Abstract
BackgroundDo 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.MethodUsing 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.ResultsThe 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.ConclusionDespite 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.
Highlights
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-Sexual orientation change efforts (SOCE), harm in addressing this question
A total of 29% of the SOCE alumni were in poverty, compared to only 18% of the non-SOCE group; and almost half (47%) of the non-SOCE group, compared to under a third (29%) of the SOCE group, had income greater than three times the poverty level
The SOCE alumni included a higher concentration of black persons and a lower concentration of women than the non-SOCE group; these differences were significant at the 0.10 critical level
Summary
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. 20 U.S states have imposed limited restrictions on SOCE, while in four states injunctions or legislation prohibit such bans (Movement Advancement Project, 2020). The American Psychological Association (APA) Task Force on the topic has expressed concern that the practice of SOCE has “become mired in ideological disputes and competing political agendas” The American Psychological Association (APA) Task Force on the topic has expressed concern that the practice of SOCE has “become mired in ideological disputes and competing political agendas” (American Psychological Association, Task Force on Appropriate Therapeutic Responses to Sexual Orientation, 2009, p. 92)
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