The Economic Impact of Conversion Therapy Harms in the US

Sexual orientation and gender identity change efforts (SOGICE), more commonly known as conversion therapy, is a discredited practice opposed by a number of medical, mental health, and human rights organizations, including the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry.

Yet annually, the practice’s harms lead to estimated direct and indirect costs of $9.23 billion in the United States, according to a new study published in JAMA Pediatrics.

SOGICE can take the form of individual or group psychotherapy, inpatient treatment, or administration by religious leaders, while many individuals undergo multiple modalities, typically as youths. The practice relies on the false belief that being LGBTQ+ is pathologic, and its enforcers promote sexual and gender identify rejection often to the mental health detriment of recipients.

Currently, 25 states; Washington, DC; and Puerto Rico all have bans in place prohibiting SOGICE for minors. However, unlicensed individuals, like religious practitioners, are not regulated, and all states allow the practice in adults.

As part of the analysis, researchers also investigated the economic and humanistic outcomes of affirmative therapy. Essentially the opposite of SOGICE, affirmative therapy is defined as “psychotherapy validating the positive expression of sexual and gender identities and recognizing the association of macrolevel forces, such as heterosexism and homophobia, with well-being.”

The systematic literature review and economic evaluation was carried out by Cytel, a clinical trial company, and The Trevor Project, a nonprofit dedicated to suicide prevention among LGBTQ+ youths.

On this episode of Managed Care Cast, we speak with lead study author Anna Forsythe, PharmD, MSc, MBA, vice president of value and access at Cytel.