experiences of discrimination and violence. The mental health effects of the three minority stressors were tested in a community sample of 741 New York City gay men. The results supported minority stress hypotheses: each of the stressors had a significant independent association with a variety of mental health measures. Odds ratios suggested that men who had high levels of minority stress were twice to three times as likely to suffer also from high levels of distress.
In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
Objectives. To explore associations between undergoing sexual orientation or gender identity conversion efforts (SOGICE) and suicidality among young LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) individuals.
Methods. Data were derived from a 2018 online cross-sectional study of young LGBTQ individuals (13–24 years of age) residing in the United States. Multivariate logistic regression was used to determine the relative odds of suicidality among young LGBTQ individuals who experienced SOGICE (in comparison with those who did not) after adjustment for age, race/ethnicity, geography, parents’ use of religion to say negative things about being LGBTQ, sexual orientation, gender identity, discrimination because of sexual orientation or gender identity, and physical threats or harm because of sexual orientation or gender identity.
Results. Relative to young people who had not experienced SOGICE, those who reported undergoing SOGICE were more than twice as likely to report having attempted suicide and having multiple suicide attempts.
Conclusions. The elevated odds of suicidality observed among young LGBTQ individuals exposed to SOGICE underscore the detrimental effects of this unethical practice in a population that already experiences significantly greater risks for suicidality. (Am J Public Health. Published online ahead of print June 18, 2020: e1–e7. doi:10.2105/AJPH.2020.305701)
Objective
Sexual orientation change efforts (SOCE), or “conversion therapy,” are pseudoscientific practices intended to suppress or deny sexual attraction to members of the same gender/sex. There are currently no data available to inform estimates of the prevalence of SOCE exposure in Canada. The objective of this study is therefore to describe the prevalence, social–demographic correlates, and health consequences of SOCE among Canadian sexual minority men.
Methods
Sex Now 2011 to 2012 was a cross-sectional nonprobability survey of Canadian sexual minority men. Respondents were asked about lifetime SOCE exposure. We estimated prevalence of SOCE exposure by sociodemographic characteristics and examined psychosocial health outcomes among those exposed to SOCE.
Results
Of N = 8,388 respondents, 3.5% (95% confidence interval, 3.2% to 4.1%) reported having ever been exposed to SOCE. Exposure to SOCE was higher among gay men (as compared with bisexual men), transgender respondents (as compared with cisgender respondents), those who were “out” about their sexuality (as compared with those who were not “out”), Indigenous men (as compared with White men), other racial minorities (as compared with White men), and those earning a personal income <60,000 CAD). Exposure to SOCE was positively associated with loneliness, regular illicit drug use, suicidal ideation, and suicide attempt.
Conclusions
SOCE exposure remains prevalent and associated with substantial psychosocial morbidity among sexual minority men in Canada. All levels of government in Canada should consider action to ban SOCE. SOCE survivors likely require intervention and support from the Canadian health-care system.
Importance
Gender identity conversion efforts (GICE) have been widely debated as potentially damaging treatment approaches for transgender persons. The association of GICE with mental health outcomes, however, remains largely unknown.
Objective
To evaluate associations between recalled exposure to GICE (by a secular or religious professional) and adult mental health outcomes.
Design, Setting, and Participants
In this cross-sectional study, a survey was distributed through community-based outreach to transgender adults residing in the United States, with representation from all 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, and US military bases overseas. Data collection occurred during 34 days between August 19 and September 21, 2015. Data analysis was performed from June 8, 2018, to January 2, 2019.
Exposure
Recalled exposure to GICE.
Main Outcomes and Measures
Severe psychological distress during the previous month, measured by the Kessler Psychological Distress Scale (defined as a score ≥13). Measures of suicidality during the previous year and lifetime, including ideation, attempts, and attempts requiring inpatient hospitalization.
Results
Of 27 715 transgender survey respondents (mean [SD] age, 31.2 [13.5] years), 11 857 (42.8%) were assigned male sex at birth. Among the 19 741 (71.3%) who had ever spoken to a professional about their gender identity, 3869 (19.6%; 95% CI, 18.7%-20.5%) reported exposure to GICE in their lifetime. Recalled lifetime exposure was associated with severe psychological distress during the previous month (adjusted odds ratio [aOR], 1.56; 95% CI, 1.09-2.24; P < .001) compared with non-GICE therapy. Associations were found between recalled lifetime exposure and higher odds of lifetime suicide attempts (aOR, 2.27; 95% CI, 1.60-3.24; P < .001) and recalled exposure before the age of 10 years and increased odds of lifetime suicide attempts (aOR, 4.15; 95% CI, 2.44-7.69; P < .001). No significant differences were found when comparing exposure to GICE by secular professionals vs religious advisors.
Conclusions and Relevance
The findings suggest that lifetime and childhood exposure to GICE are associated with adverse mental health outcomes in adulthood. These results support policy statements from several professional organizations that have discouraged this practice.
Objectives. To examine exposure to psychological attempts to change a person’s gender identity from transgender to cisgender (PACGI) among transgender people in the United States, lifetime and between the years 2010 and 2015, by US state.
Methods. We obtained data from the 2015 US Transgender Survey, a cross-sectional nonprobability sample of 27 716 transgender people in the United States, to estimate the percentage exposed to PACGI in each US state.
Results. Overall, 13.5% of the sample indicated lifetime exposure to PACGI, ranging across all US states from 9.4% (South Carolina) to 25.0% (Wyoming). The percentage of transgender adults in the United States reporting exposure to PACGI between 2010 and 2015 was 5% overall, and across all states ranged from 1.2% (Alaska) to 16.3% (South Dakota).
Conclusions. Despite major medical organizations identifying PACGI as ineffective and unethical, 13.5% of transgender people in the United States reported lifetime exposure to this practice. Findings suggest that this practice has continued in every US state as recently as the period 2010 to 2015.
Studies of adults who experienced sexual orientation change efforts (SOCE) have documented a range of health risks. To date, there is little research on SOCE among adolescents and no known studies of parents’ role related to SOCE with adolescents. In a cross-sectional study of 245 LGBT White and Latino young adults (ages 21–25), we measured parent-initiated SOCE during adolescence and its relationship to mental health and adjustment in young adulthood. Measures include being sent to therapists and religious leaders for conversion interventions as well as parental/caregiver efforts to change their child’s sexual orientation during adolescence. Attempts by parents/caregivers and being sent to therapists and religious leaders for conversion interventions were associated with depression, suicidal thoughts, suicidal attempts, less educational attainment, and less weekly income. Associations between SOCE, health, and adjustment were much stronger and more frequent for those reporting both attempts by parents and being sent to therapists and religious leaders, underscoring the need for parental education and guidance.
Introduction
Canada is commonly seen as a progressive country with its multicultural model, its tolerance for diversity and its sensitised human rights legislation (Elliot and Bonauto, 2005). Although Canada can be commended for the progress it has made in each of these areas, one need only scratch the surface to expose the inequalities and inequities that lie beneath.
Lesbian, gay, bisexual and trans (LGBT) populations are a clear example of a people who were once unrecognised culturally, neither tolerated nor accepted socially, and completely devoid of inclusion in human rights legislation and its ensuing protections in Canada. The last 45 years have seen momentous shifts in each of these areas, so much so that it has produced a near utopian veneer that serves to mask continuing forms of oppression and micro-aggressions that simmer from below. Despite the elevation of Canada's LGBT communities as a recognised population that makes up part of the multicultural fabric of the land, with near full recognition of human rights protection in legislation, LGBT people fall woefully behind the general population with regard to health and wellbeing. HIV/AIDS continues to be the illness-based focus that the Canadian state gives varying degrees of support to, barely recognising the broader health and wellness issues, needs and concerns that affect LGBT Canadians.
Two models have informed health policy in Canada (with international influence), which have progressively focused on diversity, given the multicultural make-up of the country, with varying success:
• • the world-renowned ‘Health Promotion’ model (Government of Canada, 1974), which focused on achieving a healthy lifestyle;
• • the internationally regarded Population Health model (Health Canada, 1998, 2001), which more explicitly identifies diverse populations and attempts to address the social determinants of health (SDoH) (Public Health Agency of Canada, no date).
Neither have completely addressed LGBT people as a population that experiences health inequalities: the former was critiqued for its lack of attention to structural differences; and the latter fell short, due to its over-emphasis on determinants of health at the expense of ‘social’ aspects – becoming mired in unsatisfactory notions of ‘health cause and effects’ (Orsini, 2007).
This paper describes the television stations which the Canadian Broadcasting Corporation has built in Montreal and Toronto for the inauguration of television broadcasting in Canada. In planning these stations certain special requirements had to be met such as the necessity for programming in two languages in Montreal and the need for producing a relatively large percentage of locally originated shows in both cities.
The aims of this paper are to add clarity to the discussion about paradigms for nursing research and to consider integrative strategies for the development of nursing knowledge.
Paradigms are sets of beliefs and practices, shared by communities of researchers, which regulate inquiry within disciplines. The various paradigms are characterized by ontological, epistemological and methodological differences in their approaches to conceptualizing and conducting research, and in their contribution towards disciplinary knowledge construction. Researchers may consider these differences so vast that one paradigm is incommensurable with another. Alternatively, researchers may ignore these differences and either unknowingly combine paradigms inappropriately or neglect to conduct needed research. To accomplish the task of developing nursing knowledge for use in practice, there is a need for a critical, integrated understanding of the paradigms used for nursing inquiry.
We describe the evolution and influence of positivist, postpositivist, interpretive and critical theory research paradigms. Using integrative review, we compare and contrast the paradigms in terms of their philosophical underpinnings and scientific contribution.
A pragmatic approach to theory development through synthesis of cumulative knowledge relevant to nursing practice is suggested. This requires that inquiry start with assessment of existing knowledge from disparate studies to identify key substantive content and gaps. Knowledge development in under-researched areas could be accomplished through integrative strategies that preserve theoretical integrity and strengthen research approaches associated with various philosophical perspectives. These strategies may include parallel studies within the same substantive domain using different paradigms; theoretical triangulation to combine findings from paradigmatically diverse studies; integrative reviews; and mixed method studies.
Nurse scholars are urged to consider the benefits and limitations of inquiry within each paradigm, and the theoretical needs of the discipline.
Government of Canada
- Justice Department Of
- Canada
The Williams Institute, UCLA School of Law
- C Mallory
- T N T Brown
- K J Conron
Canadian Institutes of Health Research
- H Pruden
- T Salway
Family Acceptance Project
- C Ryan
House of Commons Canada
- T Salway
House of Commons Canada
- T Salway
- K G Card
- O Ferlatte
- D Gesink
- M Gilbert
- J Jollimore
- D Kinitz
- N Lachowsky
- A Rich
- J Shoveller
Harmful treatment: The global reach of so-called conversion therapy
- A Bishop
Bishop, A. (2019). Harmful treatment: The global reach of so-called conversion therapy. OutRight Action International. https://outrightinterna
tional.org/sites/default/files/ConversionFINAL_Web_0.pdf
Yukon becomes 1st territory to ban conversion therapy
- D Entremont
d'Entremont, D. (2020, November 10). Yukon becomes 1st territory to ban
conversion therapy. Canadian Broadcasting Corporation. https://www.
cbc.ca/news/canada/north/conversion-therapy-banned-yukon-1.
Federal government introduces legislation to criminalize conversion therapy-related conduct in Canada. Government of Canada
- Justice Department Of
- Canada
Department of Justice Canada. (2020). Federal government introduces
legislation to criminalize conversion therapy-related conduct in
Canada. Government of Canada. https://www.canada.ca/en/depart
ment-justice/news/2020/03/federal-government-introduces-legislation
-to-criminalize-conversion-therapy-related-conduct-in-canada.html
Conversion therapy and LGBT youth: Update. The Williams Institute, UCLA School of Law
- C Mallory
- T N T Brown
- K J Conron
Mallory, C., Brown, T. N. T., & Conron, K. J. (2019). Conversion therapy
and LGBT youth: Update. The Williams Institute, UCLA School of Law.
https://williamsinstitute.law.ucla.edu/wp-content/uploads/
Conversion-Therapy-Update-Jun-2019.pdf
An act to amend the criminal code
- Minister Of Justice
Minister of Justice. (2020). An act to amend the criminal code (conversion
t h e r a p y ). P a r l i a m e n t o f C a n a d a. h t t p s : / / w w w. p a r l. c a /
DocumentViewer/en/43-1/bill/C-8/first-reading
Germany's Bundestag approves ban on "conversion therapy
OutRight Action International. (2020, May 7). Germany's Bundestag
approves ban on "conversion therapy" [Press release]. https://outright
international.org/content/germanys-bundestag-approves-banconversion-therapy
LGBTQ2 health in Canada: Statement to standing committee on health, house of commons of Canada. House of Commons Canada
- T Salway
Salway, T. (2019). LGBTQ2 health in Canada: Statement to standing
committee on health, house of commons of Canada. House of
Commons Canada. https://www.ourcommons.ca/DocumentViewer/
en/42-1/HESA/meeting-138/evidence
Ending conversion therapy in Canada: Survivors, community leaders, researchers, and allies address the current and future states of sexual orientation and gender identity and expression change efforts
- T Salway
Salway, T. (2020a). Ending conversion therapy in Canada: Survivors, community leaders, researchers, and allies address the current and future
states of sexual orientation and gender identity and expression change
efforts. http://www.cgshe.ca/sogiece/
To end conversion therapy, we must understand what it actually means. The Globe and Mail
- T Salway
Salway, T. (2020b, May 26). To end conversion therapy, we must understand what it actually means. The Globe and Mail. https://www.theglo
beandmail.com/opinion/article-to-end-conversion-therapy-we-mustunderstand-what-it-actually-means/
Protecting Canadian sexual and gender minorities from harmful sexual orientation and gender identity change efforts: A brief submitted to the standing committee on health for the committee's study of LGBTQ2 health in Canada. House of Commons Canada
- T Salway
- K G Card
- O Ferlatte
- D Gesink
- M Gilbert
- J Jollimore
- D Kinitz
- N Lachowsky
- A Rich
- J Shoveller
Salway, T., Card, K. G., Ferlatte, O., Gesink, D., Gilbert, M., Jollimore, J.,
Kinitz, D., Lachowsky, N., Rich, A., & Shoveller, J. (2019). Protecting
Canadian sexual and gender minorities from harmful sexual orientation
and gender identity change efforts: A brief submitted to the standing
committee on health for the committee's study of LGBTQ2 health in
Canada. House of Commons Canada. https://www.ourcommons.ca/
Content/Committee/421/HESA/Brief/BR10447600/br-external
/SalwayTravis-2-e.pdf