Sexual Orientation Change Efforts Research Articles

Conversion practices in Aotearoa New Zealand: Developing a holistic response to spiritual abuse.

Research arising from conversion practices, also known as conversion therapy and sexual orientation and gender identity change efforts, has generally been underpinned by an emancipatory discourse that has evolved to counter harmful practices by evidencing associated harms and estimating prevalence. Little attention, however, has focused on what is required to support survivors, inclusive of those currently or those having previously experienced conversion efforts. Within a context of Aotearoa New Zealand having recently criminalised conversion practices, this study adopted an in-depth qualitative research design, informed by a dual adherence to life history and an empowerment methodology. Twenty-three religious conversion practice survivors, who had experienced religious conversion practices across a range of Christian identified faith settings, were interviewed. Participants had a median age of 34 and the majority identified as New Zealand European, cisgender, and gay. Participant narratives were discursively analysed. Three primary discourses were identified that inform the needed development of interventions and supports: 1) pervasive framing of conversion practices as harm, rather than spiritual abuse, has minimised the impacts of conversion practices. Rather, conceptualising conversion as spiritual abuse positions conversion practices as requiring urgent intervention and ongoing support, inclusive of the development of policy and operational responses; 2) the coercive nature of spiritual abuse needs to be appreciated in terms of spiritual, social, and structural entrapment; 3) the metaphor of a pipeline was enlisted to encapsulate the need for a multidimensional array of interventions to ensure those entrapped within spiritual abuse have a "pipeline to safety". Holistic survivor-centric conversion-related responses to spiritual abuse are required. These need to be informed by an understanding of entrapment and the associated need for holistic responses, inclusive of extraction pathways and support for those entrenched within abusive religious settings, support immediately after leaving abusive environments, and support throughout the survivors' healing journeys.

A war against the natural order: Joseph Nicolosi, Reparative Therapy, and the Christian Right.

This article situates Joseph Nicolosi's first book, Reparative Therapy of Male Homosexuality, in historical context. Nicolosi, a Catholic clinical psychologist, was one of the most vocal practitioners of sexual orientation change efforts (SOCE) from the early 1990s until his death in 2017, and in these decades, the Christian Right became a key supporter of SOCE. In this article, I argue that two features of Nicolosi's book appealed to the Christian Right. First, Nicolosi relied on psychoanalytic thought to pathologize not only same-sex sexual desires but also poor parenting. The use of psychoanalytic thought was of particular interest to conservative Christians who believed that American fathers had forfeited their role as strong patriarchs. Second, Nicolosi's approach to therapy, which included changing one's dress and mannerisms and assertiveness training, stressed that same-sex desires could be eliminated through behavioral reconditioning. Nicolosi's psychological eclecticism, a common feature for mental health practitioners at the end of the twentieth century, has not been emphasized in prior scholarship on reparative therapy. Importantly, the psychological eclecticism practiced by Nicolosi became common within the Christian Right after the publication of Reparative Therapy of Male Homosexuality. By offering a close reading of Reparative Therapy of Male Homosexuality, this article demonstrates the interrelationship between one of the core texts of the ex-gay movement and the psychological and religious thought of the Christian Right at the turn of the twenty-first century. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

LGBTQ + Grassroots Activists’ Perspectives on Banning Sexual Orientation and Gender Identity Change Efforts

LGBTQ + Grassroots Activists’ Perspectives on Banning Sexual Orientation and Gender Identity Change Efforts

History and Iatrogenic Effects of Conversion Therapy.

Research indicates that sexual orientation change efforts (SOCEs) are not effective and furthermore commonly lead to iatrogenic effects such as depression, anxiety, and even suicide. Negative attitudes toward homosexuality derive from most formal religions and are incarnated in medical and psychological theories that support and encourage SOCEs. Oppression of sexual minorities makes it unlikely that change requests by patients are voluntary. Recently there has been a dramatic change as the field moves from reparative to affirmative approaches. Here, we review the history of SOCEs, their consequences, current affirmative treatments, and future directions in the field as they pertain to the well-being of the queer community. From an institutional community psychology perspective, we argue that even if true conversion were possible, such efforts are unethical and should not be pursued even if requested. As is the case with all psychological/psychiatric interventions, the issue is not "can" but "ought." Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Bans on Evidence-Based Care for Transgender and Gender Diverse People Present Risks for Clients and Dilemmas for Mental Health Providers

Despite efforts to improve the sociopolitical landscape for sexual and gender minorities, including legislation to ban sexual orientation and gender identity change efforts (SOGICE), new threats have arisen with a sharp increase in state legislatures enacting anti-TGD (transgender and gender diverse) legislation. Some of these laws and the accompanying hostile climate may prevent mental health providers from providing the best evidence-based care for their TGD clients. This paper briefly reviews the current sociopolitical climate, the impact of the climate on TGD people, and challenges faced by mental health providers serving TGD clients. We conclude with recommendations for supporting TGD clients in the current sociopolitical context and a call for advocacy to continue efforts to ban SOGICE and protect access to social, legal, and medical gender affirmation for youth and adults.

Changing Minds About Not Can but Ought

In my presidential speech to the Association for Advancement of Behavior Therapy (now the Association for Behavioral and Cognitive Therapies) at the 1974 Annual Convention, I took the position that requests for sexual reorientation should be declined in favor of addressing the ethical and political factors that underlie the allegedly voluntary requests of gay individuals to change in a heterosexual direction. Discrimination, prejudice, and sometimes hate crimes made it highly unlikely that requests for sexual reorientation were voluntary. The personal and professional context for my change of perspective is also described as are several pedagogical and persuasive strategies I have used over the past 50 years for changing people's minds about the propriety of sexual orientation change efforts.

The Pathways to Join, Engage in, and Quit Sexual Orientation Change Efforts (SOCE): A Qualitative Study of Sexual Minority Individuals who Self-Initiated SOCE in Hong Kong

ABSTRACT Despite the growing recognition of their harmful effects, sexual orientation change efforts (SOCE) continue to be practiced in various societies. This study examines the experiences of 11 sexual minority individuals in Hong Kong who have undergone SOCE. The findings reveal the pervasive influence of deeply ingrained homonegativity values within religious, family, educational, and soiocultural contexts during LGBTQ+ individuals’ formative years. These prevailing stigmas compelled them to pursue SOCE through different methods. However, these methods have been proven ineffective and psychologically harmful, leading to increased distress and internalized homonegativity. The availability of knowledge and access to affirming LGBTQ+ values within religious, community, and sociocultural spheres played a crucial role in helping the respondents come to accept their sexual orientation and cease their attempts at SOCE. This study shed light on how the interplay of Chinese familial values and Christian doctrine in Hong Kong contributes to the promotion of homonegativity, consequently restricting the diverse expressions of sexuality. It is important to recognize that the notion of individuals actively “choosing” to undergo SOCE is misguided, as these decisions are often driven by social stigma and external pressures. Progress in this area requires confronting the systemic heteronormativity embedded within Hong Kong’s cultural fabric.

An ecological analysis of hope amongst Asian rainbow young people in Aotearoa New Zealand

Rainbow research tends to prioritise gender and sexuality experiences over the racialised experiences of Asian rainbow young people. Informed by an intersectional lens, we employed a hope-based ecological framework to examine how multiple overlapping axes of oppression (e.g. cisgenderism, heterosexism and racism) shape the aspirations of these youth. We drew on the voices of Asian participants from the 2021 Aotearoa New Zealand Identify Survey, who had responded to an open-text question on their hopes for rainbow young people (n = 217; age range = 14 to 26). The content analysis identified seven prominent categories of hope across three ecological levels (macro exo and meso). These categories were societies: 1) break away from cisheterosexist expectations; 2) confront racism and intersection with cisheterosexism; 3) promote rainbow-inclusive education; 4) ban sexual orientation and gender identity change efforts; 5) improve access to culturally safe health care; 6) dismantle white-dominated rainbow spaces; and 7) provide more rainbow-inclusive family support. These hopes were constructed amidst the desire to challenge unacceptance and exclusion by the wider society for not adhering to white cisheterosexist expectations. The study provides critical insights for community organisations, education settings, and government to consider in addressing the diverse needs of Asian rainbow young people.

The misuse of scientific uncertainty claims in sexual orientation change efforts research: Comment on Rosik, Beckstead, and Lefevor (2023).

The misuse of scientific uncertainty claims in sexual orientation change efforts research: Comment on Rosik, Beckstead, and Lefevor (2023).

Reply to Sullins (2023) on the Ethical and Human Rights Concerns of Sexual Orientation Change Efforts

Reply to Sullins (2023) on the Ethical and Human Rights Concerns of Sexual Orientation Change Efforts

Sexual orientation change efforts: Health associations, sexual identity labeling, and reports of change by engagement status.

Sexual orientation change efforts: Health associations, sexual identity labeling, and reports of change by engagement status.

The impact of sexual orientation conversion therapies on transgender individuals

ABSTRACT The purpose of sexual orientation change efforts (SOCE) is to change an individual’s sexual orientation, not necessarily gender identity. Given that sexual orientation is a distinctly different construct than gender identity, sexual conversion therapy methods may be different for transgender individuals, and the impact may also be different. This qualitative multiple case study (N =4) investigated the experiences and impact of SOCE on transgender individuals in the Midwest using a phenomenological approach to develop the common meaning of a concept based on individuals’ shared lived experiences. Semi-structured interviews were used to gather data on participants'’ experiences of having undergone SOCE, and these data were used to uncover and describe cross-cutting themes. Participants identified the following as influences for having undergone SOCE: transphobia in the household environment, residence in a gender-normative environment, and religiosity in interpersonal relationships. The methods used by religious practitioners and those practicing reparative therapy; included electric shock therapy, electric shock on genitals paired with homosexual stimuli, physical abuse, and sexual abuse. The immediate negative impacts of SOCE included feelings of inauthenticity, pretend acceptance of their biological sex, and conformation to gender norms. Lasting effects included loss of faith, lack of trust, sexual dysfunction, and negative self-esteem.

Sexual Orientation Change Efforts among LGBT+ People of Kerala: Prevalence, Correlates, and Mental Health Aspects

ABSTRACT Sexual Orientation Change Efforts (SOCE) have been reported worldwide and have adverse psychiatric consequences. However, no data are available for India or Kerala. We assessed the prevalence of SOCE, its characteristics, and mental health aspects among LGBT+ individuals in Kerala. This cross-sectional survey used snowball sampling. An online questionnaire collected sociodemographic information and history and characteristics of SOCE. Religiosity and SOCE-associated distress were evaluated using 6-point Likert scales. Patient Health Questionnaire (PHQ-9) screened for depressive symptoms; its ninth question assessed death wishes and self-harm thoughts. Generalized Anxiety Disorder Assessment (GAD-7) screened for anxiety symptoms. Participants’ (n = 130) mean age was 26.80 ± 7.12 years. Most common biological sex (63.1%) and gender identity (50.8%) were male, and sexual orientation was gay(42.3%). Prevalence of SOCE was 45.4%. In SOCE group, 39% reported very severe distress. SOCE was most commonly self-prompted (47.5%), performed through psychotherapy (28.8%), and performed by doctors (28.8%). SOCE group had significantly higher religiosity scores (t = 2.61, p = .01). Among cisgender men, 48.48% had SOCE history, against 28.57% among cisgender women (χ2 = 3.19, p = .07). SOCE is highly prevalent among the LGBT+ community in Kerala, with high associated distress. Multi-level approaches are necessary to mitigate this problem.

A Critical Review of The “2021 Apa [American Psychological Association] Resolution on Sexual Orientation Change Efforts.”

We examined the “APA [American Psychological Association] RESOLUTION on Sexual Orientation Change Efforts” (APA, 2021) and while doing so have noted several problems. The APA (2021) resolution report is largely flawed in terms of theory, logic, and science. It relies almost exclusively on sexual minority theory when many other theories might be useful. It relies upon seriously flawed logic, treating SOCE as unchanged and unimproved over the past six decades. In addition, it relies upon very weak and limited science, overlooking recent reports on SOCE outcomes, not considering effect sizes for SOCE treatments, treating correlational results as causal, and often overlooking ways of testing more complex models of SOCE. The same limitations apply to much of the material reported in APA’s book edited by Haldeman (2022a), therefore not deserving a separate review. As such, we concluded that readers of the APA (2021) resolution report or Haldeman (2022a) for that matter, would walk away with unequivocal, one-sided, and misguided information about the topic of SOCE and therefore a condensed fact-checked critical analysis is presented.

Ending Sexual Orientation and Gender Identity Change Efforts: Steps Professional Mental Health Associations Can Take

ABSTRACT This study explored the steps or actions that therapists would like to see professional mental health associations take concerning gender identity change efforts (GICE) and sexual orientation change efforts (SOCE; also referred to as conversion therapy). Data were collected from 177 therapists utilizing an open-ended question from an online survey. A queer theory informed thematic analysis of the data revealed four themes tied to actions that professional mental health organizations can engage in, ranging from (a) acknowledging the unethicality of GICE and SOCE, (b) intervening to cease the current practice of GICE and SOCE, (c) preventing GICE and SOCE from being practiced in the future, and (d) engaging in transformation efforts to create change at systemic levels (e.g., policy, laws, organizations) to affirm lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities.

Sexual Orientation and Gender Identity Change Efforts for Young People in New Zealand: Demographics, Types of Suggesters, and Associations with Mental Health

Sexual orientation and gender identity change efforts (SOGICE) are harmful practices, yet who suggests them to young people and what impacts are associated with these suggestions have received limited attention in the literature. The present study explored whether certain suggesters, and the frequency of categories of suggesters (including religious leaders, family members, and health professionals), were associated with suicidality and non-suicidal self-injury (NSSI). The study also explored whether particular demographics of young people were more likely to report SOGICE experiences. Data were collected through an online survey of New Zealand gender- and sexuality-diverse youth. The sample (n = 3948) had an age range of 14–26 (mean age = 18.96), and approximately half (52.4%) were transgender or gender-diverse. Odds of suicidality and NSSI were highest when religious leaders suggested SOGICE and when more than one type of suggester was reported. SOGICE was more likely to be reported by transgender and gender-diverse youth, statutory care- and homelessness-experienced youth, and young people reporting current material deprivation. Implications for targeted mental health services and education for young people and the community are discussed.

Ethical and Human Rights Concerns of Sexual Orientation Change Efforts: Commentary on Sullins (2022).

Ethical and Human Rights Concerns of Sexual Orientation Change Efforts: Commentary on Sullins (2022).

Commentary: Absence of behavioral harm following non-efficacious sexual orientation change efforts: A retrospective study of United States sexual minority adults, 2016-2018.

Commentary: Absence of behavioral harm following non-efficacious sexual orientation change efforts: A retrospective study of United States sexual minority adults, 2016-2018.

Sexual Orientation Change Efforts Do Not Increase Suicide: Correcting a False Research Narrative.

Sexual orientation change efforts (SOCEs) signify activities designed to change or reduce homosexual orientation. Recent studies have claimed that such therapies increase suicide risk by showing positive associations between SOCE and lifetime suicidality, without excluding behavior that pre-dated SOCE. In this way, Blosnich et al.'s (2020) recent analysis of a national probability sample of 1518 sexual minority persons concluded that SOCE "may compound or create…suicidal ideation and suicide attempts" but after correcting for pre-existing suicidality, SOCE was not positively associated with any form of suicidality. For suicidal ideation, Blosnich et al. reported an adjusted odds ratio (AOR) of 1.92 (95% CI 1.01-3.64); the corrected AOR was .44 (.20-.94). For suicide planning, Blosnich et al.'s AOR was 1.75 (1.01-3.06); corrected was .60 (.32-1.14). For suicide attempts, Blosnich et al.'s AOR was 1.75 (.99-3.08); corrected was .74 (.36-1.43). Undergoing SOCE after expressing suicidal behavior reduced subsequent suicide attempts from 72 to 80%, compared to those not undergoing SOCE, when SOCE followed a prior expression of suicidal ideation (AOR .17, .05-.55), planning (AOR .13, .04-.45) or intention (AOR .10, .03-.30); however, SOCE following an initial suicide attempt did not significantly reduce further attempts. By violating the principle that a cause cannot occur after an effect, Blosnich et al. misstated the correct conclusion. Experiencing SOCE does not result in higher suicidality, as they claim, and may sharply reduce subsequent suicide attempts. Restrictions on SOCE will not reduce suicidal risk among sexual minorities and may deprive them of an important resource for reducing suicide attempts.

A Critical Review of the “2021 APA [American Psychological Association] Resolution on Sexual Orientation Change Efforts”

We examined the “APA [American Psychological Association] RESOLUTION on Sexual Orientation Change Efforts” (APA, 2021) and while doing so have noted several problems. The APA (2021) resolution report is largely flawed in terms of theory, logic, and science. It relies almost exclusively on sexual minority theory when many other theories might be useful. It relies upon seriously flawed logic, treating SOCE as unchanged and unimproved over the past six decades. In addition, it relies upon very weak and limited science, overlooking recent reports on SOCE outcomes, not considering effect sizes for SOCE treatments, treating correlational results as causal, and often overlooking ways of testing more complex models of SOCE. The same limitations apply to much of the material reported in APA’s book edited by Haldeman (2022a), therefore not deserving a separate review. As such, we concluded that readers of the APA (2021) resolution report or Haldeman (2022a) for that matter, would walk away with unequivocal, one-sided, and misguided information about the topic of SOCE and therefore a fact-checked critical analysis is presented.