Absence of Behavioral Harm Following Non-efficacious Sexual Orientation Change Efforts: A Retrospective Study of United States Sexual Minority Adults, 2016–2018

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.

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

“…The risk of harm behaviors for those who have experienced SOCE is no different than it is for those who have not experienced SOCE. SOCE experience was found to have no statistically discernible effect on the risk of any present harm measured in terms of suicide ideation, suicide planning, suicide intention, and attempting suicide (Sullins, 2022). Other research is based on self-reports, which is the same type of method they accuse as invalid for supporting SOCE.…”

“…At the same time, if one were to study SOCE experience among non-religious persons who currently identify strongly as lesbian or gay and probably did so before or during SOCE, or who engaged in SOCE due to external pressures rather than on their own volition, one can expect to find far more negative results and more frequent reports of harm. However, when compared in research, sexual minority persons who had undergone failed SOCE therapy do not suffer higher psychological or social harm (Sullins, 2022).…”

“…Other research is based on self-reports, which is the same type of method they accuse as invalid for supporting SOCE. While the APA frequently associates SOCE with higher suicide rates (Haldeman, 2022a), it is seemingly forgotten that correlation does not equal causation, as Sullins (2022) has demonstrated.…”

“…Psychotherapies in general have risks of deterioration, from 5-24% (Rosik & Popper, 2014). When SOCE was voluntary, non-punitive, and involved highly religious participants or participants who were anticipating heterosexual marriage, results have been positive (Bondy, 2021;Jones & Yarhouse, 2011;Karten & Wade, 2010;Pela & Sutton, 2021;Rosik et al 2021;Schumm (2022);Spitzer, 2003;Stanus, 2013;Sullins et al, 2021;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

“…Using data from Generations —a study of a nationally representative sample of sexual minority adults—Blosnich et al ( 2020 ) found that exposure to sexual orientation change effort (SOCE or “conversion therapy”) was associated with twice the odds of lifetime suicidal ideation, 75% increased odds of planning to attempt suicide, and 88% increased odds of a suicide attempt with minor injury compared with people with no history of being exposed to SOCE. Sullins ( 2022 ) raised several critiques of that study, including that it did not time the occurrence of SOCE in relation to suicidality, making it difficult to determine the causality, and that it did not sufficiently control for potential confounders of suicidality. Using the Generations data, Sullins attempted to address these limitations, but his solutions are flawed, rendering his conclusions invalid.…”