Introduction

Gender identity change efforts (GICE) aim to change one’s gender identity to be congruent with sex assigned at birth. Practicing conversion efforts with minors is outlawed for licensed professionals in many U.S. jurisdictions, yet it remains legal in many other jurisdictions and for religious counselors. Literature remains scant but points to a harmful role GICE may play in the lives of transgender and nonbinary (TNB) persons. We examine how GICE is associated with mental and physical wellbeing and proximal minority stressors among TNB persons.

Methods

Using the U.S. TransPop online survey data (2016–2018) collected from 271 TNB adults, we conducted multivariate regression models examining the association between GICE exposure and psychological distress (Kessler-6), past 30-day physical and mental health, healthcare-related stigma anticipation, and proximal stressors (i.e., negative future expectation, nondisclosure of gender identity, and internalized transphobia). Covariates included race, age, gender identity, education level, census poverty level, and sexual orientation.

Results

The average participant was 39 years old and identified as a transgender woman (44%) and white (69%). TNB participants with GICE exposure, on average, reported 4 points (0–23) higher psychological distress levels and 8.1 additional days with poor mental health over the past 30 days. Significantly higher healthcare stigma fears and negative expectation were also observed among GICE-exposed participants.

Conclusions

Findings indicate poorer mental wellbeing among GICE-exposed TNB persons who also report more healthcare-related stigma fears and negative future expectation.

Policy Implications

Considering the relationship between GICE exposure and poor mental wellbeing, our findings give further credence to efforts aimed at outlawing GICE.

中文翻译：

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性别认同转换努力是居住在美国的跨性别者和非二元性别者中少数人压力的一个来源：与幸福感和近端压力源的相关性

介绍

性别认同改变努力（GICE）旨在改变一个人的性别认同，使其与出生时指定的性别一致。在美国许多司法管辖区，对有执照的专业人士来说，与未成年人进行皈依活动是非法的，但在许多其他司法管辖区和宗教顾问中，这仍然是合法的。文献仍然很少，但指出 GICE 可能在跨性别者和非二元性别 (TNB) 人的生活中发挥有害作用。我们研究了 GICE 与 TNB 人群的心理和身体健康以及近端少数压力源之间的关系。

方法

利用从 271 名 TNB 成年人收集的美国 TransPop 在线调查数据（2016-2018 年），我们建立了多元回归模型，检验 GICE 暴露与心理困扰 (Kessler-6)、过去 30 天的身心健康、医疗保健相关的关系耻辱预期和近端压力源（即消极的未来预期、不公开性别认同和内在的变性恐惧症）。协变量包括种族、年龄、性别认同、教育水平、人口普查贫困水平和性取向。

结果

参与者的平均年龄为 39 岁，被确定为跨性别女性 (44%) 和白人 (69%)。接触过 GICE 的 TNB 参与者平均报告心理困扰水平高出 4 分 (0-23)，并且在过去 30 天内心理健康状况不佳的天数增加了 8.1 天。在 GICE 暴露的参与者中还观察到显着更高的医疗保健耻辱恐惧和负面期望。

结论

调查结果表明，接触过 GICE 的 TNB 人群的心理健康状况较差，他们还报告了更多与医疗保健相关的耻辱恐惧和对未来的负面预期。

政策影响

考虑到 GICE 暴露与不良心理健康之间的关系，我们的研究结果进一步证明了旨在取缔 GICE 的努力。