By Carolyn Crist

(Reuters Health) – One in seven transgender people in the U.S. has experienced an attempt by a professional counselor to make them undergo pseudoscientific “therapy” with the goal of changing their gender identity, a recent study suggests.

So-called conversion therapy has been debunked and repudiated by medical professional organizations and banned in several U.S. states. Yet as recently as 2015, one in 20 transgender survey participants said they’d been the object of a conversion therapy attempt within the previous five years, researchers report in the American Journal of Public Health.

“These results are alarming, as gender identity conversion efforts have significant adverse health consequences,” said Dr. Alex Keuroghlian of Massachusetts General Hospital and The Fenway Institute in Boston, the study’s senior author.

In an interview published last week, McKrae Game, a leading practitioner of conversion therapy who came out as gay last June, told the Post and Courier newspaper, “Conversion therapy is not just a lie, but it’s very harmful. Because it’s false advertising.”

More than 1 million people in the U.S. identify as transgender – having a sex assigned at birth that doesn’t align with their gender identity. They face elevated risks of anxiety, depression and suicide attempts, often due to societal nonacceptance and antitransgender legislation, the study authors note in their report.

“Many U.S. states have not yet banned conversion efforts, in some cases due to claims that these conversion efforts do not occur in a particular state,” Keuroghlian told Reuters Health by email.

The survey results suggest these efforts are still happening in every state, however.

Keuroghlian and colleagues analyzed data from the U.S. Transgender Survey conducted by the National Center for Transgender Equality, which included 27,716 transgender people in 2015. A question in the survey asked about lifetime experience with conversion therapy, and also experiences in the past five years, with the question, “Did any professional (such as a psychologist, counselor, religious advisor) try to make you identify only with your sex assigned at birth (in other words, try to stop you being trans)?”

The research team found that 3,749 participants, or 13.5%, reported having had this experience during their lifetime. Proportions ranged broadly across states, from a low of 9.4% in South Carolina to a high of 25% in Wyoming. Based on U.S. population estimates, Keuroghlian’s team calculated that this translates to an estimated 188,000 trans people exposed during their lifetimes.

About 5% reported exposure between 2010 and 2015 to conversion therapy attempts. This also ranged across states, from a low of 1.2% in Alaska to a high of 16.3% in South Dakota. Based on these rates, the estimated total number of transgender people exposed during 2010-2015 was more than 73,000.

“We were concerned to discover that gender identity conversion efforts have continued in every U.S. state as recently as the period from 2010-2015,” Keuroghlian said.

A limitation of the study is that the U.S. Transgender Survey participants tend to be younger than the general U.S. population of transgender adults, and the 2015 survey included fewer racial minorities and fewer heterosexual participants.

Future studies should address these limitations and assess whether exposure to gender identity conversion is directly associated with suicide attempts in certain states, the study authors write.

“We hope that these findings will highlight the need to pass gender identity conversion effort bans in every U.S. state,” said the study’s lead author, Dr. Jack Turban of Massachusetts General Hospital and McLean Hospital in Boston. “We firmly believe that all gender identity conversion efforts should be illegal for all ages.”

Professional organizations such as the American Medical Association have labeled psychological attempts to change a person’s gender identity as ineffective and unethical.

“Conversion therapy is a fraudulent and dangerous practice that threatens the long-term wellbeing of LGBTQ youth everywhere it’s allowed,” said Gillian Branstetter of the National Center for Transgender Equality in Washington, D.C.

Transgender youth in particular frequently face discrimination campaigns by groups that promote conversion therapy, she said.

“It’s crucial parents and healthcare providers understand that conversion therapy is a very real danger while transition-related care is safe, effective, and supported by the entire mainstream of the medical community,” she told Reuters Health by email.

SOURCE: American Journal of Public Health, online August 15, 2019.