Thursday, September 19, 2019

Transgender Conversion Therapy Linked to More Psychological Distress, Suicide Attempts, Study Finds

Individuals who identify as transgender may be at a greater risk of psychological distress and suicide in adulthood if they were exposed to conversion therapy, according to a study in JAMA Psychiatry. These risks were found to be particularly high if the individual was exposed to the therapy when they were 10 or younger.

“Our results support the policy positions of the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, the American Academy of Pediatrics, and the American Medical Association, which state that gender identity conversion therapy should not be conducted for transgender patients at any age,” Jack Turban, M.D., M.H.S., of Massachusetts General Hospital and colleagues wrote.

The researchers analyzed the responses of 27,715 transgender adults living in the United States to the 2015 U.S. Transgender Survey, whose protocol was reviewed and approved by the University of California, Los Angeles, institutional review board. The respondents’ mean age was 31.2 years, and 42.8% had been assigned male sex at birth; 19,741 reported they had spoken to a professional about their gender identity, and 3,869 reported exposure to gender identity conversion therapy (psychological interventions aimed at aligning an individual’s gender identity with the sex assigned at birth) in their lifetime. The researchers also measured respondents’ severe psychological distress during the previous month (using the Kessler Psychological Distress Scale), as well as their suicidality during the previous year and lifetime.

The researchers found that recalled exposure to gender identity conversion efforts was associated with higher odds of lifetime suicide attempts and severe psychological distress among transgender adults compared with those who discussed gender identity with a professional without conversion efforts.

The authors noted that “recalled lifetime exposure to GICE [gender identity conversion efforts] was highly prevalent among adults: 14.0% of all transgender survey respondents and 19.6% of those who had discussed gender identity with a professional reported exposure to GICE.” Exposure to gender identity conversion efforts before the age of 10 was less common among respondents, with only 1% reporting such an experience. It was, however, “associated with adverse mental health outcomes, including lifetime suicide attempts,” the authors wrote, adding that the odds of lifetime suicide attempts was higher for those exposed to conversion efforts before age 10 compared with those with lifetime exposure. This suggests that “rejection of gender identity may have more profound consequences at earlier stages of development.”

The researchers also found that respondents from more socioeconomically disadvantaged backgrounds more commonly reported exposure to gender identity conversion efforts. “These individuals may have been more likely to receive GICE, or exposure to GICE may have been so damaging that they were impaired in educational, professional, and economic advancement,” the authors wrote.

For related information, see the Psychiatric News article “‘Conversion Therapy’ Misleads, Harms Patients” and the Psychiatric Services article “Affirming Gender Identity of Patients With Serious Mental Illness.”

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