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Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults.
JAMA Psychiatry ( IF 25.8 ) Pub Date : 2019-09-11 , DOI: 10.1001/jamapsychiatry.2019.2285
Jack L Turban 1 , Noor Beckwith 2 , Sari L Reisner 3, 4 , Alex S Keuroghlian 5, 6
Affiliation  

Importance Gender identity conversion efforts (GICE) have been widely debated as potentially damaging treatment approaches for transgender persons. The association of GICE with mental health outcomes, however, remains largely unknown. Objective To evaluate associations between recalled exposure to GICE (by a secular or religious professional) and adult mental health outcomes. Design, Setting, and Participants In this cross-sectional study, a survey was distributed through community-based outreach to transgender adults residing in the United States, with representation from all 50 states, the District of Columbia, American Samoa, Guam, Puerto Rico, and US military bases overseas. Data collection occurred during 34 days between August 19 and September 21, 2015. Data analysis was performed from June 8, 2018, to January 2, 2019. Exposure Recalled exposure to GICE. Main Outcomes and Measures Severe psychological distress during the previous month, measured by the Kessler Psychological Distress Scale (defined as a score ≥13). Measures of suicidality during the previous year and lifetime, including ideation, attempts, and attempts requiring inpatient hospitalization. Results Of 27 715 transgender survey respondents (mean [SD] age, 31.2 [13.5] years), 11 857 (42.8%) were assigned male sex at birth. Among the 19 741 (71.3%) who had ever spoken to a professional about their gender identity, 3869 (19.6%; 95% CI, 18.7%-20.5%) reported exposure to GICE in their lifetime. Recalled lifetime exposure was associated with severe psychological distress during the previous month (adjusted odds ratio [aOR], 1.56; 95% CI, 1.09-2.24; P < .001) compared with non-GICE therapy. Associations were found between recalled lifetime exposure and higher odds of lifetime suicide attempts (aOR, 2.27; 95% CI, 1.60-3.24; P < .001) and recalled exposure before the age of 10 years and increased odds of lifetime suicide attempts (aOR, 4.15; 95% CI, 2.44-7.69; P < .001). No significant differences were found when comparing exposure to GICE by secular professionals vs religious advisors. Conclusions and Relevance The findings suggest that lifetime and childhood exposure to GICE are associated with adverse mental health outcomes in adulthood. These results support policy statements from several professional organizations that have discouraged this practice.

中文翻译:

被召回的性别认同转换工作暴露与跨性别成年人的心理困扰和自杀企图之间的关联。

重要性性别认同转换工作(GICE)已被广泛争论为对跨性别者的潜在破坏性治疗方法。然而,GICE与心理健康结果之间的关联仍然未知。目的评估召回的GICE(世俗或宗教专业人员)与成人心理健康结局之间的关联。设计,设置和参与者在这项横断面研究中,通过基于社区的推广活动向居住在美国的跨性别成年人分发了一项调查,来自美国50个州,哥伦比亚特区,美属萨摩亚,关岛,波多黎各的代表,以及美国在海外的军事基地。数据收集在2015年8月19日至9月21日之间的34天内进行。数据分析的执行时间为2018年6月8日至2019年1月2日。暴露召回接触GICE。主要结果和衡量方法上个月的严重心理困扰,通过凯斯勒心理困扰量表(定义为得分≥13)来衡量。前一年和一生中的自杀率的度量,包括想法,尝试和需要住院治疗的尝试。结果27 715名跨性别调查的受访者(平均[SD]年龄,31.2 [13.5]岁),出生时有11 857名(42.8%)被分配为男性。在曾与专业人士讨论过性别认同的19 741名(71.3%)中,有3869名(19.6%; 95%CI,18.7%-20.5%)报告了其一生中接触过GICE的情况。与非GICE治疗相比,前一月的终生暴露与严重的心理困扰有关(校正后的优势比[aOR]为1.56; 95%CI为1.09-2.24; P <0.001)。发现召回的终生暴露与终生自杀未遂几率较高(aOR,2.27; 95%CI,1.60-3.24; P <.001)与10岁之前的召回暴露和终生未遂自杀几率(aOR)之间存在关联,4.15; 95%CI,2.44-7.69; P <.001)。比较世俗专业人士和宗教顾问对GICE的接触时,没有发现显着差异。结论与相关性研究结果表明,一生和儿童时期接触GICE与成年期不良的心理健康结果相关。这些结果支持了一些不鼓励这种做法的专业组织的政策声明。001),并忆及10岁之前的接触和终生自杀未遂的几率增加(aOR,4.15; 95%CI,2.44-7.69; P <.001)。比较世俗专业人士和宗教顾问对GICE的接触时,没有发现显着差异。结论与相关性研究结果表明,一生和儿童时期接触GICE与成年期不良的心理健康结果相关。这些结果支持了一些不鼓励这种做法的专业组织的政策声明。001),并忆及10岁之前的接触和终生自杀未遂的几率增加(aOR,4.15; 95%CI,2.44-7.69; P <.001)。比较世俗专业人士和宗教顾问对GICE的接触时,没有发现显着差异。结论与相关性研究结果表明,一生和儿童时期接触GICE与成年期不良的心理健康结果相关。这些结果支持了一些不鼓励这种做法的专业组织的政策声明。结论与相关性研究结果表明,一生和儿童时期接触GICE与成年期不良的心理健康结果相关。这些结果支持了一些不鼓励这种做法的专业组织的政策声明。结论与相关性研究结果表明,一生和儿童时期接触GICE与成年期不良的心理健康结果相关。这些结果支持了一些不鼓励这种做法的专业组织的政策声明。
更新日期:2020-01-02
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