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Published on: May 10, 2019
Inequities in Conversion Practice Exposure at the Intersection of Ethnoracial and Gender Identities
Nguyen K Tran1, Elle Lett1, Annesa Flentje1
1Nguyen K. Tran, Annesa Flentje, Micah E. Lubensky, Zubin Dastur, Juno Obedin-Maliver, and Mitchell R. Lunn are with The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA. Elle Lett is with the Health Systems and Population Health and the Center for Anti-Racism and Community Health, University of Washington School of Public Health, Seattle. Shalonda Ingram is with the Born Brown Institute, Washington, DC.
Abstract:
Objectives. To examine inequities in conversion practice exposure across intersections of ethnoracial groups and gender identity in the United States. Methods. Data were obtained from The Population Research in Identity and Disparities for Equality Study of sexual and gender minority people from 2019 to 2021 (n = 9274). We considered 3 outcomes: lifetime exposure, age of first exposure, and period between first and last exposure among those exposed to conversion practices. We used log-binomial, Cox proportional hazards, and negative binomial models to examine inequities by ethnoracial groups and gender identity adjusting for confounders. We considered additive interaction. Results. Conversion practice prevalence was highest among minoritized ethnoracial transgender and nonbinary participants (TNB; 8.6%). Compared with White cisgender participants, minoritized ethnoracial TNB participants had twice the prevalence (prevalence ratio = 2.16; 95% confidence interval [CI] = 1.62, 2.86) and risk (hazard ratio = 2.04; 95% CI = 1.51, 2.69) of conversion practice exposure. Furthermore, there was evidence of a positive additive interaction for age of first exposure. Conclusions. Minoritized ethnoracial TNB participants were most likely to recall experiencing conversion practices. Public Health Implications. Policies banning conversion practices may reduce the disproportionate burden experienced by minoritized ethnoracial TNB participants. (Am J Public Health. 2024;114(4):424-434. https://doi.org/10.2105/AJPH.2024.307580).
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