Gender Identity Change Efforts Are Associated with Depression, Panic Disorder, and Suicide Attempts in South Korean Transgender Adults

Hyemin Lee; Don Operario; Arjee J Restar; Sungsub Choo; Ranyeong Kim; Yun-Jung Eom; Horim Yi; Seung-Sup Kim

doi:10.1089/trgh.2021.0171

Gender Identity Change Efforts Are Associated with Depression, Panic Disorder, and Suicide Attempts in South Korean Transgender Adults

Transgend Health. 2023 Jun 1;8(3):273-281. doi: 10.1089/trgh.2021.0171. eCollection 2023 Jun.

Authors

Hyemin Lee¹, Don Operario², Arjee J Restar³, Sungsub Choo⁴, Ranyeong Kim⁴, Yun-Jung Eom⁴, Horim Yi¹, Seung-Sup Kim^{1

4

5}

Affiliations

¹ Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.
² Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.
³ Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea.
⁵ Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Abstract

Purpose: Gender identity change efforts (GICEs), sometimes referred to as "conversion therapy," are considered pseudoscientific and unethical practices that are not supported by the existing scientific literature. However, a substantial portion of transgender people face such practices during their lives. We assessed lifetime exposure to GICEs and its associations with mental health indicators among transgender adults in South Korea.

Methods: We analyzed a nationwide cross-sectional survey of 566 Korean transgender adults conducted in October 2020. Lifetime exposure to GICEs was classified as follows: "never had GICE-related experiences," "received a referral, but did not undergo GICEs," and "undergone GICEs." We assessed mental health indicators, including past-week depressive symptoms; medical diagnosis or treatment of depression and panic disorder; and past 12-month suicidal ideation, suicide attempts, and self-harm.

Results: Of the total participants, 12.2% had "received a referral, but did not undergo GICEs," and 11.5% had "undergone GICEs." Compared with those who had "never had GICE-related experiences," participants who had "undergone GICEs" showed significantly higher prevalence of depression (adjusted prevalence ratio [aPR]=1.34, 95% confidence interval [CI]=1.11-1.61), panic disorder (aPR=2.52, 95% CI=1.75-3.64), and suicide attempts (aPR=1.73, 95% CI=1.10-2.72). However, we did not find significant associations between having "received a referral, but did not undergo GICEs" and mental health indicators.

Conclusion: Given our findings suggest that lifetime exposure to GICEs may harm transgender adults' mental health, legal restrictions should be imposed to ban GICEs in South Korea.

Keywords: South Korea; conversion therapy; gender identity change efforts; mental health; transgender persons.