Gibb James K, Schrock Joshua M, Smith Madison Shea, D'Aquila Richard T, McDade Thomas W, Mustanski Brian
Department of Anthropology, Northwestern University, Evanston, Illinois.
Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois.
JAMA Netw Open. 2025 May 1;8(5):e258745. doi: 10.1001/jamanetworkopen.2025.8745.
Sexual orientation and gender identity change efforts (SOGICE), commonly known as conversion therapy, persist across the United States despite having been discredited due to their harmful mental health impact. Understanding the health consequences of SOGICE is critical, particularly for conditions exacerbated by stress, such as cardiovascular disease.
To investigate the association between SOGICE exposure and cardiovascular disease risk.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study draws on data from the observational cohort study RADAR, which included sexual and gender minority (SGM) young adults assigned male at birth (AMAB) in Chicago, Illinois. All data for this analysis were collected cross-sectionally during the same study visit for each participant between December 1, 2023, and October 31, 2024. Participants who completed SOGICE exposure measures and had cardiovascular health data were eligible; participants with incomplete data were excluded.
SOGICE exposure and duration.
Primary outcomes were diastolic blood pressure (DBP) and systolic blood pressure (SBP) measured via automatic monitors, systemic inflammation (SI) assessed through plasma biomarkers, and self-reported hypertension or high blood pressure (HHBP) diagnosis. Regression analyses were adjusted for sociodemographic and behavioral covariates.
Among 703 participants (mean [SD] age, 26.75 [4.60] years), 540 (76.8%) identified as cisgender, and 163 (23.2%) identified as transgender or gender diverse. Seventy-two participants (10.2%) reported exposure to SOGICE. Exposed participants had higher SI levels (β = 0.83; 95% CI, 0.17-1.49; P = .02), increased DBP (β = 3.46; 95% CI, 0.60-6.32; P = .02), elevated SBP (β = 4.28; 95% CI, 0.68-7.87; P = .02), and greater odds of self-reported HHBP diagnosis (odds ratio, 2.86; 95% CI, 2.19-3.54; P = .003) compared with nonexposed participants. Associations remained significant after adjusting for covariates.
In this cohort study of SGM young adults AMAB, exposure to SOGICE was associated with adverse cardiovascular health indicators, including elevated DBP and SBP, increased SI, and higher odds of self-reported HHBP. These findings underscore the need for public health and policy interventions to enforce and strengthen bans on SOGICE practices. Recognizing the cardiovascular health consequences of SOGICE contributes to addressing SGM health disparities and emphasizes the importance of affirmative care approaches that prioritize the well-being of SGM individuals.
性取向和性别认同改变疗法（SOGICE），通常被称为转化疗法，尽管因其对心理健康有有害影响而声名狼藉，但在美国仍普遍存在。了解SOGICE对健康的影响至关重要，尤其是对于像心血管疾病这种因压力而加剧的病症。
调查接触SOGICE与心血管疾病风险之间的关联。
设计、设置和参与者：这项队列研究利用了观察性队列研究RADAR的数据，该研究包括伊利诺伊州芝加哥市出生时被指定为男性的性少数和性别多样化（SGM）年轻成年人。本分析的所有数据均在2023年12月1日至2024年10月31日期间，在每位参与者的同一次研究访视中进行横断面收集。完成了SOGICE接触测量且有心血管健康数据的参与者符合条件；数据不完整的参与者被排除。
SOGICE暴露情况和持续时间。
主要结局包括通过自动监测仪测量的舒张压（DBP）和收缩压（SBP）、通过血浆生物标志物评估的全身炎症（SI）以及自我报告的高血压诊断。回归分析对社会人口统计学和行为协变量进行了调整。
在703名参与者（平均[标准差]年龄为26.75[4.60]岁）中，540名（76.8%）被认定为顺性别者，163名（23.2%）被认定为跨性别者或性别多样化者。72名参与者（10.2%）报告曾接触过SOGICE。与未接触者相比，接触者的SI水平更高（β = 0.83；95%置信区间，0.17 - 1.49；P = 0.02），DBP升高（β = 3.46；95%置信区间，0.60 - 6.32；P = 0.02），SBP升高（β = 4.28；95%置信区间，0.68 - 7.87；P = 0.02），自我报告高血压诊断的几率更高（优势比，2.86；95%置信区间，2.19 - 3.54；P = 0.003）。在对协变量进行调整后，关联仍然显著。
在这项针对出生时被指定为男性的SGM年轻成年人的队列研究中，接触SOGICE与不良心血管健康指标相关，包括DBP和SBP升高、SI增加以及自我报告高血压的几率更高。这些发现强调了公共卫生和政策干预措施的必要性，以实施和加强对SOGICE做法的禁令。认识到SOGICE对心血管健康的影响有助于解决SGM群体的健康差异问题，并强调了优先考虑SGM个体福祉的肯定性护理方法的重要性。
