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. 2025 Oct;60(5):e14635.
doi: 10.1111/1475-6773.14635. Epub 2025 May 12.

State Bans on Sexual Orientation and Gender Identity Change Efforts and Youth Suicidality

Lindsay N Overhage  1   2 , Benjamin Lê Cook  1   2 , Meredith B Rosenthal  3 , Laura A Hatfield  1   4 , Alex McDowell  1   5
Affiliations

State Bans on Sexual Orientation and Gender Identity Change Efforts and Youth Suicidality

Lindsay N Overhage et al. Health Serv Res. 2025 Oct.

Abstract

Objective: To assess the impact of state legislation banning healthcare workers from using sexual orientation and gender identity change efforts with minors (attempts to convert sexual and gender diverse individuals to be heterosexual and/or cisgender; also known as "conversion therapies") on adolescent suicidality.

Study setting and design: We used high school student responses to the 2011-2019 Youth Risk Behavior Survey. Using a quasi-experimental stacked difference-in-differences (DID) approach, we estimated the association between bans and rates of seriously considering suicide in the past year. In states that included sexual orientation survey questions, we assessed the association between bans and considering suicide for sexual minority and heterosexual youth.

Data sources and analytic sample: Retrospective analysis of 181,950 youth across four treatment states (Illinois, Connecticut, Rhode Island, and Maryland) and 240,268 youth across 25 control states. Treatment states included those that: (1) passed bans during the study period, (2) passed bans independent of antibullying and nondiscrimination laws, and (3) participated in the Youth Risk Behavior Survey for one wave before and one wave after passing a ban. For secondary analyses by sexual identity, 11 control states were available.

Principal findings: Among respondents, 17% reported seriously considering suicide in the prior year. In the 2 years following sexual orientation and gender identity change effort bans, rates of considering suicide were 2.9 percentage points lower (95% CI: -4.2, -1.6) in states with bans compared to control states. Improvements appeared to be larger for lesbian, gay, and bisexual youth (4.6 percentage point reduction; 95% CI: -6.4, -2.8) than for heterosexual youth. Reductions were statistically significant in Illinois, Connecticut, and Rhode Island compared to control states, but not in Maryland.

Conclusions: State laws banning sexual orientation and gender identity change efforts by healthcare providers for minors were associated with reduced rates of considering suicide among high school students.

Keywords: adolescent; health policy; mental health; sexual and gender minorities; suicide.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

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    1. United Nations Independent Expert on Protection Against Violence and Discrimination Based on Sexual Orientation and Gender Identity , Report on Conversion Therapy (United Nations Human Rights Office of the High Commissioner, 2020), https://www.ohchr.org/en/calls‐for‐input/report‐conversion‐therapy.
    1. American Medical Association , “LGBTQ Change Efforts,” 2022, accessed February 17, 2025, https://www.ama‐assn.org/system/files/2019‐03/transgender‐conversion‐iss....

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