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‘Conversion therapy’ poses humanistic and economic burden on LGBTQ youths

The amount spent on SOGICE reaches into billions… aside from being detrimental to LGBTQIA people based on a clinical and humanistic standpoint.

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What is the total economic cost of sexual orientation and gender identity change efforts (SOGICE), also called conversion therapy, including adverse consequences, among lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) youths?

According to a study, the amount spent on SOGICE reaches into billions… aside from being detrimental to LGBTQIA people based on a clinical and humanistic standpoint.

The study – “Humanistic and Economic Burden of Conversion Therapy Among LGBTQ Youths in the United States” by Anna Forsythe, Casey Pick, Gabriel Tremblay, et al – that appeared in JAMA Pediatrics noted that “SOGICE, also called conversion therapy, is a discredited practice attempting to convert LGBTQ individuals to be heterosexual and/or cisgender.” And yet – even if discredited – it continues to be practiced.

The researchers, therefore, did a systematic literature review and economic evaluation from December 1, 2020, to February 15, 2021. The literature review analyzed published evidence on SOGICE among LGBTQ individuals of any age. The economic model evaluated the use of SOGICE vs no intervention, affirmative therapy vs no intervention, and affirmative therapy vs SOGICE to estimate the costs and adverse outcomes for each scenario and to assess the overall US economic burden of SOGICE. Published literature and public sources were used to estimate the number of LGBTQ youths exposed to SOGICE, the types of therapy received, and the associated adverse events (anxiety, severe psychological distress, depression, alcohol or substance abuse, suicide attempts, and fatalities).

The study found:

  • Among 28 published studies, which included 190 695 LGBTQ individuals, 12% (range, 7%-23%) of youths experienced SOGICE, initiated at a mean age of 25 years (range, 5-58 years), with a mean (SD) duration of 26 (29) months.
  • At least two types of SOGICE were administered to 43% of recipients.
  • Relative to LGBTQ individuals who did not undergo SOGICE, recipients experienced serious psychological distress (47% vs 34%), depression (65% vs 27%), substance abuse (67% vs 50%), and attempted suicide (58% vs 39%).
  • In the economic analysis, over a lifetime horizon with a 3% annual discount rate, the base-case model estimated additional $97 985 lifetime costs per individual, with SOGICE associated with 1.61 QALYs lost vs no intervention; affirmative therapy yielded cost savings of $40 329 with 0.93 QALYs gained vs no intervention.
  • With an estimated 508,892 youths at risk for SOGICE in 2021, the total annual cost of SOGICE is estimated at $650.16 million (2021 US dollars), with associated harms totaling an economic burden of $9.23 billion.

“This economic evaluation study suggests that there is a high economic burden and high societal costs associated with SOGICE and identifies additional research questions regarding the roles of private and public funding in supporting this harmful practice,” the researchers stated.

For them, therefore, “it is incumbent on policy makers to act to protect youths from—and stop all funding for—this unacceptable practice. Likewise, increasing access to affirmative therapy may promote health by empowering LGBTQ youths with skills and strategies to counteract minority stress.”


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