Absence of Behavioral Harm Following Non-efficacious Sexual Orientation Change Efforts: A Retrospective Study of United States Sexual Minority Adults, 2016-2018

BACKGROUND

Do sexual minority persons who have undergone unsuccessful sexual orientation change efforts (SOCE) suffer subsequent psychological or social harm from the attempt? Previous studies have conflated present and past, even pre-SOCE, harm in addressing this question. This study attempts, for the first time, to isolate and examine the question of current psychosocial harm for former SOCE participants among sexual minorities in representative population data.

METHOD

Using nationally representative data (n = 1,518) across three cohorts of sexual minorities (centered in 1969, 1987, and 2003) in the United States (U.S.), persons exposed to SOCE were compared with the remainder not exposed to SOCE on two measures of internal distress-psychological distress (Kessler scale) and current mental health-and seven measures of behavioral harm: substance abuse (DUDIT); alcohol dependence (AUDIT-C); self-harm; suicide ideation; suicide planning; suicide intentions; and suicide attempts.

RESULTS

The SOCE group was statistically indistinguishable from the non-SOCE group on any measure of harm. For behavioral harm, risk ratios were 0.97-1.02. Harm was equivalent for the two groups despite the SOCE group having experienced higher lifetime and current minority stress, greater childhood adversity, and lower socioeconomic status. Logistic regression models that adjusted for these differences suggest that SOCE exposure reduced the effect of minority stress and childhood adversity for suicide attempts, although this effect did not fully account for the equivalence between the SOCE and non-SOCE groups.

CONCLUSION

Despite higher exposure to factors predicting behavioral harm-minority stress, childhood adversity, and lower socioeconomic background-sexual minority persons who had undergone failed SOCE therapy did not suffer higher psychological or social harm. Concerns to restrict or ban SOCE due to elevated harm are unfounded. Further study is needed to clarify the reasons for the absence of harm from SOCE.

Association Between Overt and Subtle Experiences of Discrimination and Violence and Mental Health in Homosexual and Bisexual Men in Mexico

The aim of this study was to determine whether the experiences of direct or subtle forms of discrimination and violence are associated with mental health in Mexican gay, homosexual, and bisexual (GHB) men. A cross-sectional survey was conducted online; the sample consisted of 4,827 GHB men. Ten forms of overt and subtle sexual orientation-based discrimination and violence (SO-DV) were assessed. Linear and logistic regression models were used to evaluate the association between SO-DV experiences and mental health outcomes. Physical violence was reported less frequently than the other forms of SO-DV. As the number of settings in which SO-DV were experienced increased, a stronger association with negative mental health outcomes was observed. Experiences of subtle SO-DV were associated with increased distress, lower vitality, and increased risk of suicidal ideation. Disapproval of gender nonconformity was associated with negative mental health outcomes independently of violence based on sexual orientation. Subtle forms of SO-DV are more common than direct and overt forms. Both types of SO-DV could negatively affect mental health. Studies investigating these negative experiences are required to gain an understanding of the health inequalities faced by non-heterosexual populations.

Sexual Orientation Change Efforts, Depressive Symptoms, and Suicidality Among Lesbian, Gay, and Bisexual Adults: A Cross-Sectional Study in South Korea

Purpose: We examined the association of sexual orientation change efforts (SOCE) with past-week depressive symptoms and past 12-month suicidal ideation and suicide attempts among Korean lesbian, gay, and bisexual adults. Methods: A cross-sectional study of 2168 participants was used. Lifetime SOCE was classified as "never experienced," "been advised but not undergone SOCE," and "undergone SOCE." Results: Participants who had undergone SOCE showed 1.44- and 2.35-times higher prevalence of suicidal ideation and suicide attempts than those without such practices. Significant associations were also observed between having advice on SOCE alone and all mental health indicators. Conclusion: Strict legal sanctions that prohibit SOCE are required in Korea.

Parent-Initiated Sexual Orientation Change Efforts With LGBT Adolescents: Implications for Young Adult Mental Health and Adjustment

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.

Lessons From Reparative Therapy Applied to Post-Abortion Grief Counseling

There is evidence from the legislative, judicial, and counseling sectors that the sun is setting on therapies designed to change sexual orientation. Despite this evidence, there is also evidence that similar pseudoscientific interventions continue to be used in at least one other area-post-abortion counseling. The key factor shared by both interventions is their dependence on unvalidated explanations of behavior. In the case of changing the expression of sexual orientation, the harm at the personal and communal levels is clear. In the case of post-abortion counseling, the harm is hypothesized, and the reasons why a communal response is lacking in the post-abortion community are described. Steps clinicians can take to alleviate the probable harm caused by the use of unvalidated/unvalidatable interventions, with a particular emphasis on identifying and expunging culturally derived and oppressive interventions currently used, are delineated as clinical and social justice activities to reduce human suffering.