{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:11:44Z","timestamp":1791850304418,"version":"4.3.4"},"reference-count":66,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Sexual orientation and gender identity change efforts (SOGICE), commonly known as conversion therapy, persist across the United States despite having been discredited due to their harmful mental health impact. Understanding the health consequences of SOGICE is critical, particularly for conditions exacerbated by stress, such as cardiovascular disease.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the association between SOGICE exposure and cardiovascular disease risk.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study draws on data from the observational cohort study RADAR, which included sexual and gender minority (SGM) young adults assigned male at birth (AMAB) in Chicago, Illinois. All data for this analysis were collected cross-sectionally during the same study visit for each participant between December 1, 2023, and October 31, 2024. Participants who completed SOGICE exposure measures and had cardiovascular health data were eligible; participants with incomplete data were excluded.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n SOGICE exposure and duration.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes were diastolic blood pressure (DBP) and systolic blood pressure (SBP) measured via automatic monitors, systemic inflammation (SI) assessed through plasma biomarkers, and self-reported hypertension or high blood pressure (HHBP) diagnosis. Regression analyses were adjusted for sociodemographic and behavioral covariates.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 703 participants (mean [SD] age, 26.75 [4.60] years), 540 (76.8%) identified as cisgender, and 163 (23.2%) identified as transgender or gender diverse. Seventy-two participants (10.2%) reported exposure to SOGICE. Exposed participants had higher SI levels (\u03b2\u2009=\u20090.83; 95% CI, 0.17-1.49;\n P<\/jats:italic>\n \u2009=\u2009.02), increased DBP (\u03b2\u2009=\u20093.46; 95% CI, 0.60-6.32;\n P<\/jats:italic>\n \u2009=\u2009.02), elevated SBP (\u03b2\u2009=\u20094.28; 95% CI, 0.68-7.87;\n P<\/jats:italic>\n \u2009=\u2009.02), and greater odds of self-reported HHBP diagnosis (odds ratio, 2.86; 95% CI, 2.19-3.54;\n P<\/jats:italic>\n \u2009=\u2009.003) compared with nonexposed participants. Associations remained significant after adjusting for covariates.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of SGM young adults AMAB, exposure to SOGICE was associated with adverse cardiovascular health indicators, including elevated DBP and SBP, increased SI, and higher odds of self-reported HHBP. These findings underscore the need for public health and policy interventions to enforce and strengthen bans on SOGICE practices. Recognizing the cardiovascular health consequences of SOGICE contributes to addressing SGM health disparities and emphasizes the importance of affirmative care approaches that prioritize the well-being of SGM individuals.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.8745","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T11:00:50Z","timestamp":1746529250000},"page":"e258745","source":"Crossref","is-referenced-by-count":6,"title":["Conversion Therapy Exposure and Elevated Cardiovascular Disease Risk"],"prefix":"10.1001","volume":"8","author":[{"given":"James K.","family":"Gibb","sequence":"first","affiliation":[{"name":"Department of Anthropology, Northwestern University, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua M.","family":"Schrock","sequence":"additional","affiliation":[{"name":"Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois"},{"name":"Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison Shea","family":"Smith","sequence":"additional","affiliation":[{"name":"Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois"},{"name":"Department of Medical Social Sciences, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard T.","family":"D\u2019Aquila","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"McDade","sequence":"additional","affiliation":[{"name":"Department of Anthropology, Northwestern University, Evanston, Illinois"},{"name":"Institute for Policy Research, Northwestern University, Evanston, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Mustanski","sequence":"additional","affiliation":[{"name":"Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois"},{"name":"Department of Medical Social Sciences, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"issue":"10","key":"zoi250318r2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0291768","article-title":"A systematic review of the prevalence of lifetime experience with \u2018conversion\u2019 practices among sexual and gender minority populations.","volume":"18","author":"Salway","year":"2023","journal-title":"PLoS One"},{"issue":"5","key":"zoi250318r6","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1056\/NEJMp2407068","article-title":"A legacy of cruelty to sexual and gender minority groups.","volume":"391","author":"Halem","year":"2024","journal-title":"N Engl J Med"},{"issue":"7","key":"zoi250318r7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.2105\/AJPH.2020.305637","article-title":"Sexual orientation change efforts, adverse childhood experiences, and suicide ideation and attempt among sexual minority adults, United States, 2016\u20132018.","volume":"110","author":"Blosnich","year":"2020","journal-title":"Am J Public Health"},{"issue":"7","key":"zoi250318r8","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1177\/0706743720902629","article-title":"Prevalence of exposure to sexual orientation change efforts and associated sociodemographic characteristics and psychosocial health outcomes among Canadian sexual minority men.","volume":"65","author":"Salway","year":"2020","journal-title":"Can J Psychiatry"},{"issue":"7","key":"zoi250318r9","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1093\/geront\/gnaa069","article-title":"Lifetime exposure to conversion therapy and psychosocial health among midlife and older adult men who have sex with men.","volume":"60","author":"Meanley","year":"2020","journal-title":"Gerontologist"},{"issue":"1","key":"zoi250318r10","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1001\/jamapsychiatry.2019.2285","article-title":"Association between recalled exposure to gender identity conversion efforts and psychological distress and suicide attempts among transgender adults.","volume":"77","author":"Turban","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"6","key":"zoi250318r11","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1089\/lgbt.2020.0501","article-title":"Sexual orientation change efforts, depressive symptoms, and suicidality among lesbian, gay, and bisexual adults: a cross-sectional study in South Korea.","volume":"8","author":"Lee","year":"2021","journal-title":"LGBT Health"},{"issue":"8","key":"zoi250318r12","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.2105\/AJPH.2020.305701","article-title":"Self-reported conversion efforts and suicidality among US LGBTQ youths and young adults, 2018.","volume":"110","author":"Green","year":"2020","journal-title":"Am J Public Health"},{"issue":"1","key":"zoi250318r13","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/cpsp.12377","article-title":"A systematic review of the efficacy, harmful effects, and ethical issues related to sexual orientation change efforts.","volume":"28","author":"Przeworski","year":"2021","journal-title":"Clin Psychol Sci Pract"},{"issue":"5","key":"zoi250318r14","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1089\/lgbt.2021.0270","article-title":"Suicidal ideation and suicide attempts among lesbian, gay, bisexual, pansexual, queer, and asexual youth: differential impacts of sexual orientation, verbal, physical, or sexual harassment or assault, conversion practices, family or household religiosity, and school experience.","volume":"9","author":"Hill","year":"2022","journal-title":"LGBT Health"},{"issue":"5","key":"zoi250318r15","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1001\/jamapediatrics.2022.0042","article-title":"Humanistic and economic burden of conversion therapy among LGBTQ youths in the United States.","volume":"176","author":"Forsythe","year":"2022","journal-title":"JAMA Pediatr"},{"issue":"11","key":"zoi250318r16","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1016\/S2215-0366(24)00251-7","article-title":"Conversion practice recall and mental health symptoms in sexual and gender minority adults in the USA: a cross-sectional study.","volume":"11","author":"Tran","year":"2024","journal-title":"Lancet Psychiatry"},{"issue":"4","key":"zoi250318r17","doi-asserted-by":"publisher","first-page":"424","DOI":"10.2105\/AJPH.2024.307580","article-title":"Inequities in conversion practice exposure at the intersection of ethnoracial and gender identities.","volume":"114","author":"Tran","year":"2024","journal-title":"Am J Public Health"},{"issue":"5","key":"zoi250318r20","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.","volume":"129","author":"Meyer","year":"2003","journal-title":"Psychol Bull"},{"issue":"6","key":"zoi250318r21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217623","article-title":"Links between discrimination and cardiovascular health among socially stigmatized groups: a systematic review.","volume":"14","author":"Panza","year":"2019","journal-title":"PLoS One"},{"issue":"8","key":"zoi250318r22","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.120.010931","article-title":"Disentangling the links between psychosocial stress and cardiovascular disease.","volume":"13","author":"Osborne","year":"2020","journal-title":"Circ Cardiovasc Imaging"},{"issue":"5","key":"zoi250318r23","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1161\/CIRCRESAHA.121.319811","article-title":"Social determinants of cardiovascular disease.","volume":"130","author":"Powell-Wiley","year":"2022","journal-title":"Circ Res"},{"issue":"1","key":"zoi250318r24","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.neubiorev.2009.10.002","article-title":"Allostatic load biomarkers of chronic stress and impact on health and cognition.","volume":"35","author":"Juster","year":"2010","journal-title":"Neurosci Biobehav Rev"},{"key":"zoi250318r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.yhbeh.2023.105473","article-title":"Gender minority stress and diurnal cortisol profiles among transgender and gender diverse people in the United States.","volume":"159","author":"DuBois","year":"2024","journal-title":"Horm Behav"},{"issue":"4","key":"zoi250318r27","doi-asserted-by":"publisher","first-page":"e13","DOI":"10.2105\/AJPH.2016.303630","article-title":"A systematic review of cardiovascular disease in sexual minorities.","volume":"107","author":"Caceres","year":"2017","journal-title":"Am J Public Health"},{"issue":"5","key":"zoi250318r28","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1089\/lgbt.2017.0220","article-title":"Sexual orientation differences in modifiable risk factors for cardiovascular disease and cardiovascular disease diagnoses in men.","volume":"5","author":"Caceres","year":"2018","journal-title":"LGBT Health"},{"issue":"4","key":"zoi250318r29","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1177\/0890117118810246","article-title":"Cardiovascular disease disparities in sexual minority adults: an examination of the behavioral risk factor surveillance system (2014-2016).","volume":"33","author":"Caceres","year":"2019","journal-title":"Am J Health Promot"},{"issue":"19","key":"zoi250318r30","doi-asserted-by":"publisher","first-page":"e321","DOI":"10.1161\/CIR.0000000000000914","article-title":"Assessing and addressing cardiovascular health in LGBTQ adults: a scientific statement from the American Heart Association.","volume":"142","author":"Caceres","year":"2020","journal-title":"Circulation"},{"issue":"13","key":"zoi250318r31","doi-asserted-by":"publisher","first-page":"1100","DOI":"10.1136\/heartjnl-2021-319069","article-title":"Preventing cardiovascular disease among sexual and gender minority persons.","volume":"107","author":"Streed","year":"2021","journal-title":"Heart"},{"issue":"6","key":"zoi250318r32","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1007\/s10865-019-00038-z","article-title":"Cardiovascular disease risk factors are elevated among a cohort of young sexual and gender minorities in Chicago.","volume":"42","author":"Morgan","year":"2019","journal-title":"J Behav Med"},{"key":"zoi250318r33","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.bbi.2024.03.036","article-title":"Threats to social safety and neuro-inflammatory mechanisms underlying sexual orientation disparities in depression symptom severity: a prospective cohort study of young adults.","volume":"119","author":"Br\u00e4nstr\u00f6m","year":"2024","journal-title":"Brain Behav Immun"},{"key":"zoi250318r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2021.105215","article-title":"Systemic inflammation as a driver of health disparities among sexually-diverse and gender-diverse individuals.","volume":"129","author":"Diamond","year":"2021","journal-title":"Psychoneuroendocrinology"},{"issue":"4","key":"zoi250318r35","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1097\/QAD.0000000000002093","article-title":"Systemic inflammation is elevated among both HIV-uninfected and HIV-infected young MSM.","volume":"33","author":"Morgan","year":"2019","journal-title":"AIDS"},{"issue":"2","key":"zoi250318r36","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1007\/s13178-019-00396-y","article-title":"Characterizing experiences of conversion therapy among middle-aged and older men who have sex with men from the Multicenter AIDS Cohort Study (MACS).","volume":"17","author":"Meanley","year":"2020","journal-title":"Sex Res Social Policy"},{"issue":"6","key":"zoi250318r37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0252539","article-title":"Experiences with sexual orientation and gender identity conversion therapy practices among sexual minority men in Canada, 2019-2020.","volume":"16","author":"Salway","year":"2021","journal-title":"PLoS One"},{"issue":"4","key":"zoi250318r38","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1080\/00918369.2020.1840213","article-title":"Conversion therapy in the Southern United States: prevalence and experiences of the survivors.","volume":"69","author":"Higbee","year":"2022","journal-title":"J Homosex"},{"issue":"S35","key":"zoi250318r39","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1002\/ajpa.10183","article-title":"Critical periods in human growth and their relationship to diseases of aging.","volume":"119","author":"Cameron","year":"2002","journal-title":"Am J Phys Anthropol"},{"issue":"1","key":"zoi250318r40","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1146\/annurev-anthro-091908-164350","article-title":"Developmental origins of adult function and health: evolutionary hypotheses.","volume":"38","author":"Kuzawa","year":"2009","journal-title":"Annu Rev Anthropol"},{"key":"zoi250318r41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106736","article-title":"Timing, duration, and differential susceptibility to early life adversities and cardiovascular disease risk across the lifespan: implications for future research.","volume":"153","author":"Suglia","year":"2021","journal-title":"Prev Med"},{"issue":"6","key":"zoi250318r42","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1007\/s10461-019-02766-4","article-title":"Very high HIV incidence and associated risk factors in a longitudinal cohort study of diverse adolescent and young adult men who have sex with men and transgender women.","volume":"24","author":"Mustanski","year":"2020","journal-title":"AIDS Behav"},{"issue":"9596","key":"zoi250318r43","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"issue":"15","key":"zoi250318r44","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1016\/j.clinbiochem.2013.05.070","article-title":"Inflammatory biomarkers for predicting cardiovascular disease.","volume":"46","author":"Stoner","year":"2013","journal-title":"Clin Biochem"},{"issue":"51","key":"zoi250318r45","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2317232120","article-title":"Three common assumptions about inflammation, aging, and health that are probably wrong.","volume":"120","author":"McDade","year":"2023","journal-title":"Proc Natl Acad Sci U S A"},{"key":"zoi250318r46","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.bbi.2021.08.208","article-title":"Traumatic events and mental health: the amplifying effects of pre-trauma systemic inflammation.","volume":"98","author":"Schrock","year":"2021","journal-title":"Brain Behav Immun"},{"key":"zoi250318r47","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2021.105206","article-title":"Inflammation and future depressive symptoms among recently bereaved spouses.","volume":"128","author":"Wu","year":"2021","journal-title":"Psychoneuroendocrinology"},{"issue":"4","key":"zoi250318r48","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1176\/appi.ajp.2020.20050635","article-title":"Association of inflammatory activity with larger neural responses to threat and reward among children living in poverty.","volume":"178","author":"Miller","year":"2021","journal-title":"Am J Psychiatry"},{"issue":"29","key":"zoi250318r49","doi-asserted-by":"publisher","first-page":"7611","DOI":"10.1073\/pnas.1620661114","article-title":"Social and physical environments early in development predict DNA methylation of inflammatory genes in young adulthood.","volume":"114","author":"McDade","year":"2017","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"1","key":"zoi250318r50","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.23063","article-title":"Measuring arterial blood pressure in humans: auscultatory and automatic measurement techniques for human biological field studies.","volume":"30","author":"James","year":"2018","journal-title":"Am J Hum Biol"},{"issue":"1","key":"zoi250318r52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4.","volume":"67","author":"Bates","year":"2015","journal-title":"J Stat Softw"},{"issue":"3","key":"zoi250318r54","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1300\/J082v04n03_01","article-title":"Homosexual identity formation: a theoretical model.","volume":"4","author":"Cass","year":"1979","journal-title":"J Homosex"},{"issue":"3","key":"zoi250318r55","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1177\/0011000096243011","article-title":"Revisioning sexual minority identity formation: a new model of lesbian identity and its implications for counseling and research.","volume":"24","author":"McCarn","year":"1996","journal-title":"Couns Psychol"},{"issue":"3","key":"zoi250318r56","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1080\/19361653.2020.1722780","article-title":"Gender and sexual minority group identification as a process of identity development during emerging adulthood.","volume":"18","author":"Scroggs","year":"2021","journal-title":"J LGBT Youth"},{"key":"zoi250318r57","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.753954","article-title":"Sexual orientation identity development milestones among lesbian, gay, bisexual, and queer people: a systematic review and meta-analysis.","volume":"12","author":"Hall","year":"2021","journal-title":"Front Psychol"},{"key":"zoi250318r58","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.psyneuen.2017.05.018","article-title":"Diurnal cortisol slopes and mental and physical health outcomes: a systematic review and meta-analysis.","volume":"83","author":"Adam","year":"2017","journal-title":"Psychoneuroendocrinology"},{"issue":"4","key":"zoi250318r59","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1037\/0033-2909.130.4.601","article-title":"Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry.","volume":"130","author":"Segerstrom","year":"2004","journal-title":"Psychol Bull"},{"issue":"6","key":"zoi250318r60","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1037\/0278-6133.21.6.531","article-title":"Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model.","volume":"21","author":"Miller","year":"2002","journal-title":"Health Psychol"},{"issue":"1","key":"zoi250318r61","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1002\/ajhb.20096","article-title":"Life history and the early origins of health differentials.","volume":"17","author":"Worthman","year":"2005","journal-title":"Am J Hum Biol"},{"issue":"7","key":"zoi250318r62","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1097\/PSY.0b013e3181eadd2b","article-title":"Autonomic nervous system dysfunction and inflammation contribute to the increased cardiovascular mortality risk associated with depression.","volume":"72","author":"Kop","year":"2010","journal-title":"Psychosom Med"},{"issue":"5","key":"zoi250318r63","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1037\/a0016441","article-title":"How does sexual minority stigma \u201cget under the skin\u201d? a psychological mediation framework.","volume":"135","author":"Hatzenbuehler","year":"2009","journal-title":"Psychol Bull"},{"key":"zoi250318r65","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmqr.2022.100194","article-title":"Overcoming conversion therapy: a qualitative investigation of experiences of survivors.","volume":"2","author":"Dromer","year":"2022","journal-title":"SSM Qual Res Health"},{"issue":"10","key":"zoi250318r66","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0311812","article-title":"Validation of self-reported hypertension in young adults in the US-based Growing Up Today Study (GUTS).","volume":"19","author":"Chen","year":"2024","journal-title":"PLoS One"},{"key":"zoi250318r25","author":"Juster"},{"key":"zoi250318r64","author":"Glassgold","year":"2022"},{"key":"zoi250318r1","unstructured":"American Psychological Association. Report of the American Psychological Association Task Force on Appropriate Affirmative Responses to Sexual Orientation. American Psychological Association; 2009. Accessed March 19, 2025. https:\/\/www.apa.org\/pi\/lgbt\/resources\/therapeutic-response.pdf"},{"key":"zoi250318r3","unstructured":"United States Joint Statement Against Conversion Efforts. 2023. Accessed March 19, 2025. https:\/\/usjs.org\/usjs-final-version\/"},{"key":"zoi250318r4","unstructured":"American Academy of Child and Adolescent Psychiatry. Conversion therapy. 2018. Accessed March 19, 2025. https:\/\/www.aacap.org\/AACAP\/Policy_Statements\/2018\/Conversion_Therapy.aspx"},{"key":"zoi250318r5","unstructured":"American Medical Association. Issue brief: LGBTQ change efforts (so-called \u201cconversion therapy\u201d). 2019. Accessed March 19, 2025. https:\/\/www.ama-assn.org\/system\/files\/conversion-therapy-issue-brief.pdf"},{"key":"zoi250318r18","unstructured":"Movement Advancement Project (MAP). Equality maps: conversion \u201ctherapy\u201d laws. 2024. Accessed October 9, 2025. https:\/\/www.lgbtmap.org\/equality-maps\/conversion_therapy"},{"key":"zoi250318r19","unstructured":"The Trevor Project. It\u2019s still happening: a report on practitioners of so-called conversion \u201ctherapy\u201d in the U.S. 2023. Accessed March 19, 2025. https:\/\/www.thetrevorproject.org\/wp-content\/uploads\/2023\/12\/FINAL_Its-Still-Happening-Report.pdf"},{"key":"zoi250318r51","unstructured":"Centers for Disease Control and Prevention. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Published June 27, 2014. Accessed March 19, 2025. https:\/\/stacks.cdc.gov\/view\/cdc\/23447"},{"key":"zoi250318r53","unstructured":"R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. Published 2024. Accessed March 19, 2025. https:\/\/www.R-project.org\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2833579\/gibb_2025_oi_250318_1745870500.61294.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T11:00:55Z","timestamp":1746529255000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2833579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":66,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.8745","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}