Department of Sociology, The Catholic University of America, Washington, DC, 20064, USA.
Ruth Institute, Lake Charles, LA, USA.
Arch Sex Behav. 2022 Oct;51(7):3377-3393. doi: 10.1007/s10508-022-02408-2. Epub 2022 Sep 6.
Sexual orientation change efforts (SOCEs) signify activities designed to change or reduce homosexual orientation. Recent studies have claimed that such therapies increase suicide risk by showing positive associations between SOCE and lifetime suicidality, without excluding behavior that pre-dated SOCE. In this way, Blosnich et al.'s (2020) recent analysis of a national probability sample of 1518 sexual minority persons concluded that SOCE "may compound or create…suicidal ideation and suicide attempts" but after correcting for pre-existing suicidality, SOCE was not positively associated with any form of suicidality. For suicidal ideation, Blosnich et al. reported an adjusted odds ratio (AOR) of 1.92 (95% CI 1.01-3.64); the corrected AOR was .44 (.20-.94). For suicide planning, Blosnich et al.'s AOR was 1.75 (1.01-3.06); corrected was .60 (.32-1.14). For suicide attempts, Blosnich et al.'s AOR was 1.75 (.99-3.08); corrected was .74 (.36-1.43). Undergoing SOCE after expressing suicidal behavior reduced subsequent suicide attempts from 72 to 80%, compared to those not undergoing SOCE, when SOCE followed a prior expression of suicidal ideation (AOR .17, .05-.55), planning (AOR .13, .04-.45) or intention (AOR .10, .03-.30); however, SOCE following an initial suicide attempt did not significantly reduce further attempts. By violating the principle that a cause cannot occur after an effect, Blosnich et al. misstated the correct conclusion. Experiencing SOCE does not result in higher suicidality, as they claim, and may sharply reduce subsequent suicide attempts. Restrictions on SOCE will not reduce suicidal risk among sexual minorities and may deprive them of an important resource for reducing suicide attempts.
性取向改变努力(SOCE)是指旨在改变或减少同性恋倾向的活动。最近的研究声称,这些疗法会增加自杀风险,因为它们显示 SOCE 与终生自杀率之间存在积极关联,而没有排除 SOCE 之前的行为。以这种方式,Blosnich 等人(2020 年)最近对 1518 名性少数群体的全国概率样本进行了分析,得出结论认为 SOCE“可能会加剧或产生……自杀意念和自杀企图”,但在对先前存在的自杀倾向进行校正后,SOCE 与任何形式的自杀倾向都没有正相关。对于自杀意念,Blosnich 等人报告的调整后优势比(AOR)为 1.92(95%CI 1.01-3.64);校正后的 AOR 为.44(.20-.94)。对于自杀计划,Blosnich 等人的 AOR 为 1.75(1.01-3.06);校正后的 AOR 为.60(.32-1.14)。对于自杀企图,Blosnich 等人的 AOR 为 1.75(.99-3.08);校正后的 AOR 为.74(.36-1.43)。在表达自杀行为后接受 SOCE 治疗,与未接受 SOCE 治疗的人相比,随后的自杀企图减少了 72%至 80%,当 SOCE 紧随先前表达自杀意念(AOR.17,.05-.55)、计划(AOR.13,.04-.45)或意图(AOR.10,.03-.30)之后;然而,SOCE 之后的首次自杀尝试并没有显著减少进一步的尝试。Blosnich 等人违反了因果关系不能在结果之后发生的原则,错误地陈述了正确的结论。他们声称,经历 SOCE 并不会导致更高的自杀倾向,反而可能会大幅减少随后的自杀企图。对 SOCE 的限制不会降低性少数群体的自杀风险,反而可能剥夺他们减少自杀企图的重要资源。