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Hoskin JM, Erekson DM, June H, Parker A, McMurray M, Hannan CR, Spjut K, Merrill B, Davis B, Ross M, Jorgensen A, Papenfuss K, Damm A, Goates-Jones M. "I Just Want to be Acknowledged": Suicidal Ideation Experiences among Sexual Minority Students at a Religiously Affiliated University. JOURNAL OF HOMOSEXUALITY 2024; 71:2217-2242. [PMID: 37405701 DOI: 10.1080/00918369.2023.2230603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Research finds that sexual minority university students experience considerable psychological and emotional distress. Furthermore, a recent study at Brigham Young University (BYU)-a university affiliated with The Church of Jesus Christ of Latter-day Saints-found that suicidality prevalence and severity were twice as high among sexual minority students compared to their heterosexual peers. To better understand this finding, we interviewed ten sexual minority students at BYU who reported clinically significant current or previous suicidality. A coding team and auditors then analyzed and categorized the transcripts of these interviews using the Consensual Qualitative Research methodology. Five domains emerged related to suicidality among sexual minority students: deterrents from suicidal ideation and intent; contributors to suicidal ideation and intent; religious and spiritual experiences; experiences with BYU; and suggested improvements. We found patterns consistent with previous literature, including relational and belonging factors contributing to suicidality; we also found that certain doctrinal interpretations were related to increased suicidality. The primary improvement requested by participants was feeling better understood and accepted (rather than ignored or marginalized). We discuss study limitations (including small sample size and low generalizability,), future directions for research, and implications for religious university campuses.
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Affiliation(s)
- Jason M Hoskin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David M Erekson
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Haylie June
- Department of Sociology, Brigham Young University, Provo, Utah, USA
| | - Audrey Parker
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Matthew McMurray
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Corinne R Hannan
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Kersti Spjut
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Brett Merrill
- Counseling and Psychological Services, Brigham Young University, Provo, Utah, USA
| | - Brad Davis
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - McKay Ross
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Anna Jorgensen
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Kyrie Papenfuss
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Annie Damm
- Department of Psychology, Brigham Young University, Provo, Utah, USA
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2
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Yeung JCY, Chan RCH, Wong DCK, Yiu JHC. 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. JOURNAL OF HOMOSEXUALITY 2023:1-28. [PMID: 37976201 DOI: 10.1080/00918369.2023.2279574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
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.
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Affiliation(s)
| | - Randolph C H Chan
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong
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3
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Lefevor GT, Etengoff C, Davis EB, Skidmore SJ, Rodriguez EM, McGraw JS, Rostosky SS. Religion/Spirituality, Stress, and Resilience Among Sexual and Gender Minorities: The Religious/Spiritual Stress and Resilience Model. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1537-1561. [PMID: 37369080 DOI: 10.1177/17456916231179137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Although many sexual and gender minorities (SGMs) consider themselves religious or spiritual, the impact of this religiousness or spirituality (RS) on their health is poorly understood. We introduce the religious/spiritual stress and resilience model (RSSR) to provide a robust framework for understanding the variegated ways that RS influences the health of SGMs. The RSSR bridges existing theorizing on minority stress, structural stigma, and RS-health pathways to articulate the circumstances under which SGMs likely experience RS as health promoting or health damaging. The RSSR makes five key propositions: (a) Minority stress and resilience processes influence health; (b) RS influences general resilience processes; (c) RS influences minority-specific stress and resilience processes; (d) these relationships are moderated by a number of variables uniquely relevant to RS among SGMs, such as congregational stances on same-sex sexual behavior and gender expression or an individual's degree of SGM and RS identity integration; and (e) relationships between minority stress and resilience, RS, and health are bidirectional. In this manuscript, we describe the empirical basis for each of the five propositions focusing on research examining the relationship between RS and health among SGMs. We conclude by describing how the RSSR may inform future research on RS and health among SGMs.
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Affiliation(s)
| | | | - Edward B Davis
- School of Psychology, Counseling, and Family Therapy, Wheaton College
| | | | - Eric M Rodriguez
- Social Science Department, New York City College of Technology, City University of New York
| | - James S McGraw
- Department of Psychology, Bowling Green State University
| | - Sharon S Rostosky
- Department of Educational, School, and Counseling Psychology, University of Kentucky
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4
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Blosnich JR, Coulter RWS, Henderson ER, Goldbach JT, Meyer IH. Correcting a False Research Narrative: A Commentary on Sullins (2022). ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:885-888. [PMID: 36602658 DOI: 10.1007/s10508-022-02521-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Affiliation(s)
- John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34Th St, Los Angeles, CA, 90089, USA.
| | - Robert W S Coulter
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Emmett R Henderson
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34Th St, Los Angeles, CA, 90089, USA
| | - Jeremy T Goldbach
- Brown School, Washington University of St. Louis, St. Louis, MO, USA
| | - Ilan H Meyer
- The Williams Institute at UCLA School of Law, Los Angeles, CA, USA
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5
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Sullins DP. Critiques Strengthen and Improve the Original Findings: Rejoinder to Commentaries on Sullins (2022b). ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:889-899. [PMID: 36864320 DOI: 10.1007/s10508-023-02566-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/19/2023]
Affiliation(s)
- D Paul Sullins
- Department of Sociology, The Catholic University of America, 620 Michigan Ave., NE, Washington, DC, 20064, USA.
- The Ruth Institute, Lake Charles, LA, 70601, USA.
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“We Need to State it Overtly”: MFT’s Rationales for Labeling SOCE and GICE as Unethical in the Code of Ethic. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-022-09649-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sullins DP. Sexual Orientation Change Efforts Do Not Increase Suicide: Correcting a False Research Narrative. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3377-3393. [PMID: 36066677 DOI: 10.1007/s10508-022-02408-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 05/25/2023]
Abstract
Sexual orientation change efforts (SOCEs) signify activities designed to change or reduce homosexual orientation. Recent studies have claimed that such therapies increase suicide risk by showing positive associations between SOCE and lifetime suicidality, without excluding behavior that pre-dated SOCE. In this way, Blosnich et al.'s (2020) recent analysis of a national probability sample of 1518 sexual minority persons concluded that SOCE "may compound or create…suicidal ideation and suicide attempts" but after correcting for pre-existing suicidality, SOCE was not positively associated with any form of suicidality. For suicidal ideation, Blosnich et al. reported an adjusted odds ratio (AOR) of 1.92 (95% CI 1.01-3.64); the corrected AOR was .44 (.20-.94). For suicide planning, Blosnich et al.'s AOR was 1.75 (1.01-3.06); corrected was .60 (.32-1.14). For suicide attempts, Blosnich et al.'s AOR was 1.75 (.99-3.08); corrected was .74 (.36-1.43). Undergoing SOCE after expressing suicidal behavior reduced subsequent suicide attempts from 72 to 80%, compared to those not undergoing SOCE, when SOCE followed a prior expression of suicidal ideation (AOR .17, .05-.55), planning (AOR .13, .04-.45) or intention (AOR .10, .03-.30); however, SOCE following an initial suicide attempt did not significantly reduce further attempts. By violating the principle that a cause cannot occur after an effect, Blosnich et al. misstated the correct conclusion. Experiencing SOCE does not result in higher suicidality, as they claim, and may sharply reduce subsequent suicide attempts. Restrictions on SOCE will not reduce suicidal risk among sexual minorities and may deprive them of an important resource for reducing suicide attempts.
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Affiliation(s)
- D Paul Sullins
- Department of Sociology, The Catholic University of America, Washington, DC, 20064, USA.
- Ruth Institute, Lake Charles, LA, USA.
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8
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Heiden-Rootes K, McGeorge CR, Salas J, Levine S. The effects of gender identity change efforts on Black, Latinx, and White transgender and gender nonbinary adults: Implications for ethical clinical practice. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:927-944. [PMID: 34866204 DOI: 10.1111/jmft.12575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/11/2021] [Accepted: 11/16/2021] [Indexed: 06/13/2023]
Abstract
Gender identity change efforts (GICE) and sexual orientation change efforts (SOCE) continue to be practiced by mental health professionals and religious organizations. It is frequently sought out by families who are rejecting loved ones with marginalized sexual orientations and gender identities. This study explored the impact of religious and nonreligious GICE on the mental health of transgender and nonbinary adults through a secondary data analysis of the U.S. Transgender Survey. Results found that both nonreligious and religious GICE were associated with increased odds of suicidal ideation and attempts. Only nonreligious GICE was associated with severe psychological distress. Black individuals showed increased odds of binge alcohol consumption when exposed to nonreligious change efforts, while White individuals showed decreased odds with both nonreligious and religious GICE. This study supports ethical and legal bans on GICE.
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Affiliation(s)
- Katie Heiden-Rootes
- Department of Family and Community Medicine, Medical Family Therapy Program, Saint Louis University, St. Louis, Missouri, USA
| | - Christi R McGeorge
- Department of Human Development and Family Science, North Dakota State University, Fargo, North Dakota, USA
| | - Joanne Salas
- Research Division, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Samantha Levine
- Medical Education, School of Medicine, Saint Louis University, St. Louis, Missouri, USA
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9
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Philpot SP, Murphy D, Chan C, Haire B, Fraser D, Grulich AE, Bavinton BR. Switching to Non-daily Pre-exposure Prophylaxis Among Gay and Bisexual Men in Australia: Implications for Improving Knowledge, Safety, and Uptake. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:1979-1988. [PMID: 35730059 DOI: 10.1007/s13178-021-00669-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Preexposure prophylaxis (PrEP) dosing options such as event-driven PrEP hold promise to increase PrEP uptake among gay, bisexual, and queer men (GBQM), but their impacts have not yet been realized and uptake by GBQM suitable for PrEP remains slow in countries where it is only considered an alternative option to daily PrEP. METHODS We conducted semi-structured interviews between June 2020 and February 2021 with 40 GBQM in Australia to understand PrEP dosing behaviors, knowledge, and preferences. RESULTS All participants commenced PrEP daily; 35% had ever switched to non-daily PrEP, mostly taking it event-driven. GBQM who preferred non-daily PrEP had infrequent or predictable sex, were concerned about cost given infrequency of sex, and/or wanted to minimize unnecessary drug exposure. Accurate knowledge of event-driven PrEP was poor. However, reflecting concepts underpinning critical pedagogy, having accurate knowledge was supported by access to consistent messaging across clinical, social, community, and public settings. Several participants who switched to event-driven PrEP had condomless sex events in which they were unable to adhere to pills due to unanticipated sex. CONCLUSIONS AND POLICY IMPLICATIONS Implementation of comprehensive and consistent education about correct dosing for event-driven PrEP across multiple settings is needed to ensure increased uptake and safe use. GBQM require messaging about non-condom based HIV prevention strategies when they cannot access daily or event-driven PrEP.
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Affiliation(s)
| | - Dean Murphy
- The Kirby Institute, UNSW, Sydney, Australia
| | - Curtis Chan
- The Kirby Institute, UNSW, Sydney, Australia
| | | | - Doug Fraser
- The Kirby Institute, UNSW, Sydney, Australia
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10
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Sexual Complexity: A Comparison between Men and Women in a Sexual Minority Sample of Members of the Church of Jesus Christ of Latter-day Saints. RELIGIONS 2022. [DOI: 10.3390/rel13060561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report here some of the results from an online survey of 1612 LGBTQ members and former members of the Church of Jesus Christ of Latter-day Saints (CJCLDS, Mormon). The data permitted an exploration of diversity—individual similarities and differences within and between the sexes. Men and women were compared with respect to sexual identity self-labeling and behavior (i.e., identity development, disclosure, activity), orientation change efforts, marital relationships, and psychosocial health—these variables in the context of their religious lives. More women than men self-identified in the bisexual range of the sexual attraction continuum. Both men and women had engaged in extensive effort to change their sexual orientation. Only about 4% of the respondents claimed that those efforts had been successful, and the claims were for outcomes other than an alteration in erotic feeling. In general, only those who identified as bisexual reported success in maintaining a mixed-orientation marriage and continuing activity in the church. For both men and women, measures of psychosocial and sexual health were higher for those in same-sex relationships and those disaffiliated from the church.
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11
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Forsythe A, Pick C, Tremblay G, Malaviya S, Green A, Sandman K. Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States. JAMA Pediatr 2022; 176:493-501. [PMID: 35254391 PMCID: PMC8902682 DOI: 10.1001/jamapediatrics.2022.0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Sexual orientation and gender identity change efforts (SOGICE), also called conversion therapy, is a discredited practice attempting to convert lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals to be heterosexual and/or cisgender. OBJECTIVES To identify and synthesize evidence on the humanistic and economic consequences of SOGICE among LGBTQ youths in the US. DESIGN, SETTING, AND PARTICIPANTS This study, conducted from December 1, 2020, to February 15, 2021, included a systematic literature review and economic evaluation. The literature review analyzed published evidence on SOGICE among LGBTQ individuals of any age. The economic model evaluated the use of SOGICE vs no intervention, affirmative therapy vs no intervention, and affirmative therapy vs SOGICE to estimate the costs and adverse outcomes for each scenario and to assess the overall US economic burden of SOGICE. Published literature and public sources were used to estimate the number of LGBTQ youths exposed to SOGICE, the types of therapy received, and the associated adverse events (anxiety, severe psychological distress, depression, alcohol or substance abuse, suicide attempts, and fatalities). EXPOSURES SOGICE (licensed or religion-based practitioners) or affirmative therapy (licensed practitioners). MAIN OUTCOMES AND MEASURES Total incremental costs and quality-adjusted life-years (QALYs) vs no intervention and total economic burden of SOGICE. RESULTS Among 28 published studies, which included 190 695 LGBTQ individuals, 12% (range, 7%-23%) of youths experienced SOGICE, initiated at a mean age of 25 years (range, 5-58 years), with a mean (SD) duration of 26 (29) months. At least 2 types of SOGICE were administered to 43% of recipients. Relative to LGBTQ individuals who did not undergo SOGICE, recipients experienced serious psychological distress (47% vs 34%), depression (65% vs 27%), substance abuse (67% vs 50%), and attempted suicide (58% vs 39%). In the economic analysis, over a lifetime horizon with a 3% annual discount rate, the base-case model estimated additional $97 985 lifetime costs per individual, with SOGICE associated with 1.61 QALYs lost vs no intervention; affirmative therapy yielded cost savings of $40 329 with 0.93 QALYs gained vs no intervention. With an estimated 508 892 youths at risk for SOGICE in 2021, the total annual cost of SOGICE is estimated at $650.16 million (2021 US dollars), with associated harms totaling an economic burden of $9.23 billion. CONCLUSIONS AND RELEVANCE This economic evaluation study suggests that there is a high economic burden and high societal costs associated with SOGICE and identifies additional research questions regarding the roles of private and public funding in supporting this harmful practice.
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Affiliation(s)
| | - Casey Pick
- The Trevor Project, West Hollywood, California
| | | | | | - Amy Green
- The Trevor Project, West Hollywood, California
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12
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Higbee M, Wright ER, Roemerman RM. Conversion Therapy in the Southern United States: Prevalence and Experiences of the Survivors. JOURNAL OF HOMOSEXUALITY 2022; 69:612-631. [PMID: 33206024 DOI: 10.1080/00918369.2020.1840213] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Numerous studies have determined that conversion therapy, a practice meant to change one's sexual orientation to heterosexual or gender identity to cisgender, can be ineffective and severely harmful. However, few studies have documented the prevalence or characteristics of its survivors. This study is a quantitative analysis of the LGBTQ Institute Southern Survey that estimates the prevalence of conversion therapy (specifically SOCE) in the Southern United States and documents its significant association with negative mental health outcomes. Conversion therapy survivors comprised 7.6% of the sample (11.6% after listwise deletion). Respondents who were younger and reported being a gender minority; lesbian, gay, or some other sexual orientation; Hispanic; less educated; and less religious were more likely to have experienced it. Findings support previous studies which report a strong correlation between conversion therapy and poor mental health outcomes. Results regarding the prevalence and demographics of survivors offer new insights for further research.
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Affiliation(s)
- Madison Higbee
- Sociology, Georgia State University, Atlanta, Georgia, USA
| | - Eric R Wright
- Sociology, Georgia State University, Atlanta, Georgia, USA
| | - Ryan M Roemerman
- Communication Studies, University of Iowa, LGBTQ Institute, National Center for Civil and Human Rights, Atlanta, Georgia, USA
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13
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Li H, Fernández-Guasti A, Xu Y, Swaab D. Retracted: Sexual orientation, neuropsychiatric disorders and the neurotransmitters involved. Neurosci Biobehav Rev 2021; 131:479-488. [PMID: 34597715 DOI: 10.1016/j.neubiorev.2021.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/17/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor in Chief of Neuroscience and Biobehavioral Reviews after concerns were raised with respect to the phrasing of comparisons drawn between humans and animal models. These comparisons were deemed unsupportable, and thus in the best interests of publication standards the Editor has concluded it is necessary to retract the paper. The authors disagree with the reason for the retraction.
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Affiliation(s)
- Haimei Li
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, PR China; Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, Amsterdam, 1105 BA, the Netherlands
| | | | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, PR China; The Key Laboratory of Mental Disorder Management in Zhejiang Province, Hangzhou, 310003, PR China; Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, 310003, PR China; Brain Research Institute of Zhejiang University, Hangzhou, 31003, PR China.
| | - Dick Swaab
- Department of Neuropsychiatric Disorders, Netherlands Institute for Neuroscience, Amsterdam, 1105 BA, the Netherlands.
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McGeorge CR, Coburn KO, Walsdorf AA. Christian Mainline Protestant Pastors' Beliefs About the Practice of Conversion Therapy: Reflections for Family Therapists. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:698-712. [PMID: 32761630 DOI: 10.1111/jmft.12447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Efforts to change the sexual orientation of lesbian, gay, and bisexual (LGB) individuals to heterosexual are referred to as conversion therapy. Given the religious groundings that support the practice of conversion therapy, we sought to explore the beliefs of Christian religious leaders about this practice and what they want family therapists to know about the practice of conversion therapy. Twenty-one pastors from diverse Mainline Christian Protestant traditions were interviewed. Queer theory-informed thematic analysis revealed four themes that reflect the participants' perspectives on conversion therapy: (a) Conversion Therapy Is an Abomination, (b) Conversion Therapy Is Similar to Other Abusive Practices, (c) Conversion Therapy Represents A Misuse of Religion, and (d) Ethical Concerns About Therapists Who Practice Conversion Therapy. Implications of this study include a need for self-of-the-therapist work to address religious biases and heteronormative assumptions in order to examine beliefs that support practicing conversion therapy.
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15
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Meanley S, Haberlen SA, Okafor CN, Brown A, Brennan-Ing M, Ware D, Egan JE, Teplin LA, Bolan RK, Friedman MR, Plankey MW. Lifetime Exposure to Conversion Therapy and Psychosocial Health Among Midlife and Older Adult Men Who Have Sex With Men. THE GERONTOLOGIST 2021; 60:1291-1302. [PMID: 32556123 DOI: 10.1093/geront/gnaa069] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Conversion therapies to minimize same-sex attractions are classified as a dangerous practice by numerous scientific institutions in the United States. These practices may contribute to poor long-term psychosocial health, thereby interrupting processes of healthy aging. Few studies have examined psychosocial differences between persons with and without prior experiences of conversion therapy. We assessed associations between prior conversion therapy experiences and psychosocial health among midlife and older men who have sex with men (MSM; age 40+ years). RESEARCH DESIGN AND METHODS Participants included a multicity sample of MSM (N = 1,156) enrolled in the Multicenter AIDS Cohort Study who completed health surveys (2016-2019) as part of their biannual study visits. Using multivariable regressions, we investigated the associations of prior conversion therapy with current depressive symptoms, internalized homophobia, post-traumatic stress, and cumulative psychosocial conditions. Using a trait-level measure (e.g., life purpose and perseverance), we tested whether resilience moderated these associations. RESULTS The full sample was predominantly non-Hispanic white with a mean age of 62.6 years. Fifteen percent of men (n = 171/1,156) reported prior conversion therapy. In multivariable models, men exposed to conversion therapy were more likely to have depressive symptoms and above-average internalized homophobia. Men exposed to conversion therapy had 2-2.5 times the odds of reporting 1 and ≥2 psychosocial conditions, respectively, compared with those who reported 0 conditions. Resilience did not moderate these associations. DISCUSSION AND IMPLICATIONS Conversion therapies are nonaffirming social stressors for MSM and may compromise critical psychosocial aspects of healthy aging among MSM.
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Affiliation(s)
- Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia.,Research Education Institute for Diverse Scholars, Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut
| | - Sabina A Haberlen
- Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Chukwuemeka N Okafor
- Department of Public Health, Baylor University Robbins College of Health and Human Services, Waco, Texas
| | - Andre Brown
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, New York City, New York
| | - Deanna Ware
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia
| | - James E Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Linda A Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Mackey R Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania
| | - Michael W Plankey
- Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia
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16
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Sullins DP, Rosik CH, Santero P. Efficacy and risk of sexual orientation change efforts: a retrospective analysis of 125 exposed men. F1000Res 2021; 10:222. [PMID: 33968367 PMCID: PMC8080940 DOI: 10.12688/f1000research.51209.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Voluntary therapeutic interventions to reduce unwanted same-sex sexuality are collectively known as sexual orientation change efforts (SOCE). Currently almost all evidence addressing the contested question whether SOCE is effective or safe consists of anecdotes or very small sample qualitative studies of persons who currently identify as sexual minority and thus by definition failed to change. We conducted this study to examine the efficacy and risk outcomes for a group of SOCE participants unbiased by current sexual orientation. Methods: We examined a convenience sample of 125 men who had undergone SOCE for homosexual-to-heterosexual change in sexual attraction, identity and behavior, and for positive and negative changes in psychosocial problem domains (depression, suicidality, self-harm, self-esteem, social function, and alcohol or substance abuse). Mean change was assessed by parametric (t-test) and nonparametric (Wilcoxon sign rank test) significance tests. Results: Exposure to SOCE was associated with significant declines in same-sex attraction (from 5.7 to 4.1 on the Kinsey scale, p <.000), identification (4.8 to 3.6, p < .000), and sexual activity (2.4 to 1.5 on a 4-point scale of frequency, p < .000). From 45% to 69% of SOCE participants achieved at least partial remission of unwanted same-sex sexuality; full remission was achieved by 14% for sexual attraction and identification, and 26% for sexual behavior. Rates were higher among married men, but 4-10% of participants experienced increased same-sex orientation after SOCE. From 0.8% to 4.8% of participants reported marked or severe negative psychosocial change following SOCE, but 12.1% to 61.3% reported marked or severe positive psychosocial change. Net change was significantly positive for all problem domains. Conclusion: SOCE was perceived as an effective and safe therapeutic practice by this sample of participants. We close by offering a unifying understanding of discrepant findings within this literature and caution against broad generalizations of our results.
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Affiliation(s)
- D. Paul Sullins
- Department of Sociology, The Catholic University of America, Washington, DC, 20064, USA
- The Ruth Institute, Lake Charles, Louisiana, 70605, USA
| | - Christopher H. Rosik
- Department of Psychology, Fresno Pacific University, Fresno, CA, 93702, USA
- Link Care Center, Fresno, CA, 93711, USA
| | - Paul Santero
- Southern California Seminary, El Cajon, CA, 92019, USA
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Sullins DP, Rosik CH, Santero P. Efficacy and risk of sexual orientation change efforts: a retrospective analysis of 125 exposed men. F1000Res 2021; 10:222. [PMID: 33968367 PMCID: PMC8080940 DOI: 10.12688/f1000research.51209.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Voluntary therapeutic interventions to reduce unwanted same-sex sexuality are collectively known as sexual orientation change efforts (SOCE). To date almost all evidence addressing the contested question whether SOCE is effective or safe has consisted of anecdotes or very small sample qualitative studies of persons who currently identify as sexual minority and thus by definition failed to change. We conducted this study to examine the efficacy and risk outcomes for a group of SOCE participants unbiased by current sexual orientation. Methods: We examined a convenience sample of 125 men who had undergone SOCE for homosexual-to-heterosexual change in sexual attraction, identity and behavior, and for positive and negative changes in psychosocial problem domains (depression, suicidality, self-harm, self-esteem, social function, and alcohol or substance abuse). Mean change was assessed by parametric (t-test) and nonparametric (Wilcoxon sign rank test) significance tests. Results: Exposure to SOCE was associated with significant declines in same-sex attraction (from 5.7 to 4.1 on the Kinsey scale, p <.000), identification (4.8 to 3.6, p < .000), and sexual activity (2.4 to 1.5 on a 4-point scale of frequency, p < .000). Over 42.7% of SOCE participants achieved at least partial remission of unwanted same-sex sexuality; full remission was achieved by 14% for sexual attraction and identification, and 26% for sexual behavior. Rates were higher among married men, but 4-10% of participants experienced increased same-sex orientation after SOCE. From 0.8% to 4.8% of participants reported marked or severe negative psychosocial change following SOCE, but 12.1% to 61.3% reported marked or severe positive psychosocial change. Net change was significantly positive for all problem domains. Conclusion: SOCE was perceived as an effective and safe therapeutic practice by this sample of participants. We close by offering a unifying understanding of discrepant findings within this literature and caution against broad generalizations of our results.
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Affiliation(s)
- D. Paul Sullins
- Department of Sociology, The Catholic University of America, Washington, DC, 20064, USA
- The Ruth Institute, Lake Charles, Louisiana, 70605, USA
| | - Christopher H. Rosik
- Department of Psychology, Fresno Pacific University, Fresno, CA, 93702, USA
- Link Care Center, Fresno, CA, 93711, USA
| | - Paul Santero
- Southern California Seminary, El Cajon, CA, 92019, USA
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Przeworski A, Peterson E, Piedra A. A systematic review of the efficacy, harmful effects, and ethical issues related to sexual orientation change efforts. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2021. [DOI: 10.1111/cpsp.12377] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Heiden-Rootes K, Ross K, Moore R, Hasan S, Gulotta S. Freedom and struggling openly in psychotherapy: A qualitative inquiry with LGBQ young adults from religious families. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:150-165. [PMID: 32652676 DOI: 10.1111/jmft.12442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Lesbian, gay, bisexual, and queer (LGBQ) young people from religious families are at increased risk of family rejection, poor mental health outcomes, and are overrepresented in mental health services. This article describes a two-part qualitative study aimed at exploring the experiences of LGBQ young adults from religious families in psychotherapy, identifying positive and negative psychotherapy experiences, and understanding the influence of family and religion on the psychotherapy experience. Data were collected through a web-based survey (n = 77) and interviews (n = 7) with LGBQ young adults (ages 18-25) from religious families. The study followed an interpretative phenomenological approach. Integrated results found often invisible, relational therapy processes, and religious discourses as significant to LGBQ young people who seek psychotherapy. Implications for future research, effective systemic family therapy practices with LGBQ young people from religious families, and a critique on ethical and legal limits of confidentiality with policy implications are outlined.
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Meanley SP, Stall RD, Dakwar O, Egan JE, Friedman MR, Haberlen SA, Okafor C, Teplin LA, Plankey MW. Characterizing Experiences of Conversion Therapy Among Middle-Aged and Older Men Who Have Sex with Men from the Multicenter AIDS Cohort Study (MACS). SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2020; 17:334-342. [PMID: 33281996 PMCID: PMC7717625 DOI: 10.1007/s13178-019-00396-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
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 United States. 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 1,237 middle-aged and older 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 impose on MSM's health across the life course as well as test potential, indirect associations that may link these practices to HIV.
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Affiliation(s)
- Steven P. Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Ron D. Stall
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Omar Dakwar
- Division of Infectious Diseases, Georgetown University Department of Medicine, Washington, District of Columbia
| | - James E. Egan
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Mackey R. Friedman
- Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Sabina A. Haberlen
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Chukwuemeka Okafor
- Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles, CA
| | - Linda A. Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael W. Plankey
- Division of Infectious Diseases, Georgetown University Department of Medicine, Washington, District of Columbia
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Parmenter JG, Crowell KA, Galliher RV. Subjective Importance of Masculinity as a Factor in Understanding Risky Sexual Attitudes and Behaviors among Sexual Minority Men. SEX ROLES 2019. [DOI: 10.1007/s11199-019-01067-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cernovsky Z, Bureau Y. Lady with Erotic Preference for Diapers. Ment Illn 2016; 8:6687. [PMID: 27994834 PMCID: PMC5136749 DOI: 10.4081/mi.2016.6687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 08/26/2016] [Accepted: 08/26/2016] [Indexed: 12/02/2022] Open
Abstract
A patient in her 20s was referred to us for psychological assessment due to her depression and suicide attempts. She mentioned being anorgasmic except when diapered and emphasized her erotic preference for diapers. Her childhood included maternal deprivation in an impecunious family headed by an irritable physically disabled father on social assistance. Given the maternal deprivation in childhood, her erotic fixation on diapers parallels the emotional attachment to diapers observed by Harlow in mother deprived infant monkeys. Etiological hypotheses should also include the paradigm of avoidance learning from theories of behavior therapy. Our patient does not wish to change her sexual preference: in such cases, fetishism is not considered as an illness by DSM5. However, she needs to be treated for pathological levels of depression with suicidal ideation and low self-esteem.
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Affiliation(s)
- Zack Cernovsky
- Department of Psychiatry, University of Western Ontario , London, Canada
| | - Yves Bureau
- Departments of Psychology and Medical Biophysics, University of Western Ontario , London, Canada
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Diamond LM, Rosky CJ. Scrutinizing Immutability: Research on Sexual Orientation and U.S. Legal Advocacy for Sexual Minorities. JOURNAL OF SEX RESEARCH 2016; 53:363-91. [PMID: 26986464 DOI: 10.1080/00224499.2016.1139665] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
We review scientific research and legal authorities to argue that the immutability of sexual orientation should no longer be invoked as a foundation for the rights of individuals with same-sex attractions and relationships (i.e., sexual minorities). On the basis of scientific research as well as U.S. legal rulings regarding lesbian, gay, and bisexual (LGB) rights, we make three claims: First, arguments based on the immutability of sexual orientation are unscientific, given what we now know from longitudinal, population-based studies of naturally occurring changes in the same-sex attractions of some individuals over time. Second, arguments based on the immutability of sexual orientation are unnecessary, in light of U.S. legal decisions in which courts have used grounds other than immutability to protect the rights of sexual minorities. Third, arguments about the immutability of sexual orientation are unjust, because they imply that same-sex attractions are inferior to other-sex attractions, and because they privilege sexual minorities who experience their sexuality as fixed over those who experience their sexuality as fluid. We conclude that the legal rights of individuals with same-sex attractions and relationships should not be framed as if they depend on a certain pattern of scientific findings regarding sexual orientation.
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Dehlin JP, Galliher RV, Bradshaw WS, Crowell KA. Navigating Sexual and Religious Identity Conflict: A Mormon Perspective. IDENTITY-AN INTERNATIONAL JOURNAL OF THEORY AND RESEARCH 2015. [DOI: 10.1080/15283488.2014.989440] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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