Swiftly on the heels of his 2021 study showing sexual orientation change efforts (SOCE) “strongly reduces suicidality” and that restrictions on SOCE may “deprive sexual minorities of an important resource for reducing suicidality, putting them at substantially increased suicide risk,”[1]^,[2] Sociologist Paul Sullins’ new peer-reviewed analysis revealed, as per its title, an “Absence of Behavioral Harm Following Non-efficacious Sexual Orientation Change Efforts: A Retrospective Study of United States Sexual Minority Adults, 2016–2018.”[3]

Sullins begins with a clear definition of SOCE: “Sexual orientation change efforts (SOCE) is a summary term for therapies or programs that support change from same-sex to opposite-sex orientation in sexual attraction, identity, and/ or behavior.” As of 2016 the preferred terminology is not SOCE but SAFE-T (Sexual Attraction Fluidity Exploration in Therapy).[4] That was the first naming of it by actual competent professional practitioners. The popular—but pejorative, misrepresentative, provocative and vague—“conversion therapy” label was spawned in 1991 by its opponents.[5] With time, the same monoculture morphed it into “SOCE.” Keep that in mind when reading about the renaming of “conversion therapy” allegedly to fool people—it’s the reclamation of representative language from the den of disinformation.

As with his previous analysis, the nationally representative data came from the open-access Williams Institute’s Generations study. Specifically, Sullins’ paper examined data across three cohorts of United States sexual minorities (centered in 1969, 1987 and 2003) who were exposed to SOCE, comparing them with “the remainder not exposed to SOCE on two measures of internal distress—psychological distress (Kessler scale) and current mental health—and seven measures of behavioral harm: substance abuse (DUDIT); alcohol dependence (AUDIT-C); self-harm; suicide ideation; suicide planning; suicide intentions; and suicide attempts.”

Sullins was interested in two questions: “First, how much harm actually exists?” He explains, “As noted, prior studies finding harm from SOCE in the sexual minority population have only examined lifetime harm, including harm that occurred before SOCE, not present harm.” In short, they engage in the “association equals causation” fallacy by failing to simply compare pre and post SOCE exposure mental health, settling instead for any lifetime presence of harm without securing the timeline for it. It’s a fatal error, ignoring temporal sequence, and all the anti-therapy studies seem to do it. Sullins poses the analogy that it would be “perverse policy…for heart surgery to be discouraged or even banned because those undergoing it experienced higher rates of cardiac dysfunction than the general population before the surgery.” Indeed, so.

On to Sullins’ next question: “Second, to what extent, if any, is current harm associated with past SOCE affected or explained by early life covariates, current comorbidities, or differences in minority stress?” Simply put, what other factors are at play in potential causation of lifetime harm in this sexual minority population?

Results were impressive: “The SOCE group was statistically indistinguishable from the non-SOCE group on any measure of harm. For behavioral harm, risk ratios were 0.97–1.02.” Put another way, “sexual minority persons who had undergone failed SOCE therapy did not suffer higher psychological or social harm.” That contradicts the claims of SOCE/SAFE-T harm studies.

Furthermore, the details of the results were stunning, “Harm was equivalent for the two groups despite the [failed] SOCE group having experienced higher lifetime and current minority stress, greater childhood adversity, and lower socioeconomic status.” Sullins expounds, “This group constituted not only a test, but a stress test of the hypothesis that SOCE therapy induces harm. If any group were likely to suffer harm from SOCE therapy, this group would have done so.” And yet they didn’t! To reiterate, the study findings contradict those predicted by minority stress theory (MST). An additional detail was present regarding suicidality, “… the majority of suicidal morbidity occurred prior to SOCE, and the most serious form of suicidal morbidity was reduced following SOCE.” These “Easter eggs” were in the Generations study data all along for any to see, and yet Sullins is the first with the statistical acuity to sight (and cite) them.

To recap, using a strongly representative sample of a United States sexual minority population in data from the Generations study of the Williams Institute, Sullins used several validated measures to assess behavioral harm from having experienced sexual orientation change efforts (SOCE, now preferably called SAFE-T). The findings “demonstrated positive evidence of the absence of harm from SOCE therapy.” Specifically, “Those who had undergone [failed] SOCE were no more likely to experience psychological distress or poor mental health, to engage in substance or alcohol abuse, to intentionally harm themselves, or to think about, plan, intend or attempt suicide, than were those who had not undergone SOCE.” The SOCE group (“alumni”) happened to experience “higher lifetime and current minority stress, greater childhood adversity, and lower socioeconomic status” and yet still did as well as the non-SOCE cohort. Therefore, as Sullins elaborated, this constituted a veritable “stress test” of the SOCE harm hypothesis. This is the second Sullins research article based on the Generations study to show not harm but benefit from SOCE/SAFE-T. This is further evidence that, “Concerns to restrict or ban SOCE due to elevated harm are unfounded.”

[1] Sullins, Donald, SEXUAL ORIENTATION CHANGE EFFORTS (SOCE) *REDUCE* SUICIDE: CORRECTING A FALSE RESEARCH NARRATIVE (March 16, 2021). Available at SSRN: https://ssrn.com/abstract=3729353 or http://dx.doi.org/10.2139/ssrn.3729353

[2] https://cmda.org/soce-reduces-suicidality-in-a-new-study/

[3] Sullins DP (2022) Absence of Behavioral Harm Following Non-efficacious Sexual Orientation Change Efforts: A Retrospective Study of United States Sexual Minority Adults, 2016–2018. Front. Psychol. 13:823647. doi: 10.3389/fpsyg.2022.823647

[4] https://www.core-issues.org/UserFiles/File/SAFE_T/Rosik_on_SAFE_T.pdf

[5] Haldeman, D. (1991). Sexual orientation conversion therapy for gay men and lesbians: A scientific examination. In J. Gonsiorek & J. Weinrich (Eds.), Homosexuality: Research Implications for Public Policy (pp. 149-160). Newbury Park, CA: Sage.