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People who identify as LGBTQ+ and undergo conversion practices, commonly known as conversion therapy, are more likely to have worse mental health, according to a study published in the Lancet Psychiatry journal.
The findings, based on a survey of 4,426 LGBTQ+ adults in the U.S., show that those exposed to controversial practices that target their gender identity or sexual orientation are more likely to experience depression, PTSD, suicidal thoughts, and more. This suggests that they may be more likely to experience a suicide attempt. Transgender participants reported greater mental health symptoms overall.
Conversion practices are formal, structured attempts to change a person’s sexual orientation, gender identity, or gender expression. It often includes psychological, behavioral, physical, and faith-based practices.
Cisgender and transgender people are similarly more likely to experience symptoms of depression and PTSD when looking at conversion practices that target only sexual orientation or both. Suicidal ideation and attempts were higher in cisgender participants than in transgender participants who underwent both types of suicidal behavior, but the reason for this is unclear and requires further research.
Conversion practices continue to occur in parts of the United States despite widespread opposition from professional medical and mental health organizations How often conversion practices occur in the United States remains unclear However, a significant number of LGBTQ+ people engage in this conversion practice, although previous research suggests that it may be between 4% and 34% of LGBTQ+ people who experience conversion practices. Transgender people report that they do, and the rate is higher among transgender people compared to cisgender people. It remains legal in many parts of the world, including the UK, parts of central and eastern Europe, Asia and Africa.
Previous research suggests that conversion practices are associated with mental health conditions such as depression and suicidal thoughts and attempts. To date, no studies have investigated whether efforts to change a person’s sexual orientation have different effects on mental health than efforts to change gender identity. Also, little was known about how the effects of these various practices differ between cisgender (people who identify as the gender assigned at birth) and transgender people.
“Our findings add to the growing body of evidence that proselytism practices are unethical and associated with poorer mental health outcomes. “Protecting people will require multifaceted legislation, including state and federal prohibitions. A network of additional measures such as support and targeted mental health support for survivors is also essential.” said Dr. Nguyen Tran of Stanford University School of Medicine (USA).
The authors of the new study obtained data for their analysis by surveying participants in the PRIDE study, a long-term health study of LGBTQ+ people in the United States. Participants completed a questionnaire about their experiences with conversion practices (if any) and their mental health.
Other information recorded included participants’ gender identity, sexual orientation, and gender assigned at birth. Participants also reported where they lived, education level, age, ethnic and racial identity, and details about their background (such as religious affiliation or support for LGBTQ+ people).
The authors used statistical analysis to identify associations between conversion practices and mental health conditions. Outcomes were symptoms of anxiety, depression, post-traumatic stress disorder (PTSD), and suicidal ideation or attempt, assessed using established diagnostic scales.
Most participants (92%) identified as Caucasian. There were 2,504 (57%) cisgender participants and 1,923 (43%) transgender participants. Their ages ranged from 18 to 84 years, with a mean age of 31 years.
Of the 4,426 participants, 149 (3.4%) had experienced conversion practices aimed at changing sexual orientation, 43 (1%) had experienced practices targeting gender identity, and 42 ( 1%) reported both.
Participants who received transition training that targeted both gender identity and sexual orientation had the most symptoms of depression, PTSD, and suicidal thoughts and attempts.
Some participants reported receiving more conversion training than others. These included transgender participants, people experiencing homelessness, and people with low levels of education. This behavior was also more commonly reported among people with a religious upbringing, those raised in communities that do not accept their gender identity, and participants from ethnic minority backgrounds.
Cisgender and transgender participants who underwent transition practices were similarly more likely to develop depression and PTSD. Neither had an increase in anxiety symptoms. However, cisgender participants who underwent both types of transition practices had a higher risk of suicidal ideation or attempts than transgender participants. The authors state that there are several possible explanations for the observed differences in suicide risk.
Compared to the broader transgender population, participants in the PRIDE study may be healthier and have better access to social and financial resources, and as a result, may be less likely to experience conversion behavior or have mental health problems. less likely to experience negative health effects. Transgender participants who did not voluntarily participate in the PRIDE study may have been among those most adversely affected by transition behavior and who may have worse mental health than those who participated. there is.
There is also the potential for survivorship bias among the transgender participants in the PRIDE study, with fewer transgender people living long enough to participate in the study. Longitudinal studies that follow people from youth to adulthood are needed to more clearly understand the impact of transition practices among transgender people.
Conversion practices aimed at changing an individual’s sexual orientation were most often implemented by religious leaders or organizations (52%, 100 of 191 participants), followed by mental health providers or organizations. (29%, 55 out of 191 people) followed. Practices targeting participants’ gender identity were most commonly implemented by mental health care providers or organizations (54% of participants, 46 of 85 participants), followed by religious leaders or organizations (33% of participants, 46 of 85 participants). (28 of 85 participants), followed by both (13%, of 11 participants). 85).
“Our findings demonstrate that effective policy interventions may require multifaceted legislative action at the federal, state, and local levels, including state and federal prohibitions on religious proselytism. Educational efforts involving families, religious leaders, and mental health providers are also needed to identify and support survivors of conversion practices and support networks for LGBTQ+ youth. The same goes for mental health screenings,” Tran said.
The authors acknowledge that their study has some limitations. Errors in people’s memories may have led to misclassification of some experiences of conversion practices. Some potentially important early life factors, such as family rejection of participants’ gender identity, were not considered in the analysis and should be considered in future research. This study cohort may not include those whose mental health is most affected by conversion practices. This is because doing so may delay their willingness to publicly share their identity or participate in research such as the PRIDE study.
“The key message from Tran et al.’s paper is that mainstream mental health… Health organizations need to better regulate the activities of outlier licensed clinicians who engage in diversionary behavior…Ethical guidelines for professional organizations require greater acceptance of diverse sexual orientations and genders identity that needs to reflect and integrate the changing cultural beliefs and values of the wider world.”
He further added, “Rather than developing an unwarranted and unhelpful clinical obsession with asking patients why they have the sexual orientation or gender identity they report, it would be better if such individuals were more open.” “It is clinically more useful to ask how we can help them live their lives adaptively.” Please keep in mind the medical teachings to first do no harm. ”
Further information: Global, regional and national burden of stroke and its risk factors, 1990-2021: A systematic analysis of the Global Burden of Disease Study 2021, Lancet Psychiatry (2024). DOI: 10.1016/S2215-0366(24)00251-7
Citation: Conversion practices linked to increased risk of mental health symptoms, US study of LGBTQ+ people suggests (September 30, 2024) https://medicalxpress.com/news/2024-09 Retrieved October 1, 2024 from -conversion-linked-greater- mentalhealth.html
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