Gender Identity Conversion Efforts as a Source of Minority Stress Among Transgender and Nonbinary Persons Living in the U.S.: Correlation with Wellbeing and Proximal Stressors

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.

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.

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.

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

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