Sexual Orientation Research Articles

Who Gets Denied Telework in the U.S. Federal Service?

Discretionary rewards can motivate employees but increase social inequity. Before the COVID-19 pandemic, when supervisors had substantial discretion over whether and how frequently U.S. federal employees teleworked, those who did so several times a week liked most aspects of their jobs more than those who teleworked less, especially those who were denied telework. Though telework became a necessity rather than a reward during the pandemic, supervisor discretion is increasing during the return-to-the-office period, making unequal access to telework a potential site of social inequity. Using logit analysis on the Federal Employee Viewpoint Survey (FEVS) before and during the pandemic, we examine how race, sex, disability status, and sexual orientation affected who was denied telework and how job characteristics affected those decisions. Black, Latino, and younger employees and employees with disabilities were more likely to have telework requests turned down; differences by gender and sexual orientation barely existed.

What Sexual Orientation Change Efforts Change: Evidence From a United States Sample of 72 Exposed Men.

Voluntary non-coercive therapeutic interventions for adults arecollectively known assexual orientation change efforts (SOCE).Research on SOCE has reported global or average sexual orientation change, but not in more detail. This study addresses two questions: Does change consist primarily of reduced homosexual orientation or increased heterosexual orientation?Does change consist primarily of change in behavior or change in attraction? Method:Aconvenience sample of 72 men who had completed SOCEwas examined for the decrease in homosexual attraction, increase in heterosexual attraction, and corresponding changes in sexual behavior among those experiencing a homosexual-to-heterosexual shift.All measures were self-reported. Participants reported extremely high religiosity. A third (32%, N=23) reported a shift from general homosexual attraction (score of 4-6) to general heterosexual attraction (score of 0-2) on the Kinsey scale, which ranges from "exclusively heterosexual" (0) to "exclusively homosexual" (6). Among these, effect sizes (Cohen's d) for sexual fantasy and desire for romantic intimacy were larger for homosexual reduction (fantasy: -2.3, desire: -1.5) than for heterosexual increase (fantasy: +1.8, desire: + 1.0). Effect sizes for sexual behaviors, measured by kissing and sex relations, dropped the largest possible amount for homosexual behavior (kissing: -1.0, sex: -1.5, both statistically significant at p<0.004) while there was little to no increase in heterosexual behavior (kissing: +0.36, sex +0.38, both statistically non-significant at p>0.13). Change consisted primarily of reduced homosexual orientation and change in behavior was much stronger than change in attraction.SOCE supported conformity to strong religious norms against homosexual behavior, but not attractions, for this group of extremely religious men.Implications for understanding SOCE-related sexual orientation change are discussed.

Inequities in Self-Reported Social Risk Factors by Sexual Orientation and Gender Identity

Sexual minority (ie, people who self-identify as gay, lesbian, bisexual, and other nonheterosexual identities) and gender minority (ie, people who self-identify as transgender, nonbinary, or other noncisgender identities) adults report worse health outcomes compared with heterosexual and cisgender adults, respectively. Although social risk factors (SRFs; eg, housing instability) are associated with health outcomes, little is known about the prevalence of SRFs among sexual and gender minority adults. To examine differences in the prevalence of SRFs by sexual orientation and gender identity among adults. This cross-sectional study used Behavioral Risk Factor Surveillance System data collected from January 2022 to February 2023 for adults aged 18 years or older residing in 22 US states. Self-reported sexual orientation and gender identity. Outcome measures were dissatisfaction with life, lack of emotional support, social isolation, employment loss in the past 12 months, Supplementary Nutrition Assistance Program participation in the past 12 months, insufficient food, inability to pay bills, inability to pay utilities, lack of transportation, and stress. Survey weights were applied. Multivariable linear regression models were used to measure the association between sexual orientation and gender identity for each outcome. The study sample comparing outcomes by sexual orientation included 178 803 individuals: 84 881 men (48.5%; 92.9% heterosexual; 7.1% sexual minority) and 93 922 women (51.5%; 89.4% heterosexual; 10.6% sexual minority). The study sample comparing outcomes by gender identity included 182 690 adults (99.2% cisgender; 0.8% gender minority). Of sexual minority women, 58.1% reported at least 1 SRF compared with 36.5% of heterosexual women. Sexual minority women were significantly more likely to report social isolation (difference, 7.4 percentage points [PP]; 95% CI, 4.9-10.0 PP) and stress (difference, 12.2 PP; 95% CI, 9.8-14.7 PP) compared with heterosexual women. A greater proportion of sexual minority men (51.1%) reported at least 1 SRF than heterosexual men (34.0%); the largest magnitudes of inequity were in dissatisfaction with life (difference, 7.9 PP; 95% CI, 5.8-10.1 PP) and stress (difference, 6.7 PP; 95% CI, 4.5-8.9 PP). Of gender minority adults, 64.1% reported at least 1 SRF compared with cisgender adults (37.1%). Gender minority adults were significantly more likely to report social isolation (difference, 14.8 PP; 95% CI, 9.9-19.7 PP) and stress (difference, 17.0 PP; 95% CI, 11.9-22.1 PP). In this cross-sectional study, sexual and gender minority adults were significantly more likely to report multiple SRFs. These findings suggest that policies and community-based systems to advance socioeconomic equity among sexual and gender minority adults are critical.

Examining the Role of Family, Media, Peers in Young Caucasian Men’s Understandings of Body Dissatisfaction: A Thematic Analysis Using the Tripartite Influential Model and Social Comparison Theory

This study explores the factors contributing to body dissatisfaction among young Caucasian men. It focuses on family, peers, and media influences, addressing a gap in the literature that rarely integrates men’s experiences. The research draws on the Tripartite Influence Model and Social Comparison Theory, using thematic analysis to examine semi-structured interviews with eight participants aged 20–21. The research considers participants’ sexual orientation and country of origin when analysing the data. The findings show that family, peers, and the media positively and negatively shape body dissatisfaction among participants. Positive familial support can enhance body image, while negative comments from family members and peers exacerbate dissatisfaction. Social media was found to often reinforce unattainable body standards. The research contributes to the limited literature on men’s body dissatisfaction by expanding the application of the Tripartite Influence Model and Social Comparison Theory to this population. The study underscores the need for greater societal awareness and a more inclusive approach to body image research that considers diverse ethnic backgrounds and sexual orientations. We argue that more attention needs to be paid to men’s body dissatisfaction, as men are often excluded from these discussions. This study provides valuable insights into the dynamics of male body image, offering a foundation for future research and societal discourse on this often-overlooked issue.

Comparing and Predicting Rape Acknowledgment Between Sexual Orientation and Gender Identity Categories.

It is well known that sexual violence is a prevalent social problem that often results in numerous deleterious outcomes for victims and these outcomes are often influenced by rape acknowledgment (i.e., whether the rape victim acknowledges their experience as rape). Most research on rape acknowledgment examines acknowledgment as a dichotomous variable and comprises heterosexual cisgender women, revealing two gaps in the literature. To fill these gaps, this study used quantitative data that oversampled LGBTQ+ populations to examine three categories of rape acknowledgment (yes, no, uncertain) among a gender and sexually diverse sample (N = 817). Results indicate that 20% of the sample were uncertain as to whether they had been raped, 33% were unacknowledged victims, and 44% acknowledged their rape. Sexual minority transgender/nonbinary people had the highest prevalence of rape acknowledgment (56%), compared with four other groupings: heterosexual cis men and women as well as sexual minority cis men and women (28%-49%). Multivariate analysis revealed that when controlling for other factors, gender identity, but not sexual orientation, significantly predicts rape acknowledgment. Namely, sexual minority transgender/nonbinary people and cis women were more likely than cis men to acknowledge their rape. This study offers evidence to suggest that acknowledgment differs significantly by gender identity and is worth further inquiry. Limitations and suggestions for future research are discussed.

Parental attitudes towards sexual orientation and gender diversity: challenging LGBT discrimination in Australian schools.

As Australia considers legislative reform regarding the rights of religious schools to discriminate against LGBT students and staff, claims are often made that religious parents or those enrolling children in religious schools do not affirm diversity of sexuality or gender. Using a national dataset of parents (n = 2418), attitudes towards sexual orientation, gender diversity, homophobia and transphobia were examined. Across all religiosities, school sectors and attitudinal statements, significant majorities of parents reported positive attitudes (62.7%-93.5%). Only small minorities expressly reported negative attitudes (1.6%-20.2%). Pairwise religiosity comparisons between parents with children only at a secular school, versus any religious school, revealed few differences. Amongst Catholic parents, those with children at Catholic schools and those with children only at secular schools, held similar attitudes towards LGBT issues and a majority held favourable attitudes, suggesting most Catholic parents who enrol their children in Catholic schools do so despite or in ignorance of Catholic doctrine. Findings suggest a significant majority of parents sending children to religious schools hold supportive attitudes towards diverse sexual orientations, gender diversity, and actions to address homophobia and transphobia. This empirical evidence contradicts religious schools' calls for the rights to discriminate against LGBT persons based on parental values and attitudes.

Prevalence of Depression and Generalized Anxiety Among LGBTQ+ Medical Students in Thailand.

This study evaluated the prevalence and associated factors of depression and generalized anxiety among LGBTQ+ in five medical schools in Thailand. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively, and multivariable logistic regression was employed to identify associated factors. Of 1,322 students, 412 (31.16%) identified as LGBTQ+. The prevalence for MDD and GAD among LGBTQ+ students were 32.77% and 17.23%, respectively. Significant associated factors for both MDD and GAD were a history of psychiatric illness (AOR for MDD = 2.32, p = .020; AOR for GAD = 3.67, p < .001), educational problems (AOR for MDD = 6.62, p < .001; AOR for GAD = 5.12, p < .001), and dissatisfaction with gender identity or sexual orientation (AOR for MDD = 1.92, p = .019; AOR for GAD = 2.47, p = .005). Additional factors associated with MDD were preclinical years (AOR = 2.30, p = .023), financial struggles (AOR = 2.05, p = .021), and inadequate peer support (AOR = 2.57, p = .044). In conclusion, nearly one-third and one-fifth of Thai LGBTQ+ medical students suffer from MDD and GAD, respectively. Our findings suggest that Thai medical schools should promote LGBTQ+ inclusivity to enhance students' identity satisfaction. Peer support groups should be encouraged, especially for preclinical LGBTQ+ students who face educational and financial challenges.

Strategic insights from a Delphi study: enhancing employment for multiply marginalized people with disabilities.

The employment landscape for multiply marginalized people with disabilities presents significant challenges, exacerbated by intersecting identities such as race/ethnicity, sexual orientation, gender identity, poverty, and geography. Recent studies highlight the compounded employment disparities faced by this group, including discriminatory hiring practices, inadequate accommodations, and uneven gains in employment during the COVID-19 public health emergency. Our study employed a three-round Delphi process with 20 diverse experts across 14 states across the United States (U.S.) to formulate recommendations for improving employment experiences for multiply marginalized people with disabilities. The panel's insights were gathered through surveys administered online, with each round designed to refine the collective recommendations. This iterative process aimed to build a consensus on the most effective policy and practice recommendations for improving employment outcomes within this population. The Delphi study identified key areas for strategic focus, including emergency preparedness, education and training, transportation, assistive technology, workplace accommodations, and combating discrimination and stigma. Notable recommendations included improving emergency preparedness training, enhancing employment education, increasing funding for accessible transportation and assistive technology, and promoting inclusive hiring practices. The study also emphasized the need for policies supporting telework and simplifying disability-related benefits. The findings highlight the critical role of tailored strategies to address employment challenges faced by people with disabilities from marginalized communities. Meaningfully and fully implementing these recommendations would create a more inclusive environment that improves employment outcomes for multiply marginalized people with disabilities.

A Latent Profile Analysis of Religious Parents' Responses to Their Sexual and Gender Diverse Child.

Prior research indicates that religious parents can have negative, positive, or ambivalent responses to their child's sexual orientation and gender identity (SOGI). Yet, to our knowledge no research has quantitatively examined patterns of sexual and gender diverse (SGD) youth's perceptions of their religious parents' responses to their SOGI. Without examining variations in these patterns, we are unable to better understand the experiences of SGD youth with religious parents. In the current paper, we examined patterns of SGD youth's perceptions of their religious parents' SOGI-specific rejection, acceptance, and SOGI change efforts. We also examined if these patterns differed by SGD youth's individual and contextual factors. The analytic sample consisted of online responses from 5,686 SGD youth (Mage = 15.95). We found four distinct profiles: Positive Parental Response, Moderate Negative Parental Response, Low Parental Response, and High Negative Parental Response. The largest profile was the Positive Parental Response, suggesting that many SGD youth perceived positive responses from their religious parents. SGD youth with diverse gender identities and intersecting identities, such as race/ethnicity, were more vulnerable to religious parents' negative responses. Findings have implications for existing resources and programs aimed at strengthening SGD youth's relationship with their religious parents.

Emotional Intelligence Profiles and Cyber-Victimization in Secondary School Students: A Multilevel Analysis

The research examined how different profiles of emotional intelligence (attention, clarity, and emotional regulation) act as protective or risk factors against cyber-victimization, taking into account individual and behavioral variables such as gender, sexual orientation, self-esteem, social anxiety, Internet risk, and parental control among high school students (11–18 years). A simulated sample was used, which was derived from an experimental sample of 1908 subjects (50.7% girls). Statistical equivalence was ensured between the two samples, and a multilevel analysis was conducted using the emotional intelligence profiles as the grouping variable. The results showed that the variability in emotional intelligence profiles predicted 96.7% of the variability of cyber-victimization. Factors that increase this likelihood include excessive interpersonal attention and low emotional regulation, higher social anxiety, offline victimization, older age, high parental supervision, and low self-esteem. In addition, being male and heterosexual is associated with a lower risk of cyber-victimization than being female and non-heterosexual. In general, it is suggested that protective measures against cyber-victimization should warn about the risk of Internet use, avoid paternalistic behavior by adults, and reduce rumination or excessive attention to the opinions of others.

Workplace Bullying and Harassment in Higher Education Institutions: A Scoping Review.

Workplace bullying is broadly defined as a detrimental form of negative micro-political interaction(s) incorporating a range of aggressive interpersonal behaviours. While targeted toxic behaviour based upon legally protected grounds such as ethnicity, gender, or sexual orientation is conceptualised as harassment, this paper positions harassment as a constituent subset of workplace bullying-distinct, but inextricably linked to the broader landscape of workplace predation and incivility. Meta-analyses of cross-sectional and longitudinal studies demonstrate a robust relationship between being bullied and compromised health, and some sectors, e.g., education, display higher than average levels of exposure, suggesting that contexts matter. The higher education sector is the focus of this scoping review. High rates of bullying have been reported in Higher Education Institutions (HEIs), where many of the organisational factors that drive bullying are present. One systematic literature review has been carried out on bullying in HEIs, reviewing papers prior to 2013. Since the sector has seen considerable contextual change since that time, another review is timely. This systematic scoping review aims to identify the volume, range, nature, and characteristics of studies of workplace bullying in HEIs between 2003 and 2023, with a specific focus on how the context of HEIs contributes to the enactment and/or the response to workplace bullying. To this end, 3179 records were identified, with 140 papers charted to identify methods, institution, population, and country. Forty-seven papers were subjected to full-text review for the exploration of contextual factors. Priorities for future research lie in addressing the pernicious effects of neoliberal governance models as well as the complex and intersecting power relations that are unique to higher education.

Lesbian and Heterosexual Women's Implicit Responses to Gender Figures.

This study explored how heterosexual and lesbian women differ in their implicit sexual responses. Previous research indicates that heterosexual women have physiological and implicit responses to both genders, whereas lesbian women show stronger responses to their preferred gender. This study used two implicit measures: the Implicit Relational Assessment Procedure (IRAP) and the Function Acquisition Speed Test (FAST), both of which were novel in this context. We recruited 33 heterosexual and 25 lesbian women. Both IRAP and FAST were successful in differentiating the two sexual orientations as a group. The results confirmed that heterosexual women exhibit positive responses to both genders, while lesbian women show stronger, category-specific responses to their preferred gender. These findings align with previous research and provide further insight into the nuanced differences in sexual orientation responses among women.

Beyond Borders: The Accelerating Momentum of Domestic Violence Research Worldwide

This paper covers publication trends, co-author networks, and research keyword co-occurrences on academic research related to domestic violence between 2000 and 2023. Throughout these years, first, the number of published articles dealing with this topic was very limited, from just four articles in the year 2000 to 37 in 2013. Still, after an imposing surge in publications registered after 2013, particularly between 2020 and 2023, the numbers increased from 217 to 653, establishing a significantly increased impact on the reviewed issue at a global level. This network identifies some central figures in the research community, such as Gene Feder, Louise M. Howard, and Nicky Stanley among others. It underlines the existence of collaboration clusters around issues such as gender, domestic violence, mental health, and social work, hence emphasizing the very essence of interdisciplinary research. Through keyword co-occurrence analysis, the word cloud shows some central themes to include intimate partner violence and the effect of COVID-19 on different population focuses, including strong qualitative research methods. The second word cloud, that of author affiliation, demonstrates the concentration of research output by leading institutions, with a high volume emanating from the UK, but also global collaboration - significant contributions from universities in Australia being one of them. Domestic violence is a complicated issue that affects individuals and communities of all ages, genders, sexual orientations, educational backgrounds, and more. These terminological complications in defining domestic violence can result in confusion during the practice of identification, assessment, and intervention. This study follows a holistic approach to bibliometrics in reviewing scholarly literature on domestic violence by drawing on data from Lens.org along with the visualization tools of VOSviewer. Improvement in understanding the domestic violence research landscape, major contributors, collaboration patterns, and the gap in research is what this study attempts to address. A total of 92,443 documents in their study were filtered to 2,362 scholarly works that included research articles published from 1999 up to 2023. The findings indicate the important factors of institutions and countries, the necessity of interdisciplinary-wise collaboration, and emerging hotspots of research. A bibliometric approach emphasizes that for effective intervention and prevention, there is a need for systematic reviews and synthesis of the available literature to provide informed evidence-based policy and practice in the context of domestic violence.

Female sexual Objectification Among Gay Men: Neural and Cultural Insights

Research on sexual objectification has mostly taken a heterosexual perspective and has studied gay men to understand when they become victims rather than agents of this phenomenon. In three studies we investigated gay men as agents of sexual objectification and the underlying motives that guide their biased perceptions. In Study 1, using electroencephalography, gay men showed to objectify women more than men. In Study 2a and Study 2b, results confirmed this tendency and demonstrated that exposure to sexually objectified depictions of women on content-rather than relational-based (social) media was positively related to the sexual objectification of women. Media exposure to female sexualization can increase and explain why women remain the target of sexual objectification regardless of one’s sexual orientation.

Pornography consumption and its effect on sexual performance in young men: Urology point of view

AbstractChronic pornography use is a public health problem that has considerable effects on men's health, especially on their sexual performance, having effects that can be encompassed from a biological, social, and psychological approach. Our objective was to conduct a literature review to evaluate the consequences in terms of sexual performance of young men who have chronic consumption of pornography. Chronic pornography consumption was related to erectile dysfunction, premature ejaculation, and alterations in genital anatomy and physiology. Social and psychological effects were also found, such as increased rates of violence towards women, problems with partners, and intimacy. However, benefits of controlled consumption of pornography have also been identified, such as reaffirmation of sexual orientation, stimulation of self‐discovery of the body, and improved communication with partners. Chronic consumption of pornography has direct effects on the sexual performance of young people and should be evaluated by a multidisciplinary team that includes physiological, social, and psychological elements. However, its use may be recommended for people with psychological problems, urological problems, and urological cancer.

Assessment Survey and evaluation of LGBT-Psychology in Nigeria: current state and recommendations

There is no gainsaying that individuals with diverse sexual orientations and gender identities are faced with serious socio-legal, and medical discrimination following the enactment of anti-homosexuality law in Nigeria. However, not much is known of the effort of an organized body of psychology in the country to ensure adequate knowledge and competence among Nigerian psychologists. This article, therefore, appraises the stance of Lesbian, Gay, Bisexual, and Transgender (LGBT) psychology in Nigeria in relation to the cardinal quadrants: Advocacy, Education, Research, and Practice. A multi-method design was adopted to sort for both primary and secondary data. Purposive sampling was adopted to involve 124 practicing psychologists. Findings revealed that the Nigerian psychology curriculum limits its scope to sexual and gender disorders (sexual dysfunction, gender dysphoria, and paraphilic disorders) while missing out on sexual and gender diversity content. Furthermore, the outcome shows that not much is documented on the contribution of the field of psychology to the knowledge of LGBT. Many of the participants had a history (and still) working with LGBT clients and did not have formal LGBT-affirmative training. The study concluded that the integration of LGBT psychology is essential for significant achievement in the space of advocacy, education, research, and professional practices.

Gender-Based Violence in the Context of the Future of Work: A Qualitative Review of the Literature.

Discussions about the Future of Work have become ubiquitous both in academic and international organizations' discourse. As part of these developments, the platform economy has revolutionized work practices and relationships. Despite the emergence of a burgeoning literature on platform studies, little is known about whether and to what extent platform work exacerbates the risk of gender-based violence among workers. This review article examines 39 academic articles, book chapters, reports, and conference papers published between 2016 and 2023 using qualitative content analysis to provide a preliminary understanding of empirical data on this issue. The reviewed studies were selected using relevant keywords on the basis of a database of 175 studies examining the platform economy with gender perspective, complemented with additional sources identified during the review. The main findings are: platform workers across sectors are vulnerable to gender-based violence, especially those at the intersection of several axes of subordination; platforms' socio-technological features exacerbate the risk of gender-based violence; (fear of) gender-based violence limits women's access to platform work and the economic benefits derived from it; most platforms lack effective preventative and redressal mechanisms against violence; and, faced with platforms' inaction, workers adopt individual and collective measures to address (the risk of) gender-based violence in platform work. The analysis also evidences the need for more research on intersectional vulnerabilities, particularly with regard to sexual orientation and gender expression and identity, as well as on the physical and psychological impact of gender-based violence on platform workers, which provides avenues for future research.

University Student Attitudes Regarding Answering Sex, Sexual Orientation, and Gender Identity Questions on University Application Forms

ABSTRACT A sample of 700 undergraduate university students throughout the US completed an online survey about their attitudes answering questions about their sex, sexual orientation, and gender identity (SSOGI) on their university admission form. This study examined differences between cisgender and transgender and gender diverse students in attitudes related to answering sex assigned at birth and gender identity questions, and between heterosexual students and students of diverse sexual orientations in attitudes related to answering sexual orientation questions. Overall, students indicated positive attitudes about answering SSOGI questions on their university application form, but attitudes toward sexual orientation questions were less positive. Differences were found in question/answer choice understanding (gender identity and sexual orientation), ease of answering (sex assigned at birth), offensiveness in asking (sex assigned at birth), privacy concerns (sex assigned at birth), comfort in answering (sex assigned at birth and sexual orientation), confidentiality concerns (gender identity), and importance of asking (sex assigned at birth and sexual orientation). Findings demonstrate that most respondents held positive attitudes about answering SSOGI questions and that communicating to LGBTQ+ applicants the importance of and privacy protections associated with answering SSOGI questions on university application forms might be important.

Differences by Sexual Orientation in Patient-Centered Care Outcomes for Veterans Utilizing Primary Care Services at the Veterans Health Administration.

Purpose: This study examined the differences by sexual orientation in patient-centered care outcomes (including health care experiences and health-related screening) of veterans utilizing Veterans Health Administration (VHA) primary care. Methods: VHA's adapted version of the Consumer Assessment of Healthcare Providers and Systems was used to compare the health care experience of primary care services among sexual minority (SM) and heterosexual veterans. Health care experience measures were dichotomized to "always" versus "less" and stratified by SM status. Health-related screening measures were dichotomous. Survey data were weighted using provided sample weights. Descriptive statistics were performed on sociodemographic characteristics. Logistic regression coefficients were represented as adjusted odds ratios (aORs). A total of 66,348 veterans were included in the analytic sample, of which 2.9% (n = 1,935) identified as SM. Sexual orientation was ascertained by self-report measures by veterans. Results: SM veterans were significantly younger (56.95 years vs. 63.43 years, p < 0.001), were less likely to report that their provider showed respect for what they had to say (aOR: 0.76; 95% confidence interval [CI]: 0.61-0.95), that they were asked about difficulties taking care of their health (aOR: 0.81; 95% CI: 0.67-0.96), and their provider listened carefully to them (aOR: 0.71; 95% CI: 0.57-0.87) compared to heterosexual veterans. Conclusion: Health care experiences differed between SM and heterosexual veterans who sought VHA primary care, suggesting the need to increase provider trainings, which may improve cultural competency and promote a more welcoming and inclusive environment.

Conversion practice recall and mental health symptoms in sexual and gender minority adults in the USA: a cross-sectional study.

Conversion practices are associated with psychological morbidity, yet few studies have evaluated differences between efforts to change gender identity, sexual orientation, or both. We aimed to examine the individual and joint association of conversion practice recall targeted at gender identity or sexual orientation, or both, with current mental health symptoms among sexual and gender minority people. This cross-sectional study used data from The PRIDE Study, a US-based, online, prospective cohort study of sexual and gender minority adults who were recruited through social media, digital advertisements, and sexual and gender minority community-based events and organisations. For this analysis, we included participants who completed a lifetime questionnaire in 2019-20 and a subsequent annual questionnaire in 2020-21 without missing outcome data. All questionnaires were in English. The exposure was lifetime recall of conversion practice targeting gender identity alone, sexual orientation alone, or both (versus no conversion practice). Mental health outcomes were continuous measures: Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire 9-item (depression) scale, Post-Traumatic Stress Disorder Checklist 6-item scale, and Suicide Behaviors Questionnaire-Revised scale. We used linear regression to analyse the associations of conversion practice recall and mental health symptoms, controlling for demographic and childhood factors and stratified between cisgender and transgender and gender diverse groups. Sensitivity analyses evaluated the potential impact of unmeasured confounding. Analyses were conducted in R. We included people with related lived experience in the design and implementation of this study. Of 6601 participants who completed the lifetime questionnaire in 2019-20, 4440 completed the subsequent annual questionnaire in 2020 or 2021, and 4426 did not have missing outcome data. Of the 4426 included participants, 4073 (92·0%) identified as White (either alone or in combination with other ethnoracial options), 460 (10·4%) identified with multiple ethnoracial identities, and 1923 (43·4%) were transgender and gender diverse. Participants' age ranged from 18 years to 84 years (median 31·7 years, IQR 25·5-44·1). 149 (3·4%) participants reported sexual orientation-related conversion practice alone, 43 (1·0%) reported gender identity-related conversion practice alone, and 42 (1·0%) reported both. Recalling both forms of conversion practice was most strongly associated with greater post-traumatic stress disorder (PTSD; β 2·84, 95% CI 0·94-4·74) and suicidality (2·14, 0·95-3·32) symptoms. Recall of only sexual orientation-related conversion practice was associated with greater symptoms of PTSD (1·10, 0·22-1·98). Recall of gender identity-related conversion practice alone was most strongly associated with greater depressive symptoms (3·24, 1·03-5·46). Only associations for suicidality differed between cisgender and transgender and gender diverse participants, although the latter showed higher mental health symptoms overall. Findings were moderately robust to potential sources of unmeasured confounding in sensitivity analysis. Recall of conversion practice exposure was associated with a range of mental health symptoms among sexual and gender minority people. These findings support calls to ban conversion practices because of their effects as a structural determinant of mental health. Gill Foundation, Dona Rockstand, and Patient-Centered Outcomes Research Institute.