{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:06:37Z","timestamp":1782277597350,"version":"3.54.5"},"reference-count":53,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,10,18]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Conversion is a term for treatments that seek to suppress or change a person\u2019s sexual orientation or gender. Our review focuses on transgender and gender-diverse (TGD) people. Our aims were to (1) describe the frequency, nature and structure of conversion practices; (2) document difficulties in accessing transition-related healthcare and (3) evaluate the mental health consequences of such practices and access barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Systematic review and narrative synthesis using the Critical Appraisals Skills Programme and Joanne Briggs Institute critical appraisal tools. Data sources include Embase, MEDLINE, PsychINFO, PsychARTICLES and Web of Science between 1990 and June 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Studies were included that (1) document use of conversion therapies or access barriers to transition-related healthcare; and\/or (2) describe how such therapeutic practices and access barriers have been applied and\/or (3) evaluate the mental health impacts of such therapies and difficulties accessing transition-related healthcare. Two reviewers screened papers for eligibility. Data were then grouped according to the objectives. Narratives and themes were presented per study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven studies met inclusion criteria. Four reports were on \u2018realignment\u2019, involving case studies or case series. Two involved psychoanalysis, one self-exposure therapy and one open-ended play psychotherapy. All four studies concerning \u2018realignment\u2019 were of poor methodological quality. The other three studies explored access barriers from the view point of TGD youth, their parents and healthcare providers. All papers reported access barriers, such as inability to access puberty-delaying medications. The papers concerning barriers to access were of good methodological quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found limited published evidence on use, nature, structure and\/or health consequences of conversion therapies and access barriers to transition in TGD people. However, reports of restriction to access may indicate a more widespread problem. Research is needed into TGD people\u2019s experiences of conversion therapy and access barriers to transition-related healthcare<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>CRD42017062149.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-022425","type":"journal-article","created":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T09:05:12Z","timestamp":1545469512000},"page":"e022425","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Conversion therapies and access to transition-related healthcare in transgender people: a narrative systematic review"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4155-0821","authenticated-orcid":false,"given":"Talen","family":"Wright","sequence":"first","affiliation":[{"name":"Division of Psychiatry, University College London, London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Candy","sequence":"additional","affiliation":[{"name":"Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"King","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London, London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,12,22]]},"reference":[{"key":"2025120523420856000_8.12.e022425.1","doi-asserted-by":"crossref","first-page":"e12184","DOI":"10.1111\/nin.12184","article-title":"Respecting variations in embodiment as well as gender: Beyond the presumed \u2018binary\u2019 of sex","volume":"24","author":"Saewyc","year":"2017","journal-title":"Nurs Inq"},{"key":"2025120523420856000_8.12.e022425.2","doi-asserted-by":"crossref","DOI":"10.2105\/AJPH.2011.300315","article-title":"Transgender health in Massachusetts: results from a household probability sample of adults","volume":"102","author":"Conron","year":"2012","journal-title":"Am J Public Health"},{"key":"2025120523420856000_8.12.e022425.3","unstructured":"Reed B , Rhodes S , Schofield P , et al . 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