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Conversion Therapy cost the U.S. an estimated $9.23 billion annually

“It’s hoped this analysis can help decision makers evaluate the massive impact this therapy continues to exact on society as a whole”

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Photo Credit: Harrison J. Bahe

NEW YORK – Research scientists at The Trevor Project, the world’s largest suicide prevention and mental health organization for LGBTQ young people, in partnership with health economists at Cytel, a multinational research organization, published a new peer-reviewed study this week in JAMA Pediatrics that found the practice of conversion therapy on LGBTQ youth, and its associated harms, cost the United States an estimated $9.23 billion annually.

Conversion therapy refers to a range of dangerous and discredited practices aimed at changing one’s sexual orientation or gender identity. The study estimates that 508,892 LGBTQ youth in the U.S. were at risk of being subjected to conversion therapy last year, and that the direct cost of conversion therapy annually is an estimated $650 million.

  • According to the findings of the study, the estimated annual cost of conversion therapy performed on LGBTQ young people in the U.S. is $650 million. This includes direct payment of services, health insurance reimbursements, and donations or fees associated with religious forms of conversion therapy practices.
  • However, the harms associated with undergoing conversion therapy, such as substance abuse and suicide attempts, are significantly higher—an estimated $8.58 billion annually. This is over 13 times more costly than the direct costs of conversion therapy itself. 
  • Combined, this brings the total economic burden of the practice of conversion therapy—and its associated harms—to an estimated $9.23 billion on the U.S. economy each year.
  • According to the findings of the study, suicide attempts ($2.42 billion) and substance abuse ($2.18 billion) comprise over half of the estimated economic burden of harms associated with conversion therapy.
  • The study also found that replacing current conversion therapy practices with affirmative therapy practices is associated with an estimated total savings of $6.19 billion annually.

However, the study finds that the harms associated with the practice, such as substance abuse and negative mental health outcomes, including depression, anxiety, and suicide attempts, are significantly higher — an estimated $8.58 billion annually; bringing the total estimated cost of conversion therapy to $9.23 billion annually. 

“This alarming study illustrates that subjecting LGBTQ young people to conversion therapy continues to have deep and detrimental costs from both a humanistic and economic standpoint,” said Amit Paley, CEO and Executive Director at The Trevor Project. “The Trevor Project urges policymakers to protect LGBTQ youth from the dangers of this so-called ‘therapy’ and to also expand access to LGBTQ-affirming therapy as a means to empower young people to accept themselves for who they are and promote positive health outcomes. Doing so would drastically reduce these reported economic burdens.”

To calculate the economic costs of conversion therapy and its associated harms, a comprehensive model was developed in collaboration among leading health economists and research scientists, leveraging tools and methods of health economics and outcomes research.

“The mental health risks of conversion therapy have long been suspected, but this scientific research quantifies, for the first time, the staggering cost of this therapy in financial terms,” says Dr. Anna Forsythe, principal scientist for this investigation. “Our study uses the most advanced economic techniques and analysis to comprehensively review the data, and to systematically uncover the significant harms of conversion therapy. It is our hope that this peer-reviewed analysis can be an objective tool to help decision makers evaluate the massive impact this therapy continues to exact on not only the victims, but on society as a whole.”

This is the first known study to apply a comprehensive model to assess the socioeconomic impacts of conversion therapy in the U.S.

“We know conversion therapy has long been a burden on LGBTQ young people and their families, as the practice has consistently been associated with poor mental health and greater risk for suicide. But the economic costs this practice has on society are just starting to be understood,” said Casey Pick, Senior Fellow for Advocacy & Government Affairs at The Trevor Project. “We must ensure that taxpayers’ dollars are never again spent on this dangerous and discredited practice and that we are instead investing in LGBTQ-inclusive health and education programs to uplift the well-being of LGBTQ youth.”

Through its corporate collaboration with The Trevor Project, Bristol Myers Squibb provided a financial grant and limited health economic consultation.

The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health, capturing the experiences of nearly 35,000 LGBTQ youth across the U.S., found that 13% of LGBTQ youth reported being subjected to conversion therapy, with 83% reporting it occurred when they were under age 18.

Further, a peer-reviewed study by The Trevor Project’s researchers, published in the American Journal of Public Health, found that LGBTQ youth who underwent conversion therapy were more than twice as likely to report having attempted suicide and more than 2.5 times as likely to report multiple suicide attempts in the past year.

The full article, “Humanistic and Economic Burden of Conversion Therapy on LGBTQ Youth in the United States: A Systematic Literature Review and an Economic Evaluation,” can be found here.

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Research/Study

New study on resilience & mental health among LGBTQ youth

LGBTQ youth with high resilience had 59% lower odds of reporting a suicide attempt- 69% lower odds of considering suicide in the past year

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Los Angeles Blade graphic

NEW YORK – The Trevor Project observing the 53rd anniversary of the riots at the Stonewall Inn that sparked a greater movement for LGBTQ+ rights and equality this week, released new data that examines resilience and mental health among LGBTQ youth.

“As we celebrate Pride Month and commemorate the Stonewall Riots, there is often discussion of the ‘resilience’ of the LGBTQ community and the ways in which members are able to bounce back in the face of adversity. These data highlight the fact that resilience is not just an admirable quality – but one that can be associated with improved mental health among LGBTQ youth,” said Dr. Jonah DeChants, Research Scientist at The Trevor Project.

“Higher resilience in our sample was consistently associated with better mental health outcomes including decreased risk for anxiety, depression, and suicide attempts in the past year among LGBTQ youth. Moving forward, we should invest further research into understanding how LGBTQ youth can successfully develop high resilience. Additionally, we should work to dismantle systems of oppression and implement LGBTQ-inclusive anti-discrimination protections  so that LGBTQ youth are not required to possess resilience to excel and thrive.” 

Key Findings:

  • LGBTQ youth with high resilience had 59% lower odds of reporting a suicide attempt, and 69% lower odds of considering suicide in the past year, compared to LGBTQ youth with low resilience. 
  • LGBTQ youth with high resilience reported 81% lower odds  of anxiety symptoms, compared to LGBTQ youth with low resilience. 
  • LGBTQ youth with  high resilience reported 79% lower odds of recent depression, compared to LGBTQ youth with low resilience. 
  • LGBTQ youth who have supportive families and  are in supportive environments have higher resilience.
  • LGBTQ youth ages 18 to 24 reported significantly higher resilience than LGBTQ youth ages 13 to 17. 

Read the report:

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Research/Study

150 people on Tennessee’s sex offender registry for HIV-related conviction

Nearly one-half of HIV registrants on the SOR were women and over three-quarters of HIV registrants were Black

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Los Angeles Blade graphic

LOS ANGELES – At least 154 people have been placed on Tennessee’s sex offender registry (SOR) for an HIV-related conviction since 1993, according to a new report by the Williams Institute at UCLA School of Law.

Enforcement of HIV crimes in Tennessee disproportionately affects women and Black people. Nearly one-half of HIV registrants on the SOR were women and over three-quarters of HIV registrants were Black.

Tennessee’s two primary HIV criminalization laws—aggravated prostitution and criminal exposure—make it a felony for people living with HIV to engage in sex work or other activities, such as intimate contact, blood donation, or needle exchange, without disclosing their status. Both are considered a “violent sexual offense” and require a person convicted to register as a sex offender for life.

Examining Tennessee’s sex offender registry, researchers found that Shelby County, home to Memphis, accounts for most of the state’s HIV convictions. Shelby County makes up only 13% of Tennessee’s population and 37% of the population of people living with HIV in the state, but 64% of HIV registrants on the SOR. Moreover, while Black Tennesseans were only 17% of the state’s population and 56% of people living with HIV in the state, 75% of all HIV registrants were Black.

In Shelby County, 91% of aggravated prostitution convictions resulted from police sting operations in which no physical contact ever occurred. In addition, the case files showed that 75% of those convicted were Black women. When it came to criminal exposure case files, all of those convicted except one person were Black men.

“Tennessee’s HIV criminal laws were enacted at a time when little was known about HIV and before modern medical advances were available to treat and prevent HIV,” said lead author Nathan Cisneros, HIV Criminalization Analyst at the Williams Institute. “Tennessee’s outdated laws do not require actual transmission or the intent to transmit HIV. Moreover, the laws ignore whether the person living with HIV is in treatment and virally suppressed and therefore cannot transmit HIV.”

KEY FINDINGS

  • Incarcerating people for HIV-related offenses has cost Tennessee at least $3.8 million.
  • Of the 154 people who have been placed on Tennessee’s SOR for an HIV-related conviction, 51% were convicted of aggravated prostitution, 46% were convicted of criminal exposure, and 3% were convicted of both.
  • Women account for 26% of people living with HIV in Tennessee and 4% of people on the SOR, but 46% of the SOR’s HIV registrants.
  • Black people account for 17% of people living in Tennessee, 56% of those living with HIV, 27% of people on the SOR, but 75% of the SOR’s HIV registrants.
  • Black women were the majority of aggravated prostitution registrants (57%), while Black men were the majority of criminal exposure registrants (64%).
  • People with an HIV-related offense are more economically vulnerable when compared to others on the state’s SOR.
    • One in five (19%) HIV registrants were homeless compared to 9% of all SOR registrants.
    • 28% of HIV registrants reported an employer address compared to about half (49%) of all SOR registrants.
  • Shelby County has one aggravated prostitution conviction for every 115 people living with HIV in the county, and Black people were 90% of all people convicted for aggravated prostitution.
    • Over 90% of aggravated prostitution convictions in Shelby County were the result of police sting operations.
    • Only 3% of aggravated prostitution convictions in Shelby County alleged any intimate contact.
    • Nearly all (95%) people arrested in Shelby County for criminal exposure were Black men, compared to 64% of people statewide.  

The Williams Institute has conducted research on HIV criminalization in numerous U.S. states.

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Research/Study

New Pew Research Center poll: Americans at odds over Trans issues 

Strong majorities favor non-discrimination protections but weaker support for access to transition-related care among minors

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Texas trans activist Landon Richie speaking at Texas Capitol against trans youth sports bill (Los Angeles Blade file photo)

WASHINGTON – A new survey from a leading non-partisan research center reveals Americans have mixed views on transgender issues at a time when states are moving forward with measures against transgender youth, with strong majorities favoring non-discrimination protections but weaker support for access to transition-related care among minors and participation in school sports.

The Pew Research Center issued the findings on Tuesday as part of the results of its ongoing study to better understand Americans’ views about gender identity and people who are transgender or non-binary. The findings are based on a survey of 10,188 U.S. adults from data collected as part of a larger survey conducted May 16-22.

A majority of respondents by wide margins favor non-discrimination protections for transgender people. A full 64 percent back laws or policies that would protect transgender people from discrimination in jobs, housing, and public spaces, while roughly 8-in-10 acknowledge transgender people face at least some discrimination in our society.

Additionally, nearly one half of Americans say it’s extremely important to use a transgender person’s new name after they undergo a transition, while an additional 22 percent say that is somewhat important. A smaller percentage, 34 percent, say using a transgender person’s pronouns is extremely important, and 21 percent say it is somewhat important.

But other findings were less supportive:

  • 60 percent say a person’s gender is determined by sex assigned at birth, reflecting an increase from 56 percent in 2021 and 54 percent in 2017, compared to 38 percent who say gender can be different from sex assigned at birth.
  • 54 percent say society has either gone too far or been about right in terms of acceptance, underscoring an ambivalence around transgender issues even among those who see at least some discrimination against transgender people.
  • About six-in-ten adults, or 58 precent, favor proposals that would require transgender athletes to compete on teams that match the sex they were assigned at birth as opposed to teams consistent with their gender identity, compared to 17 percent who oppose that and 24 percent neither favor nor oppose it.
  • 46 percent favor making it illegal for health care professionals to provide transition-related care, such as hormones or gender reassignment surgery, to someone younger than 18, compared to 31 percent who oppose it.
  • Americans are more evenly split when it comes to making it illegal for public school districts to teach about gender identity in elementary schools (which is favored by 41 percent, and opposed by 38 percent) and investigating parents for child abuse if they help someone younger than 18 obtain transition-related care (37 percent are in favor and 36 percent oppose it).

Young adults took the lead in terms of supporting change and acceptance. Half of adults ages 18 to 29 say someone can be a man or a woman even if that differs from the sex they were assigned at birth, compared to about four-in-10 of those ages 30 to 49 and about one-third of respondents 50 and older.

Predictably, stark differences could be found along party lines. Democrats by 59 precent say society hasn’t gone far enough in accepting people who are transgender, while 15 percent say it has gone too far and 24 percent say it’s been about right. For Republicans, 10 percent say society hasn’t gone far enough, while 66 percent say it’s gone too far and 22 percent say it’s been about right.

Read the full report here.

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