Risks Associated With Sexual Orientation Change Efforts on Youth: A European Cross-National Study

Purpose: Sexual orientation change efforts (SOCE) are harmful practices linked to adverse mental health outcomes among sexual minority (SM) individuals. We investigated the associations between (1) sociodemographic factors and exposure to SOCE; (2) SOCE experiences and the risk for depression, anxiety, and suicidality; (3) SOCE characteristics-recency, frequency, and the person responsible-and mental health outcomes. Methods: Data were collected from 11,642 SM adolescents across 12 European countries via an online survey between 2020 and 2022. Depression, anxiety, and suicidality symptoms were assessed using the Patient Health Questionnaire-2, the Generalized Anxiety Disorder-2, and the Suicide Behaviors Questionnaire-Revised, respectively. Results: About 10% of the sample reported experiencing SOCE, with higher prevalence among younger and immigrant participants, and those from religious families. SOCE were associated with higher levels of anxiety, depression, and suicidality. More SOCE experiences were associated with higher anxiety (β = 0.11, p < .05, CI: 0.02-0.20) and suicidality (β = 0.32, p < .01, CI: 0.10-0.54), whereas recent SOCE was associated with higher anxiety (β = 0.09, p < .05, CI: 0.01-0.17) and multiple practitioners with higher depression (β = 0.55, p < .01, CI: 0.18-0.92). Over half of participants who experienced SOCE 2 years prior were at high risk of adverse mental health outcomes, with younger age, recency, number of SOCE, family-initiated SOCE, and multiple practitioners associated with higher risks. Discussion: The findings support the need for policies and interventions to prevent SOCE and address their harmful effects on SM youth.