Conversion 'therapy' begins at home

Whether change efforts are carried out at home by parents and caregivers or by practitioners and religious leaders, parents serve as gatekeepers to both engage in and take their LGBT children for external conversion interventions. Both home-based parent and external sexual orientation conversion interventions by therapists and religious leaders, coupled with parent conversion efforts, contribute to multiple health and adjustment problems in young adulthood. These include higher levels of depression and suicidal behavior, as well as lower levels of self-esteem, social support and life satisfaction, and lower levels of education and income in young adulthood, compared with LGBT young people who did not experience conversion efforts.

"Parent-Initiated Sexual Orientation Change Efforts with LGBT Adolescents: Implications for Young Adult Mental Health and Adjustment" is the first study to examine the sexual orientation change experiences for LGBT youth across several domains and to ask about conversion experiences with both parents / caregivers and with practitioners and religious leaders. This builds on an earlier Family Acceptance Project study on family rejection and health risks that identified and measured more than 50 specific family rejecting behaviors that include parental and caregiver efforts and external interventions to change their LGBT child's sexual orientation.

In the current study published online in the Journal of Homosexuality, more than half (53%) of LGBT non-Latino white and Latino young adults, ages 21-25, reported experiencing sexual orientation change efforts during adolescence. Of these, 21% reported specific experiences by parents and caregivers to change their sexual orientation at home; and 32% reported sexual orientation change efforts by both parents and by therapists and religious leaders. Notably, any sexual orientation change efforts -- whether by parents alone or by parents, therapists and religious leaders contribute to higher risk for LGBT young people. However, those who experience both parental and external conversion efforts by therapists or religious leaders had the highest levels of risk.

Specific Research Findings

• Rates of attempted suicide by LGBT young people whose parents tried to change their sexual orientation were more than double (48%) the rate of LGBT young adults who reported no conversion experiences (22%). Suicide attempts nearly tripled for LGBT young people who reported both home-based efforts to change their sexual orientation by parents and intervention efforts by therapists and religious leaders (63%).
• High levels of depression more than doubled (33%) for LGBT young people whose parents tried to change their sexual orientation compared with those who reported no conversion experiences (16%) and more than tripled (52%) for LGBT young people who reported both home-based efforts to change their sexual orientation by parents and external sexual orientation change efforts by therapists and religious leaders.
• Sexual orientation change experiences during adolescence by both parents / caregivers and externally by therapists and religious leaders were associated with lower young adult socioeconomic status: less educational attainment and lower weekly income.
• LGBT adolescents from highly religious families and those from families with lower socioeconomic status were most likely to experience both home-based and external conversion efforts, while those who were gender nonconforming and who were from immigrant families were more likely to experience external conversion efforts initiated by parents and caregivers.

Dr. Caitlin Ryan, Director of the Family Acceptance Project at San Francisco State University and lead author noted, "Although parents and religious leaders who try to change a child's LGBT identity may be motivated by attempts to 'protect' their children, these rejecting behaviors instead undermine an LGBT child's sense of self-worth, contribute to self-destructive behaviors that significantly increase risk and inhibit self-care which includes constricting their ability to make a living. That's why we developed a family support model to help diverse families learn to support their LGBT children that we're integrating in behavioral health, out-of-home care, primary care and pastoral care in communities across the country."

"We now have even more dramatic evidence of the lasting personal and social cost of subjecting young people to so-called 'change' or 'conversion' therapies. Prior studies with adults have shown how harmful these practices are. Our study shows the role central role that parents play. It is clear that there are public health costs of 'change' efforts for LGBT adolescents over the long-term. The kind of change we really need is family education and intervention" said study co-author, Stephen T. Russell, Ph.D., Regents Professor, University of Texas at Austin.

Said Stephenie Larsen, CEO of Encircle, an LGBT Family & Youth Resource Center in Provo, Utah -- a state where suicide rates are highest among adolescents -- that is working with the Family Acceptance Project to increase family support: "We founded Encircle to provide an accepting environment where LGBT youth can receive a range of supportive services, including quality mental health care, and also a place where parents and families can learn to support their children's sexual orientation and gender identity in culturally affirming ways. The Family Acceptance Project's latest study shows how deeply rooted efforts are to change LGBT youth, how great the personal cost and how vital our services are to nurture their positive development -- just as they are. Engaging families is not only important but life-saving, particularly here in Utah."

This study is noteworthy since knowledge of conversion efforts among LGBT adolescents is limited, and research that guides public policy responses to prevent conversion efforts is based on the experiences of adults. This knowledge gap has obscured the central role of parents and caregivers both in trying to change their child's sexual orientation at home though a range of rejecting behaviors and in serving as gatekeepers to take their LGBT children to practitioners and religious leaders to try to change their sexual orientation though conversion interventions.

Although responses to prevent conversion efforts have focused on adopting state laws to curtail licensed practitioners from engaging in sexual orientation change interventions (deemed unethical and harmful by mainstream professional associations), this study underscores the urgent need for culturally appropriate education and guidance for families and religious leaders to provide accurate information on sexual orientation, gender identity and expression, on the harmful effects of family rejecting behaviors which include sexual orientation conversion efforts, and on the need for supporting LGBT young people to reduce risk and increase well-being.

The Family Acceptance Project is a research, intervention, education and policy initiative, affiliated with San Francisco State University, that is designed to: 1) prevent risk, including suicide and homelessness, and promote well-being for LGBTQ children and adolescents in the context of their families, cultures and faith communities; and 2) Implement and disseminate the first research-based, family model of wellness, prevention, and care to build healthy futures for LGBTQ children and youth.

For more information, visit https://familyproject.sfsu.edu/

For more information on Human Development & Family Sciences, University of Texas at Austin: https://he.utexas.edu/hdfs

For more information about Encircle: https://encircletogether.org