People identifying as LGBTQ+ who have undergone conversion therapy are more likely to experience poor mental health, according to a study published in The Lancet Psychiatry journal.

Conversion practice is a formal, structured attempt to alter a person’s sexual orientation, gender identity, or gender expression. It often involves psychological, behavioural, physical, and faith-based practices. It is also called "reparative therapy" or "gay cure therapy trying to stop or suppress someone from being gay, or from identifying as a different gender to their sex recorded at birth. The conversion therapy includes therapies and prayer, exorcism, physical violence and food deprivation.

The findings based on surveys of 4,426 LGBTQ+ adults in the USA, suggest people subjected to controversial practices targeting their gender identity or sexual orientation may be more likely to experience depression, PTSD, and suicidal thoughts or attempts. Transgender participants reported greater mental health symptoms overall.

The Lancet Study

The study covered 2,504 (57%) cisgender and 1,923 (43%) transgender participants, 92% of them identifying as white.  Their ages ranged from 18 to 84 years old, with an average of 31 years.

Of the 4,426 participants, 149 (3.4%) experienced conversion practice aimed at altering their sexual orientation, 43 (1%) had undergone practices targeting gender identity, and 42 (1%) reported both.

Participants who had been subjected to conversion practice targeting both their gender identity and sexual orientation had the greatest symptoms of depression, PTSD, and suicidal thoughts or attempts.

• • Cisgender and transgender participants experience more severe symptoms of depression and PTSD if they undergo conversion practice.

• • Cisgender participants subjected to both types of conversion practice have a greater risk of suicidal thoughts and attempts than transgender participants – but mental health symptoms were more severe for transgender people overall, highlighting a need for long-term studies.

• • Survey results indicate that religious leaders or organisations tended to lead practices aimed at changing sexual orientation, while mental health care providers or organisations most often led attempts to alter gender identity.

• • The authors say the findings underscore the negative impact that conversion practice has on mental health and highlight the need for legislation banning the practices.

Some participants reported being subjected to conversion practice more than others. These included transgender participants, people experiencing homelessness, and those with lower levels of education. The practices were also more commonly reported among people with religious upbringings, those raised in communities not accepting of their gender identity, and participants from minority ethnic backgrounds.

Cisgender and transgender participants who had undergone conversion practice had a similarly increased likelihood of depression and PTSD. Neither had increased symptoms of anxiety. However, cisgender participants who had undergone both types of conversion practice had a greater risk of suicidal thoughts or attempts than transgender participants. 

“Our findings add to a body of evidence that shows conversion practice is unethical and linked with poor mental health,”  said study author Dr Nguyen Tran, of Stanford University School of Medicine (USA). “Protecting LGBTQ+ people from the impacts of these harmful practices will require multi-pronged legislation, including state and federal bans. Additional measures such as support networks and targeted mental health support for survivors are also vital.” 

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