Switching to Non-daily Pre-exposure Prophylaxis Among Gay and Bisexual Men in Australia: Implications for Improving Knowledge, Safety, and Uptake

Sexual Orientation Change Efforts Among LGBT+ People of Kerala: Prevalence, Correlates, and Mental Health Aspects

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.

The Pathways to Join, Engage in, and Quit Sexual Orientation Change Efforts (SOCE): A Qualitative Study of Sexual Minority Individuals who Self-Initiated SOCE in Hong Kong

Despite the growing recognition of their harmful effects, sexual orientation change efforts (SOCE) continue to be practiced in various societies. This study examines the experiences of 11 sexual minority individuals in Hong Kong who have undergone SOCE. The findings reveal the pervasive influence of deeply ingrained homonegativity values within religious, family, educational, and soiocultural contexts during LGBTQ+ individuals' formative years. These prevailing stigmas compelled them to pursue SOCE through different methods. However, these methods have been proven ineffective and psychologically harmful, leading to increased distress and internalized homonegativity. The availability of knowledge and access to affirming LGBTQ+ values within religious, community, and sociocultural spheres played a crucial role in helping the respondents come to accept their sexual orientation and cease their attempts at SOCE. This study shed light on how the interplay of Chinese familial values and Christian doctrine in Hong Kong contributes to the promotion of homonegativity, consequently restricting the diverse expressions of sexuality. It is important to recognize that the notion of individuals actively "choosing" to undergo SOCE is misguided, as these decisions are often driven by social stigma and external pressures. Progress in this area requires confronting the systemic heteronormativity embedded within Hong Kong's cultural fabric.

Contextual Influence of School-Level Gender Role Attitudes and Sexual Prejudice on Allyship, Bullying, and Internalized Homonegativity

Previous studies have primarily used an individual differences approach to identify dispositional factors associated with bullying behavior, which often neglect the broader school context in which bullying occurs. The present study used a multilevel research design to examine the contextual influence of school normative climate on allyship, bullying, and internalized homonegativity. The study included 3020 students (M = 15.83 years, SD = 1.50) from ten secondary schools in China. The results showed that school-level gender role attitudes were positively associated with bullying perpetration among heterosexual students as well as bullying victimization and internalized homonegativity among LGBQA+ students. In addition, there was a negative association between school-level sexual prejudice and allyship among heterosexual students. The findings demonstrate the contextual influence of school normative climate and highlight the need for regular school climate assessments, so that appropriate instructions, policies, and practices can be implemented to address gender biases and homophobia and the resulting bullying behavior.

Sexual Orientation and Gender Identity Change Efforts for Young People in New Zealand: Demographics, Types of Suggesters, and Associations with Mental Health

Sexual orientation and gender identity change efforts (SOGICE) are harmful practices, yet who suggests them to young people and what impacts are associated with these suggestions have received limited attention in the literature. The present study explored whether certain suggesters, and the frequency of categories of suggesters (including religious leaders, family members, and health professionals), were associated with suicidality and non-suicidal self-injury (NSSI). The study also explored whether particular demographics of young people were more likely to report SOGICE experiences. Data were collected through an online survey of New Zealand gender- and sexuality-diverse youth. The sample (n = 3948) had an age range of 14-26 (mean age = 18.96), and approximately half (52.4%) were transgender or gender-diverse. Odds of suicidality and NSSI were highest when religious leaders suggested SOGICE and when more than one type of suggester was reported. SOGICE was more likely to be reported by transgender and gender-diverse youth, statutory care- and homelessness-experienced youth, and young people reporting current material deprivation. Implications for targeted mental health services and education for young people and the community are discussed.

The Influence of Concerns About a Child's Sexual Orientation on Mental Health Among Parents of Lesbian, Gay, and Bisexual Children in Hong Kong

Sexual minority stress affects not only lesbian, gay, and bisexual (LGB) individuals, but also their families. Due to the pervasiveness of stigma and discrimination, parents of LGB children often express concerns about the public perception of their child's sexual orientation and its possible impact on children, parents, and families. The concerns are particularly pertinent to parents in Chinese families, where there is a strong bond between parents and children. The present study seeks to understand the different dimensions of concerns among Chinese parents of LGB children and examine how these concerns affect their mental health. A total of 146 parents of LGB children in Hong Kong were recruited to participate in a survey regarding attitudes and concerns about their child's sexual orientation. The results revealed three areas of concern, which reflect parental worries about how a child's LGB identity may negatively impact the child, parent, and family. Parents who viewed homosexuality and bisexuality as innate and accepted their child's sexual orientation were likely to show fewer concerns. The results of structural equation modeling indicated that parental acceptance was negatively related to depression and anxiety symptoms through lower levels of child-oriented and family-oriented concerns. As accepting a child's sexual orientation is the key to reducing parental concerns and mental health problems, family-focused psychoeducation is needed to provide parents with accurate information about sexual orientation and foster supportive attitudes toward their LGB child. Clinicians and human service providers should also address child-oriented and family-oriented concerns among parents of LGB adolescents who are more inclined to be concerned about their child's sexual orientation.