September 16, 2019
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Gender identity conversion linked to psychological distress, suicide attempts

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Lifetime and childhood exposure to gender identity conversion efforts were linked to adverse mental health outcomes among transgender adults, including severe psychological distress, suicidal ideation and suicide attempts, according to study findings.

“Several U.S. states have passed legislation banning conversion therapy for gender identity. Professional organizations including the [AMA], the American Psychiatric Association, the American Academy of Child & Adolescent Psychiatry, and the [AAP] have labeled the practice unethical and ineffective,” Jack L. Turban, MD, MHS, from the division of child and adolescent psychiatry, Massachusetts General Hospital, and colleagues wrote. “Despite these policy statements, however, the question of whether to ban gender identity conversion therapy remains a contentious policy debate.”

In a cross-sectional study, researchers examined survey data from U.S. transgender adults to determine the associations between recalled exposure to gender identity conversion efforts by a secular/religious professional, and mental health outcomes in adulthood. They measured participants’ severe psychological distress in the prior month via the Kessler Psychological Distress Scale as well as suicidality in the prior year and lifetime.

Of 27,715 transgender survey respondents, 14% reported lifetime exposure to gender identity conversion efforts (GICE). Of 19,741 respondents who had spoken to a professional about their gender identity, 3,869 (19.6%) reported lifetime exposure to gender identity conversion efforts. Also, 206 participants who reported discussing their gender identity with a professional were exposed to conversion efforts before age 10 years.

Compared with those not exposed to gender identity conversion efforts, Turban and colleagues reported that lifetime exposure was tied to severe psychological distress during the previous month among transgender adults (adjusted OR = 1.56; 95% CI, 1.09-2.24). Participants with gender identity conversion effort exposure were also more likely to report lifetime suicide attempts (aOR = 2.27; 95% CI, 1.6-3.24), even when they were exposed before age 10 years (aOR = 4.15; 95% CI, 2.44-7.69).

“Results from this study support past positions taken by leading professional organizations that GICE should be avoided with children and adults,” Turban and colleagues wrote. “Further research is needed to better understand the associations between stage of development at time of exposure to GICE and risk of lifetime suicide attempts.” – by Savannah Demko

Disclosure: Turban reports royalties from Springer. No other author reports relevant financial disclosures.