So-called conversion therapy causes severe emotional damage to LGBTQ people and can even be fatal, but it also comes at a high financial cost to individuals and to society as a whole, according to a new study.
The study, published Monday in the medical journal JAMA Pediatrics, analyzed 28 previous studies of conversion therapy, which attempts to convert people who identify as lesbian, gay, bisexual, transgender, queer or questioning into heterosexual people. or cisgender.
The practice, also known as restorative or sexual orientation change efforts, has been discredited by all major professional associations dealing with mental health. The assumption that a person’s sexual orientation or gender identity can be changed is not based on medical or scientific evidence, according to the American Medical Association. In fact, the practice can lead to serious harm.
Conversion therapy is banned in at least 20 states and several cities nationwide, but several bills have been introduced to preserve the practice or even repeal the bans.
The study found that people who underwent conversion therapy suffered from severe psychological distress, had significantly higher rates of depression and substance abuse problems, and were more likely to attempt suicide.
Over a lifetime, the estimated cost of this therapy is nearly $100,000 per person, the researchers found. Compared to no intervention, positive therapy — psychotherapy that validates positive expression of sexual and gender identity — resulted in savings of more than $40,000 per person, the study found. .
Direct costs include treatment costs, health outcomes and mortality; indirect costs include lost productivity, according to the study.
More than half a million LGBTQ youth in the United States were at risk of undergoing conversion therapy in 2021, the researchers wrote, based on reported therapy rates. The total costs of conversion therapy were estimated at over $650 million per year, and the damages associated with this estimated economic burden were $8.58 billion, for a total burden of $9.23 billion. .
If LGBTQ youth received positive therapy, the estimated savings would be $1.81 billion compared to no intervention and nearly $6.19 billion compared to conversion therapy over the course of their life. life.
“It is incumbent on policymakers to act to protect young people from – and to end all funding for – this unacceptable practice,” the researchers wrote. “Similarly, increasing access to positive therapy can promote health by giving LGBTQ youth the skills and strategies to deal with minority stress.”
Cytel researchers conducted the analysis, and it was funded by The Trevor Project, a nonprofit suicide prevention and crisis intervention organization that supports LGBTQ youth. Some of the study authors have received grants from the Trevor Project, and their organization has been a paid consultant for the Trevor Project.
In an editorial accompanying the study, Dr. Johanna Olson-Kennedy of the University of Southern California’s Keck School of Medicine and Children’s Hospital Los Angeles wrote that “what remains troublesome is the need for a study that describes the financial burden of such rigidity because the human toll is simply not enough to eradicate the dangerous practice of forcing individuals to conform to the heterosexual and cisgender normative expectation .
Because this study identifies a substantial cost, the editorial concludes, “perhaps humanity could redirect its reparation efforts toward dismantling the nefarious straight and cisgender normative vice that continues to stifle social evolution.” .
The research has certain limitations. The model only considers costs and outcomes for three years after the person has undergone therapy, and harms and costs could persist for much longer, suggesting that this practice is much more expensive.
Mike Parent, director of the Gender, Sexuality and Behavioral Health Lab at the University of Texas at Austin, said the research was important.
“I think we’ve been saying for a long time that conversion therapy efforts are damaging, in addition to being futile. But the study asks a different kind of question and shows that not only does it harm the individual, but it ends up also by costing society money,” said Parent, who was not involved in the study.
Parent thinks it’s unfortunate that some people only care about the financial consequences of this problem, especially when the practice is so detrimental to a person’s mental and physical well-being – the suicide rate alone is ” astronomically high” – but he said it is a legitimate question to try to figure out.
“It’s another piece of the picture of how damaging this is, not just to the individual but to society as a whole,” Parent said.
The past five years have seen several bans on the practice, but a handful of pro-conversion therapy bills have been introduced, many of which focused on trans children, said Alex Petrovnia, founder of the Trans Formation Project, a Step Up for Trans Kids project that follows anti-trans legislation.
Petrovnia said there are two bills that would explicitly allow the practice in Tennessee. There is a “religious liberty” measure in Kentucky that provides a specific allowance. And Petrovnia said that “each of the anti-trans medical bans we’ve seen contains an explicit clause that specifically allows intersex conversion therapy.”
Sean Cahill, director of health policy research at the Fenway Institute, a health association that advocates for and provides LGBTQIA+-focused health care and research in Boston, said this study adds to the whole picture. growing body of evidence that conversion therapy harms everyone who comes in contact with it.
“I think a lot of times parents, they don’t try to hurt their kids, or they think they’re trying to help them,” said Cahill, who was not involved in the research. “I think it’s really important for parents to know that if they put their child in conversion therapy, their child is more likely to suffer from severe psychological distress, depression, substance abuse and suicide. I think a lot of parents wouldn’t be happy to hear that.
Cahill hopes people will take note of this research and understand its implications.
“I think it’s a really compelling analysis that hopefully public health professionals and health care providers, public health professionals and policy makers will pay attention to and think about, what are the political implications? And what are healthcare applications? »