Conversion Therapy and a Survey of 25,896 LGBTQ youth

[Shizuku]

Trigger Warning - this post discusses suicidal feelings.

As the banning of conversion therapy is currently being debated, it might be useful for members of this group to see a survey of 25,896 LGBTQ youth which found that 57% of transgender and non-binary youth who have undergone conversion therapy report a suicide attempt in the last year:

www.thetrevorproject.org/survey-2019/?section=Conversion-Therapy-Change-Attempts

If anyone reading this is experiencing suicidal thoughts, please know that suicide is preventable, and that support is available. Here is a link to the Samaritans:

www.samaritans.org/

Would you discourage a cis woman with a full beard from having it removed if she said that having such an overt physical masculinity made her uncomfortable and depressed?

This women may actually have a medical condition such as PCOS or maybe in menopause. You might already know this if you are a female. If so, there is likely to be also these significant health issues that could also be causing her discomfort.

Would you suggest she had therapy to convert her personality to one that enjoyed being a bearded lady?

This is not a logical equivalence. You have just stated she was uncomfortable and depressed.

@Helleofabore

Thanks OldCrone. I was just reading one of the links posted by another poster on another thread and remembered Dr Steensma's recent clarification on this.

And was reminded to that Dr Will Malone posted this link too.

This is a good balancing article from a group of gender specialist clinicians who are very worried about the push for affirming only treatment from around the world.

www.segm.org/danger_of_conflation

I would suggest Shizuku in the name of balance, might like to read this. It does discuss treatment options in relation to suicide risk and mental health.

Here is a couple of paragraphs:

Without a doubt, attempts to force a change in one’s gender identity have no place in the field of mental health. Yet, we have been growing increasingly concerned with the conflation of ethical psychotherapy for gender dysphoria with conversion therapy. The study authors erased the critical lines that separate coercive and unethical attempts of conversion from ethical psychotherapy. Our analysis also revealed a number of serious methodological flaws and misinterpretations of the data that invalidate the study conclusions. In fact, the study provides no credible evidence that either psychological distress or suicide attempts (which are present at elevated rates in gender dysphoric individuals), are a result of ethical psychotherapy.

The authors also fail to reflect on their own key finding—the high prevalence of serious uncontrolled mental illness in the study subjects who recalled “GICE” efforts. The fact that gender dysphoric people continue to struggle with a significant burden of mental illness, both pre- and post-transition, has been documented consistently across a range of studies, and this finding in itself calls for more emphasis on the provision of quality mental health services for this population.

link.springer.com/content/pdf/10.1007/s10508-020-01844-2.pdf

It pretty much sums things nicely though.

ETHICAL psychotherapy vs coercive and unethical attempts of conversion.

So, thanks OP for providing us the opportunity to pull together some interesting balancing counterviews for us all to read.

And to discuss what may be the potential motivations behind each perspective. I know that the readers of these threads appreciate having this information and seeing how the different perspectives are presented and supported.

Just posting this link and paper here that might provide a more positive and balanced discussion about this Trevor Project Survey.

I will repeat again, this survey done by the Trevor Project is a good indicative survey that surely shows areas for further exploration and study.

The major significant problem though is the lack of definition of conversion therapy. (And the OP's wide definition must also surely be considered a starting point for discussion on what is conversion therapy rather than leaving it ambiguous.)

How conversion therapies differ between LGB & therapies for the T.

I find it rather disturbing that OP claims to care about children with gender dysphoria but refuses to engage with serious questions about the research into how to help those children.

OP, aren't you super interested in any correlation between religion, attempts at conversion and suicidal thoughts? That could be such helpful therapeutic information for the children and supporting adults.

What about correlation vs causation between suicidal thoughts and conversion therapy. Were the children suicidal before the CT? Did they seek out CT themselves or were they forced into it? Were they more, less or same suicidal afterwards?

Some of the respondents will have gone through some form of transition from hair length and name change through to genital alteration. What's the difference between the groups?

Is there any difference between experiences of each of the groups L,G,B & T? It would seem likely there would be differences wouldn't it?

If you care about helping these children why aren't you pushing hard for research to answer these questions? Why aren't you worried about the short-comings with the Trevor Project resulting in harm being done to children?

You sound like a pusher of one single miracle treatment for all, like a rep.

Don't you see any problems with using this research to drive legislation yourself?

You would dismiss a study that suggests conversion therapy causes suicides in trans youths when deciding whether to ban conversion therapy in trans youths?

In addition to the caveats already posted by others before me, I would like to add two more in response to your question:

This survey, useful as it may be for highlighting mental health pressure points for LGBT youth, is purely quantitative in nature. This is a drawback when studying suicidal behaviour, because respondents frequently overstate the number of suicide attempts made, or the seriousness of their suicidal ideation. When quantitative methods are combined with qualitative ones such as discussions, interviews, diaries, rates of suicide attempts are typically halved. So these numbers may or may not be accurate, but the survey is not designed to ascertain that because it does not capture anything other than self-reported data.

Furthermore, suicidal behaviour is a complex issue with multifactorial causes. As others habe sought to explain before me, it is overly simplistic (if not to say incorrect and often irresponsible) to blame one factor for such behaviour. There is a large body of research into suicides and suicidal behaviour that has established this fact, which is reflected in the Samaritans'media guidelines for reporting suicides.

Now I understand what the Trevor Project is aiming to and it is much needed work, which has undoubtedly saved lives in the 20+ years since it was founded. And I understand what they seek to do with their survey. But it cannot do anything other than suggest that certain things increase or decrease suicidal behaviour, because their survey isn't designed to do anything other than paint a mental health picture of LGBT youth in broad brushstrokes.

That isn't a sound basis for policymaking.

Again I’m not sure why anyone with an ounce of sense would be in favour of the affirmation model for children.
Can I ask Shuzuku why they feel that children who are dealing with serious mental health issues that make them think they are in the wrong body should have surgery and if anyone who is safeguarding this child thinks that amputations and hormones aren’t appropriate that is suddenly conversion therapy?
I think you might not understand children.

The OP isn't playing nice and I am not sure that this individual is really reading and engaging.

OP - so many very experienced posters (many with qualifications in scientific fields, the social sciences and research in general) have responded to your post, your claims, and your demands with careful, well-thought-out and reasoned responses. Do read these. You will learn from them.

This is true Spartacus. I have had a previous decades long career in designing and analyzing these types of data collection tools, along with two qualifications in it.

I know very well how to word them to get different results and just how easy they are to misinterpret (accidentally and deliberately). And how to communicate those results to manipulate the message....

So, no. I don’t put any credibility in top level data like this. It would have been my job to present this data like this to suit the agenda of the client.

For the record, this definition is incredibly wide and still is non-specific. Because in some parts of the world, psychotherapy for underlying co-morbidites has been considered conversion therapy.

Note also that such actual/proposed laws are usually framed asymmetrically. "Converting" "trans" to "cis" is illegal, "cis" to "trans" is not.

So they make sure anyone suggesting "oh, you don't like football, are you sure you're a boy?" is in no danger.

I'd have a hell of a lot more confidence in such bills not being widely applied if they hadn't just made themselves exempt by fiat.

With a report like this, which cherry-picks soundbites to suit an agenda, noticing what isn't reported can be just as informative as looking at the information that is included.

For example, it would have had more impact to report that the incidence of suicide attempts in trans and non-binary young people was much higher in the group who had undergone conversion therapy than in the group who hadn't. The fact that the report doesn't do this, and only mentions the figure in the conversion therapy group, suggests that in reality the incidence of suicide attempts may have been very similar in both groups, regardless of intervention history.

This sort of "spin" is what the peer review process is designed to avoid. Good reviewers will spot these glossed-over gaps and ask researchers to include the missing information to give a more transparent picture of the data.

What I would take seriously is you presenting me with quality studies showing that conversion therapy is harmless or even beneficial for trans youths.

A quality study for setting policy or drawing conclusions to set world wide standards for health care is not a widely targeted quantitative questionnaire asking ill-defined and top level questions from self selected respondents. Furthermore, quality studies does not necessarily refer to the quality of the graphics used to present the data, although, I did love the way it was presented.

A quality study for influencing policy could use this as a foundation to do further qualitative studies to discover and confirm correlation and draw causation statements from those correlations. I would hope no scientist would use the information as it is presented in that link as their sole source of data.

(I will also point out I have not looked at the original questionnaire device and any other information given to the respondents. There might be more relevant information collected but not shown)

Any policymaker that had even a brief exposure to marketing would understand this is not quality data for the purpose you are stating it should be used, no matter the reputation for doing good work the organization behind it.

Just to make this even more clear, the size of the data set also doesn’t increase the quality much either. Rubbish in/rubbish out.

For driving awareness, which is the purpose of this project, it is fit for purpose and can be considered high quality. And as I said, high quality presentation if you are into infographics. This is a marketing campaign! Not a scientific study.

For policy making, this is poor quality research.

@Helleofabore

What I would take seriously is you presenting me with quality studies showing that conversion therapy is harmless or even beneficial for trans youths.

A quality study for setting policy or drawing conclusions to set world wide standards for health care is not a widely targeted quantitative questionnaire asking ill-defined and top level questions from self selected respondents. Furthermore, quality studies does not necessarily refer to the quality of the graphics used to present the data, although, I did love the way it was presented.

A quality study for influencing policy could use this as a foundation to do further qualitative studies to discover and confirm correlation and draw causation statements from those correlations. I would hope no scientist would use the information as it is presented in that link as their sole source of data.

(I will also point out I have not looked at the original questionnaire device and any other information given to the respondents. There might be more relevant information collected but not shown)

Any policymaker that had even a brief exposure to marketing would understand this is not quality data for the purpose you are stating it should be used, no matter the reputation for doing good work the organization behind it.

Just to make this even more clear, the size of the data set also doesn’t increase the quality much either. Rubbish in/rubbish out.

For driving awareness, which is the purpose of this project, it is fit for purpose and can be considered high quality. And as I said, high quality presentation if you are into infographics. This is a marketing campaign! Not a scientific study.

For policy making, this is poor quality research.

Are you in favour of banning conversion therapy? If so would you only ban doing it to LGB people, or would you want to ban doing it to trans people too?

I am not sure that this individual is really reading and engaging

Yeah, me too. This isn't a conversation, this is someone wearing earplugs, who is handing us leaflets, which all say the same thing.

@NecessaryScene1

For the record, this definition is incredibly wide and still is non-specific. Because in some parts of the world, psychotherapy for underlying co-morbidites has been considered conversion therapy.

Note also that such actual/proposed laws are usually framed asymmetrically. "Converting" "trans" to "cis" is illegal, "cis" to "trans" is not.

So they make sure anyone suggesting "oh, you don't like football, are you sure you're a boy?" is in no danger.

I'd have a hell of a lot more confidence in such bills not being widely applied if they hadn't just made themselves exempt by fiat.

"Cis to trans" would be attempting convert someone's gender identity so that would be covered under a ban on conversion therapy.

The definition of conversion therapy is clear. The definition I gave you was:

"Trans conversion therapy would be any "therapy" that attempts to change a trans person's gender identity to match the sex they were assigned at birth."

Or take this one from yesterday's BBC article:

""Conversion therapy" refers to any form of treatment or psychotherapy which aims to change a person's sexual orientation or gender identity."

Here's another from Stonewall:

"Conversion therapy (or ‘cure’ therapy or reparative therapy) refers to any form of treatment or psychotherapy which aims to change a person’s sexual orientation or to suppress a person’s gender identity. It is based on an assumption that being lesbian, gay, bi or trans is a mental illness that can be ‘cured’. These therapies are both unethical and harmful."

As there is some discussion here about what the Trevor Project actually mean by "conversion therapy" here is a link to their page on it:

www.thetrevorproject.org/get-involved/trevor-advocacy/50-bills-50-states/about-conversion-therapy/

"Conversion therapy refers to any of several dangerous and discredited practices aimed at changing an individual’s sexual orientation or gender identity. For example, that could mean attempting to change someone’s sexual orientation from lesbian, gay, or bisexual to straight or their gender identity from transgender or nonbinary to cisgender. And it could include efforts to change a person’s gender expression (to make a person act more stereotypically masculine or feminine, for example), or to reduce or eliminate sexual or romantic attraction or feelings toward a person of the same gender."

Meanwhile, here's another study showing the harm:

ajph.aphapublications.org/doi/10.2105/AJPH.2020.305701

"Results. Relative to young people who had not experienced SOGICE [sexual orientation or gender identity conversion efforts], those who reported undergoing SOGICE were more than twice as likely to report having attempted suicide and having multiple suicide attempts."

"Conclusions. The elevated odds of suicidality observed among young LGBTQ individuals exposed to SOGICE underscore the detrimental effects of this unethical practice in a population that already experiences significantly greater risks for suicidality."

@ArcheryAnnie

I am not sure that this individual is really reading and engaging

Yeah, me too. This isn't a conversation, this is someone wearing earplugs, who is handing us leaflets, which all say the same thing.

I'm not here to debate your definitions, or do your additional research for you, I am merely pointing you to the research that shows that trans conversion therapy is harmful, and I am doing that because I have seen objection in this forum to including trans people in the proposed ban on conversion therapy.

Are you in favour of banning conversion therapy? If so would you only ban doing it to LGB people, or would you want to ban doing it to trans people too?

Please stop with the all or nothing simplistic arguments.

If you cannot read nuance, if you cannot actually go and read the posts people are posting, maybe this style of forum is not for you.

Or.....

you could go back and answer some of the many question asked including some from me asking YOU to clarify what conversion therapy is in relation to LGB and what conversion therapy is in relation to T.

"YOU to clarify what conversion therapy is in relation to LGB and what conversion therapy is in relation to T."

Scroll up - I have given you 4 definitions so far, all of them in agreement with each other. If you try to change a trans person's gender identity, by whatever means, that is conversion therapy and it is harmful - simple.

Meanwhile, you are also completely ignoring your whole point of your other posts.

This questionnaire is NOT good evidence.

@Helleofabore

Meanwhile, you are also completely ignoring your whole point of your other posts.

This questionnaire is NOT good evidence.

You can debate the quality of the evidence as much as you like, but it is a study done by world-leading experts on suicidality in LGBTQ youths, who, as you can see above, have a detailed page explaining what they mean by "conversion therapy.

www.thetrevorproject.org/get-involved/trevor-advocacy/50-bills-50-states/about-conversion-therapy/

And there is also another study showing similar:

ajph.aphapublications.org/doi/10.2105/AJPH.2020.305701

At this point, the only evidence you have is that conversion therapy is harmful. If you want to ignore it and campaign to allow the practice to continue for LGB people or trans people or both, then that's on you. If you want people to take you seriously, you need to post evidence that conversion therapy on trans people is either harmful or beneficial.

"Trans conversion therapy would be any "therapy" that attempts to change a trans person's gender identity to match the sex they were assigned at birth."

And I commented, and others too, that this is too broad and can and HAS been misused in the context of in-depth psychotherapy that treats underlying co-morbidities. Where is the line where it crosses? And I even posted twice, clinician's opinions to how this impacts on the quality of care for trans people.

Or take this one from yesterday's BBC article:

""Conversion therapy" refers to any form of treatment or psychotherapy which aims to change a person's sexual orientation or gender identity."

This too too, is too broad and can and HAS been misused in the context of in-depth psychotherapy that treats underlying co-morbidities. Where is the line where it crosses? And I even posted twice, clinician's opinions to how this impacts on the quality of care for trans people.

Here's another from Stonewall:

"Conversion therapy (or ‘cure’ therapy or reparative therapy) refers to any form of treatment or psychotherapy which aims to change a person’s sexual orientation or to suppress a person’s gender identity. It is based on an assumption that being lesbian, gay, bi or trans is a mental illness that can be ‘cured’. These therapies are both unethical and harmful."

And again. This does not address what is allowable as pyschotherapy. There is a whole lot of nuance that cannot be condensed into statements that are as simplistic as you want them to be.

There are many therapies that are intentional conversion therapies and are unethical and harmful. We know this. We have regular posters on this very thread that experienced them first hand.

But, what is a conversion therapy and what is a positive psychotherapy that allows a person to be comfortable with their body as it is or with changes, but to have their underlying mental health issues resolved enough to be no longer suicidal.

None of this also acknowledges the needs of the female children or teenagers that have complex mental health needs.

DO YOU have a solution to propose?

At this point, the only evidence you have is that conversion therapy is harmful.

This is either incredibly naive, or disingenuous. It is known that certain conversion therapies are incredibly harmful.

Please stop with the all or nothing style of debate.

If you want to ignore it and campaign to allow the practice to continue for LGB people or trans people or both, then that's on you.

This post is incredibly offensive and it shows that you are not actually reading with any sense of an open mind. You are coming across as intractably pushing an agenda with the constant 'all or nothing' statements and no actual discussion.

I am NOT ignoring the needs of LGB or T people by stating that this very study is an awareness campaign study and it is not fit for basing UK policy around this very complex issue on. IT IS NOT ON ME!

If you want people to take you seriously, you need to post evidence that conversion therapy on trans people is either harmful or beneficial.

I don't think that I am the poster on this thread that has a credibility issue. At all.

"this is too broad and can and HAS been misused in the context of in-depth psychotherapy that treats underlying co-morbidities. Where is the line where it crosses?"

It crosses the line when you are trying to change a person's gender identity, so you can be as supportive as you like, help them deal with any and all comorbidities, help them come to terms with any and all the traumas they may or may not have suffered, but don't try to change their gender identity.

I realise you want it to be complicated so that you can leverage that complexity to exclude trans people from the legislation, but it isn't - it's really very simple: don't try to change a person's gender identity because it harms them.

And again, all you have to do to support the exclusion of trans people from the legislation is to present evidence that conversion therapy is either harmless or beneficial to trans people. Still waiting...

Goodness you don't answer any of the questions do you op. Smoke and mirrors all the way. Shadows and subterfuge.

What do you think conversion therapy is? I think all people that want to medically transition need emotional support / counselling, and a watchful waiting approach to make sure they have enough time to make a decision about something that is not reversible and potentially extremely damaging to health.

This is evident from the people who thought they needed to transition, and later, when it was too late, realised the decision was wrong for them.

I further believe that to push someone down the road of medical tranistion without exploring why, is in itself conversion therapy. Medically/surgically altering people's bodies without exploring why this is the right option is dangerous, poor practice, without any consideration to legal safeguards and statutory duty. So conversion therapy in this sense is wrong.
Emotional support / counselling is however good practice.

Gay conversion therapy and T conversion therapy are not the same thing. Stop conflating the two to legitimise the cause.

Could you please stop ascribing opinions and statements that seem to imply 'transphobia' to me that I am not saying.