TOPLINE:
Conversion practices targeting gender identity or sexual orientation are associated with increased depression, posttraumatic stress disorder (PTSD), and suicidality in LGBTQ+ adults, a new study shows.
METHODOLOGY: Researchers analyzed data from the PRIDE study, a US-based, online, prospective cohort study of 4426 adults (57% cisgender, 43% transgender/gender diverse) who completed two questionnaires related to conversion practices and mental health outcomes. Self-reported mental health symptoms of anxiety, depression, PTSD, and suicidality were measured using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, Posttraumatic Stress Disorder Checklist, and Suicide Behaviors Questionnaire-Revised scale. The primary exposure was recalled exposure to conversion practices targeting gender identity alone, sexual orientation alone, or both compared with no conversion practices. TAKEAWAY: About 1% of participants recalled conversion practices targeting both gender identity and sexual orientation, which was associated with increased symptoms of depression (unstandardized difference [beta], 2.48; 95% CI, 0.26-4.78), PTSD (beta, 2.84; 95% CI, 0.94-4.74), and suicidality (beta, 2.14; 95% CI, 0.95-3.32). About 3.4% of participants recalled only sexual orientation-related conversion practice, which was associated with increased symptoms of PTSD (beta, 1.10; 95% CI, 0.22-1.98) and suicidality (beta, 0.93; 95% CI, 0.26-1.60). About 1% of participants recalled only gender identity-related conversion practice, which was associated with increased symptoms of depression (beta, 3.24; 95% CI, 1.03-5.46), PTSD (beta, 2.70; 95% CI, 1.06-4.34), and suicidality (beta, 1.35; 95% CI, 0.38-2.32). Cisgender participants undergoing both types of conversion practices had a higher risk for suicidal thoughts and attempts (beta, 2.69; 95% CI, 0.42-4.97) than transgender participants (beta, 0.98; 95% CI, −0.48 to 2.44). IN PRACTICE:
“Our findings add to a body of evidence that shows conversion practice is unethical and linked with poor mental health. Educational efforts involving families, religious leaders, and mental health providers are also needed, as are support networks for LGBTQ+ youths and targeted mental health screening to identify and support survivors of conversion practice,” lead author Nguyen K. Tran, PhD, Stanford University School of Medicine, Stanford, California, stated in a press release.
SOURCE:
The study was published online on September 30, in The Lancet Psychiatry.
LIMITATIONS:
Limitations include a potential recall bias, which may have led to the misclassification of conversion practice experiences. Childhood factors such as rejection of one’s gender identity by their family were not considered in the analysis. The study may not have included individuals whose mental health was the most affected by conversion practices, potentially leading to a selection bias. The nonprobability sampling methods used in the PRIDE study limited the generalizability of the results.
DISCLOSURES:
The study was funded by the Gill Foundation, Dona Rockstand, and Patient-Centered Outcomes Research Institute. Several authors disclosed having financial ties, being part of advisory boards, or being employees of various organizations, including pharmaceutical companies. Details are provided in the original article.
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