Sexual Orientation and Gender Identity Change Efforts Before Age 18: Demographic Correlates and Associations with Mental Health Conditions

Abstract

Purpose:

We examined the associations of sexual orientation and gender identity change efforts (SOGICE), both experienced over the lifetime and before adulthood, with demographic characteristics and a wide range of mental health outcomes in a sample of lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adults.

Methods:

The analytic sample was 3023 LGBTQ+ adults (M_age = 31.59) from a cross-sectional survey conducted in 2024 in North Carolina. Participants reported SOGICE experiences during their lifetime and before age 18, past-year mental health conditions (i.e., depression, bipolar disorder, post-traumatic stress disorder, anxiety disorder, gender dysphoria, eating disorder, nonsuicidal self-injury, suicidal thought, and suicide attempt), and past-2-week anxiety and depressive symptoms. Bivariate regression models and multivariate regression models were tested on the associations between SOGICE experiences and mental health conditions.

Results:

Reports of SOGICE experiences were higher among those assigned male at birth compared with those assigned female at birth, Black participants compared with White participants, and transgender and gender-diverse participants compared with cisgender participants. In multivariate models, lifetime SOGICE was associated with three out of nine mental health conditions. In multivariate models, experiencing SOGICE before age 18 was associated with higher odds of five out of nine mental health conditions.

Conclusion:

Our study demonstrates that SOGICE experiences, particularly before adulthood, were associated with multiple severe mental health conditions. These findings reinforce calls from professional organizations to end SOGICE due to its threat to LGBTQ+ well-being and to support legislative efforts to ban such practices.