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We present prospective, longitudinal data from a sample of 315 sexual minority current\/former members of the Church of Jesus Christ of Latter-day Saints to examine the efficacy and impact of self-initiated sexual orientation change efforts (SISOCE). We found that 74.6% of participants engaged in SISOCE at some point in their lives. Of the 13.7% of participants who were engaged with SISOCE at the start of the study, 62.8% terminated their SISOCE in the 2-year window of the study. We failed to find significant differences in sexual attraction, aversion, or behavior two years later between those who were actively engaged in SISOCE and those who were not. At baseline, participants engaged in SISOCE reported more religiousness, self-alienation, desires to be exclusively heterosexual (i.e., internalized homonegativity), and concealment than participants not engaged in SISOCE. We also found that participants engaged in SISOCE reported less social support, well-being, and self-rated health alongside more depression than participants not engaged in SISOCE at baseline. Two years later, participants who engaged in SISOCE at baseline reported more depression and less social support than participants not engaged in SISOCE. Results support the idea that trying to change one\u2019s sexual orientation is health-undermining and ineffective with caveats on how health-undermining, whether we know it is ineffective for everyone, and whether it is always health-undermining. We recommend therapists provide acceptance-focused and person-affirming assessments\/interventions that promote identity development.<\/jats:p>","DOI":"10.1007\/s10508-026-03517-y","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T21:15:37Z","timestamp":1786828537000},"page":"2773-2789","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Preregistered, Prospective, Longitudinal Examination of the Impact of Self-Initiated Sexual Orientation Change Efforts on Health and Changes in Sexuality"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-7306","authenticated-orcid":false,"given":"G. 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