David Kinitz

All Publications

• 'How can you worry about employment and survival at the same time?': employment and mental health among precariously employed cisgender and transgender sexual minority adult men in Toronto, Canada. Culture, health & sexuality Kinitz, D. J., Ross, L. E., MacEachen, E., Gesink, D. 2024: 1-16

  Abstract

  This study addresses a gap in the labour market and occupational health literatures among sexual and gender minority workers by exploring the relationship between precarious employment and mental health through a political economy framework. Narratives from 20 cisgender and transgender sexual minority men were analysed to uncover the production of employment and mental health inequities. Results are presented temporally, including employment readiness, looking for work, and on the job, illuminating the social and structural processes that underly participants' stories of precarious employment and mental health. A cyclical pattern was identified whereby participants' mental ill-health resulted in separation from the labour market and increased employment precarity that subsequently further impacted their mental health. Interventions and programmes must consider multipronged approaches that address all aspects of this syndemic, including social stigma and discrimination towards sexual and gender minority people and improved access to stable employment, mental healthcare, and adequate social welfare systems.

  View details for DOI 10.1080/13691058.2024.2408349

  View details for PubMedID 39342499

• Conversion practice recall and mental health symptoms in sexual and gender minority adults in the USA: a cross-sectional study. The lancet. Psychiatry Tran, N. K., Lett, E., Cassese, B., Streed, C. G., Kinitz, D. J., Ingram, S., Sprague, K., Dastur, Z., Lubensky, M. E., Flentje, A., Obedin-Maliver, J., Lunn, M. R. 2024

  Abstract

  Conversion practices are associated with psychological morbidity, yet few studies have evaluated differences between efforts to change gender identity, sexual orientation, or both. We aimed to examine the individual and joint association of conversion practice recall targeted at gender identity or sexual orientation, or both, with current mental health symptoms among sexual and gender minority people.This cross-sectional study used data from The PRIDE Study, a US-based, online, prospective cohort study of sexual and gender minority adults who were recruited through social media, digital advertisements, and sexual and gender minority community-based events and organisations. For this analysis, we included participants who completed a lifetime questionnaire in 2019-20 and a subsequent annual questionnaire in 2020-21 without missing outcome data. All questionnaires were in English. The exposure was lifetime recall of conversion practice targeting gender identity alone, sexual orientation alone, or both (versus no conversion practice). Mental health outcomes were continuous measures: Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire 9-item (depression) scale, Post-Traumatic Stress Disorder Checklist 6-item scale, and Suicide Behaviors Questionnaire-Revised scale. We used linear regression to analyse the associations of conversion practice recall and mental health symptoms, controlling for demographic and childhood factors and stratified between cisgender and transgender and gender diverse groups. Sensitivity analyses evaluated the potential impact of unmeasured confounding. Analyses were conducted in R. We included people with related lived experience in the design and implementation of this study.Of 6601 participants who completed the lifetime questionnaire in 2019-20, 4440 completed the subsequent annual questionnaire in 2020 or 2021, and 4426 did not have missing outcome data. Of the 4426 included participants, 4073 (92·0%) identified as White (either alone or in combination with other ethnoracial options), 460 (10·4%) identified with multiple ethnoracial identities, and 1923 (43·4%) were transgender and gender diverse. Participants' age ranged from 18 years to 84 years (median 31·7 years, IQR 25·5-44·1). 149 (3·4%) participants reported sexual orientation-related conversion practice alone, 43 (1·0%) reported gender identity-related conversion practice alone, and 42 (1·0%) reported both. Recalling both forms of conversion practice was most strongly associated with greater post-traumatic stress disorder (PTSD; β 2·84, 95% CI 0·94-4·74) and suicidality (2·14, 0·95-3·32) symptoms. Recall of only sexual orientation-related conversion practice was associated with greater symptoms of PTSD (1·10, 0·22-1·98). Recall of gender identity-related conversion practice alone was most strongly associated with greater depressive symptoms (3·24, 1·03-5·46). Only associations for suicidality differed between cisgender and transgender and gender diverse participants, although the latter showed higher mental health symptoms overall. Findings were moderately robust to potential sources of unmeasured confounding in sensitivity analysis.Recall of conversion practice exposure was associated with a range of mental health symptoms among sexual and gender minority people. These findings support calls to ban conversion practices because of their effects as a structural determinant of mental health.Gill Foundation, Dona Rockstand, and Patient-Centered Outcomes Research Institute.

  View details for DOI 10.1016/S2215-0366(24)00251-7

  View details for PubMedID 39362229

• Intersecting Stigma and the HIV Care Cascade: Qualitative Insights from Sex Workers, Men who have Sex with Men, and Transgender Women Living with HIV in Jamaica. AIDS and behavior Logie, C. H., Kinitz, D. J., Gittings, L., Lalor, P., MacKenzie, F., Newman, P. A., Baral, S. D., Mbuagbaw, L., Shuper, P., Levermore, K. 2024

  Abstract

  In Jamaica, stigma experiences of sex workers (SW), gay men and other men who have sex with men (MSM), and transgender women living with HIV remain understudied. To address this gap, we explored experiences of stigma and linkages with the HIV care cascade among key populations living with HIV in Jamaica, including cisgender women SW, MSM, and transgender women. This qualitative study involved n = 9 focus groups (FG), n = 1 FG per population living with HIV (SW, MSM, transgender women) in each of three sites (Kingston, St. Ann, Montego Bay). We also conducted key informant (KI) interviews. We applied thematic analysis informed by the Health Stigma and Discrimination (HSD) Framework. FG participants (n = 67) included SW (n = 18), MSM (n = 28), and trans women (n = 21); we interviewed n = 10 KI (n = 5 cisgender women, n = 5 cisgender men). Participant discussions revealed that stigma drivers included low HIV treatment literacy, notably misinformation about antiretroviral therapy (ART) benefits and HIV acquisition risks, and a lack of legal protection from discrimination. Stigma targets health (HIV) and intersecting social identities (sex work, LGBTQ identities, gender non-conformity, low socio-economic status). Stigma manifestations included enacted stigma in communities and families, and internalized stigma-including lateral violence. HIV care cascade impacts included reduced and/or delayed HIV care engagement and ART adherence challenges/disruptions. Participants discussed strategies to live positively with HIV, including ART adherence as stigma resistance; social support and solidarity; and accessing affirming institutional support. In addition to addressing intersecting stigma, future research and programing should bolster multi-level stigma-resistance strategies to live positively with HIV.

  View details for DOI 10.1007/s10461-024-04460-6

  View details for PubMedID 39098884

  View details for PubMedCentralID 7875118

• Expanding Policy and Programming to Address Conversion Therapy and 2SLGBTQ+ Health Inequity: A Discussion of Challenges. HealthcarePapers Kinitz, D. J., Tran, N. K., MacKinnon, K. R. 2024; 22 (1): 46-54

  Abstract

  Advocates and researchers have made myriad recommendations to guide policy actors in stopping conversion therapy. This commentary extends these recommendations by identifying core challenges that policy actors face with interventions that solely focus on conversion therapy. Conversion therapy exists because of pervasive social values and beliefs that devalue, erase and stigmatize Two-Spirit, lesbian, gay, bisexual, transgender, queer and other sexual and gender minority (2SLGBTQ+) people, in turn, creating a supply and demand market. That is, those who espouse oppressive values enable and supply conversion therapy for the demand of 2SLGBTQ+ people struggling against these values and those who influence their lives (e.g., guardians). The discussion underscores why policy actors must disrupt the cisheteronormative bedrock that sustains conversion therapy. It is imperative for policy actors to expand policies and programming beyond conversion therapy using an intersectional framework that considers colonialism, racism and cisheterosexism. Interventions must encompass all systems (e.g., health, legal, social, economic) that shape 2SLGBTQ+ people's lives to disrupt the market of conversion therapy.

  View details for DOI 10.12927/hcpap.2024.27386

  View details for PubMedID 39315424

• Affirming Everyone in the Rainbow: Is Gender-Affirming Healthcare "Gay Conversion Therapy?". HealthcarePapers MacKinnon, K. R., Expósito-Campos, P., Kinitz, D. J., Bonifacio, J. 2024; 22 (1): 55-62

  Abstract

  Many young people today embrace gender-diverse identities, with adolescents and young adults comprising the largest and fastest-growing demographic of gender-affirming healthcare seekers. Simultaneously, gender-affirming healthcare for this demographic has been debated, and restrictions have been introduced in many jurisdictions. Within this politically charged climate, some journalists, cultural commentators, gender clinicians and politicians have leveraged rhetorical claims that gender-affirming healthcare comprises a new form of "gay conversion therapy." In this commentary, we explore the extent to which empirical evidence supports or contradicts this discourse as a real phenomenon. While we conclude that gender-affirming healthcare is not gay conversion therapy, we also draw attention to opportunities to enrich gender-affirming healthcare by embracing the complexity of sexuality and gender.

  View details for DOI 10.12927/hcpap.2024.27385

  View details for PubMedID 39315425

• Precarious Employment: A Neglected Issue Among Lesbian, Gay, Bisexual, and Transgender Workers SEXUALITY RESEARCH AND SOCIAL POLICY Kinitz, D. J., Shahidi, F., Kia, H., MacKinnon, K., MaEachen, E., Gesink, D., Ross, L. E. 2024

  View details for DOI 10.1007/s13178-024-00950-3

  View details for Web of Science ID 001170317700001

• "…full of opportunities, but not for everyone": A narrative inquiry into mechanisms of labor market inequity among precariously employed gay, bisexual, and queer men. American journal of industrial medicine Kinitz, D. J., Ross, L. E., MacEachen, E., Fehr, C., Gesink, D. 2024

  Abstract

  This study brings lesbian, gay, bisexual, transgender (trans), and queer (LGBTQ+) populations into scholarly discourse related to precarious employment through a political economy of queer struggle.Drawing on narrative inquiry, 20 gay, bisexual, and queer men shared stories of precarious employment that were analyzed using Polkinghorne's narrative analysis.Results tell an overarching narrative in three parts that follow the trajectory of participants' early life experiences, entering the labor market and being precariously employed. Part 1: Devaluation of LGBTQ+ identities and adverse life experiences impacted participants' abilities to plan their careers and complete postsecondary education. Part 2: Participants experienced restricted opportunities due to safety concerns and learned to navigate white, cis, straight, Canadian ideals that are valued in the labor market. Part 3: Participants were without protections to respond to hostile treatment for fear of losing their employment.These stories of precarious employment illustrate unique ways that LGBTQ+ people might be particularly susceptible to exploitative labor markets.

  View details for DOI 10.1002/ajim.23574

  View details for PubMedID 38374777

• Improving LGBT Labor Market Outcomes Through Laws, Workplace Policies, and Support Programs: A Scoping Review SEXUALITY RESEARCH AND SOCIAL POLICY Gould, W., Kinitz, D. J., Shahidi, F., Maceachen, E., Mitchell, C., Venturi, D., Ross, L. E. 2024

  View details for DOI 10.1007/s13178-023-00918-9

  View details for Web of Science ID 001154282300001

• Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study. SSM - population health Kinitz, D. J., Shahidi, F. V., Ross, L. E. 2023; 24: 101535

  Abstract

  Employment outcomes among sexual minority (i.e., lesbian, gay, bisexual) workers are poorly understood, and previous research on this topic has focused almost exclusively on inequities in earnings, neglecting other important dimensions of job quality. We address this gap by describing and comparing the job quality of straight and sexual minority workers in Canada.Data are from the 2016 General Social Survey: Canadians at Work and Home, the only national survey providing both a measure of sexual orientation and a multidimensional view of job quality in Canada. We identified 25 unique job quality indicators (e.g., temporary employment; job insecurity; health benefits; low income; job satisfaction; job control; discrimination). Latent class cluster analysis was used to establish a typology of job quality describing standard, flexible, and precarious employment types. We used multivariable regression methods to examine the association between sexual orientation and job quality.Sexual minorities reported lower job quality than their straight counterparts along many dimensions, with bisexual people reporting the lowest job quality. While inequities were generally observed among both sexual minority men and women, they sometimes differed in magnitude by gender. The prevalence of precarious employment was nearly three times higher among lesbian, gay, and bisexual workers (PR: 2.94, CI: 1.89-4.58 among all sexual minorities; PR: 3.04, CI: 1.71-5.43 among gay/lesbian workers; and PR: 2.81, CI: 1.45-5.47 among bisexual workers) compared to their straight counterparts.Inequities in job quality among sexual minorities persist despite comprehensive human rights protections in Canada. These inequities are pervasive, extending well beyond conventional indicators such as dollars earned and hours worked. Multi-pronged interventions are needed that move beyond simply ensuring that sexual minority workers are employed. Sexual minority workers deserve access to secure, well-paid work with benefits where they can foster connection and be free from discrimination.

  View details for DOI 10.1016/j.ssmph.2023.101535

  View details for PubMedID 38021458

  View details for PubMedCentralID PMC10661442

• A systematic review of the prevalence of lifetime experience with 'conversion' practices among sexual and gender minority populations. PloS one Salway, T., Kinitz, D. J., Kia, H., Ashley, F., Giustini, D., Tiwana, A., Archibald, R., Mallakzadeh, A., Dromer, E., Ferlatte, O., Goodyear, T., Abramovich, A. 2023; 18 (10): e0291768

  Abstract

  Conversion practices (CPs) refer to organized attempts to deter people from adopting or expressing non-heterosexual identities or gender identities that differ from their gender/sex assigned at birth. Numerous jurisdictions have contemplated or enacted legislative CP bans in recent years. Syntheses of CP prevalence are needed to inform further public health policy and action.To conduct a systematic review describing CP prevalence estimates internationally and exploring heterogeneity across country and socially relevant subgroups.We performed literature searches in eight databases (Medline, Embase, PsycInfo, Social Work Abstracts, CINAHL, Web of Science, LGBTQ+ Source, and Proquest Dissertations) and included studies from all jurisdictions, globally, conducted after 2000 with a sampling frame of sexual and gender minority (SGM) people, as well as studies of practitioners seeing SGM patients. We used the Hoy et al. risk of bias tool for prevalence studies and summarized distribution of estimates using median and range.We identified fourteen articles that reported prevalence estimates among SGM populations, and two articles that reported prevalence estimates from studies of mental health practitioners. Prevalence estimates among SGM samples ranged 2%-34% (median: 8.5). Prevalence estimates were greater in studies conducted in the US (median: 13%), compared to Canada (median: 7%), and greater among transgender (median: 12%), compared to cisgender (median: 4%) subsamples. Prevalence estimates were greatest among people assigned male at birth, whether transgender (median: 10%) or cisgender (median: 8%), as compared to people assigned female at birth (medians: 5% among transgender participants, 3% among cisgender participants). Further differences were observed by race (medians: 8% among Indigenous and other racial minorities, 5% among white groups) but not by sexual orientation.CPs remain prevalent, despite denouncements from professional bodies. Social inequities in CP prevalence signal the need for targeted efforts to protect transgender, Indigenous and racial minority, and assigned-male-at-birth subgroups.

  View details for DOI 10.1371/journal.pone.0291768

  View details for PubMedID 37792717

  View details for PubMedCentralID PMC10550144

• "This is the System We Live in": The Role of Social Assistance in Producing and Sustaining 2SLGBTQ+Poverty in Ontario, Canada SEXUALITY RESEARCH AND SOCIAL POLICY Daley, A., Kia, H., Kinitz, D., Schneckenburger, S. A., Robinson, M., Reid, J., Mule, N. J., Kayn, F., Duncan, D., Ross, L. E. 2023

  View details for DOI 10.1007/s13178-023-00852-w

  View details for Web of Science ID 001051469100001

• Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study Social Science and Medicine - Population Health Kinitz, D. J., Shahidi, F. V., Ross, L. E. 2023

  View details for DOI 10.1016/j.ssmph.2023.101535

• Cisheteronormativity, Conversion Therapy, and Identity Among Sexual and Gender Minority People: A Narrative Inquiry and Creative Non-fiction. Qualitative health research Kinitz, D. J., Salway, T. 2022; 32 (13): 1965-1978

  Abstract

  Sexual and gender minorities (SGMs) navigate systems of oppression that reify cisgender and heterosexual norms (cisheteronormativity) while developing their identities. 'Conversion therapy' represents a particularly prominent and harmful threat in this landscape. We explore how SGM who experienced conversion therapy develop their identities to understand antecedents to mental health struggles in this population. In-depth interviews were conducted with 22 people in Canada. A 'master narratives' framework combined with Polkinghorne's narrative analysis were used to explore individual-structural relations that affect identity in settings where cisheteronormative master narratives are amplified (i.e., conversion therapy). We present research findings through a creative non-fiction, which includes learning cisheteronormative master narratives; internalizing master narratives; feeling broken and searching for alternatives; and embracing self-love amidst pain. The amplification of master narratives through conversion therapy leads to conflict and delays in adopting a coherent identity. Health professionals should enact institutional practices that affirm SGM and thereby deemphasize cisheteronormativity.

  View details for DOI 10.1177/10497323221126536

  View details for PubMedID 36120897

  View details for PubMedCentralID PMC9629512

• Perceived influence of alcohol consumption, substance use, and mental health on PrEP adherence and condom use among PrEP-prescribed gay, bisexual, and other men-who-have-sex-with-men: a qualitative investigation. BMC public health Shuper, P. A., Varatharajan, T., Kinitz, D. J., Gesink, D., Joharchi, N., Bogoch, I. I., Loutfy, M., Rehm, J. 2022; 22 (1): 1875

  Abstract

  Gay, bisexual, and other men-who-have-sex-with-men (GBMSM) continue to be disproportionately affected by Human Immunodeficiency Virus (HIV). Although HIV pre-exposure prophylaxis (PrEP) offers an effective means of reducing incident HIV among this population, the HIV-preventive success of oral-based PrEP is contingent upon regimen adherence. Elevated rates of alcohol-, substance use-, and mental health-related issues among GBMSM potentially hinder PrEP-taking efforts, however the evidence for this remains mixed. Accordingly, the present study entailed a comprehensive qualitative investigation to explore PrEP-prescribed GBMSM's perceptions surrounding the influence of alcohol, substance use, and mental health on PrEP adherence.PrEP-prescribed GBMSM (age ≥ 18 years; prescribed PrEP for ≥ 3 months) were recruited from two PrEP-delivery clinics in Toronto, Canada for focus groups as part of the formative phase of an alcohol-, substance use-, and mental health-focused randomized controlled intervention trial. Focus group discussions qualitatively explored perceived strengths and barriers associated with adherence to PrEP treatment; with an emphasis on alcohol, substance use, and mental health concerns. Condom use among PrEP-prescribed GBMSM within the context of these concerns was also discussed.A total of five focus groups involving 35 GBMSM were conducted (4-10/group; mean age = 42.4; white = 71.4%). Although participants themselves generally reported successfully adhering to their PrEP regimens-resulting from a strong, underlying motivation for self-care-they recognized the detrimental impact that alcohol, substance use, and mental health had on adherence among their peers. In this regard, alcohol and substances were perceived as detracting from adherence only when consumption was excessive or temporally linked to PrEP dosing. Pronounced mental health issues (e.g., severe depression) were also seen as hindering adherence, although these effects were nuanced and perceived as person-dependent. Alcohol and substances were linked to condomless sex, regardless of PrEP use, and PrEP was therefore viewed as an HIV-protective 'safety net.'Overall, findings suggest that PrEP adherence can often be successfully achieved in the presence of alcohol-, substance use-, and mental health-related issues. Augmenting self-care, and addressing pronounced addictions- and mental health-related concerns, may enhance PrEP treatment among GBMSM.

  View details for DOI 10.1186/s12889-022-14279-2

  View details for PubMedID 36207757

  View details for PubMedCentralID PMC9540691

• The Emotional and Psychological Labor of Insider Qualitative Research Among Systemically Marginalized Groups: Revisiting the Uses of Reflexivity. Qualitative health research Kinitz, D. J. 2022; 32 (11): 1635-1647

  Abstract

  In response to decades-long exclusionary practices, academic institutions are now recruiting early career researchers (ECRs) from systemically marginalized populations who specialize in equity-related research. As a result, these ECRs are likely to conduct research within their communities on topics that have personal relevance-insider research. Methodological training for insider research places an emphasis on methods, such as reflexivity, to ensure rigor; however, the emotional and psychological impacts of these research methods on the researcher are seldom discussed. Therefore, I use analytic autoethnography to illustrate the embodied impacts of conducting insider research using an example of personal relevance and argue that methodological practices require an embodied reflexivity that centers the researcher and the impacts the research has on them. This paradoxically rewarding and taxing work necessitates changes in methodological training and practice, institutional support, and an openness to innovation when calling for equity, diversity, and inclusion in the academy.

  View details for DOI 10.1177/10497323221112620

  View details for PubMedID 35790140

• Eliciting critical hope in community-based HIV research with transgender women in Toronto, Canada: methodological insights. Health promotion international Logie, C. H., Kinitz, D. J., Gittings, L., Persad, Y., Lacombe-Duncan, A., Poteat, T. 2022; 37 (Supplement_2): ii37-ii47

  Abstract

  Critical hope centres optimism and possibilities for change in the midst of struggles for social justice. It was a central tenet of early participatory pedagogy and HIV research. However, critical hope has been overlooked in contemporary HIV research that largely focuses on risk and biomedical interventions in ways that obscure collective agency and community strengths. We conducted a community-based study with transgender (trans) women of colour in Toronto, Canada to adapt an evidence-based HIV prevention intervention. Participants resisted a focus on HIV, instead calling researchers to centre journeys to self-love in contexts of social exclusion. In response, we piloted three arts-based, participatory methods generated with community collaborators: (i) affirmation cards sharing supportive messages with other trans women, (ii) hand-held mirrors for reflecting and sharing messages of self-acceptance and (iii) anatomical heart images to visualize coping strategies. Participants generated solidarity and community through shared stories of self-acceptance within contexts of pain, exclusion and loss. Narratives revealed locating agency and self-acceptance through community connectedness. Critical hope was a by-product of this participatory process, whereby participants shared personal and collective optimism. Participatory and arts-based methods that centre self-acceptance and solidarity can nurture resistance to pathologizing discourses in HIV research. Centring critical hope and participant-generated methodologies is a promising approach to transformative health promotion and intervention research. These methodological insights can be engaged in future participatory work with other marginalized groups facing dominant biomedical risk discourses. Critical hope holds potential as a participatory health promotion strategy for envisioning possibilities for sustainable change.

  View details for DOI 10.1093/heapro/daac017

  View details for PubMedID 35213717

  View details for PubMedCentralID PMC9226654

• Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug and alcohol dependence Shokoohi, M., Kinitz, D. J., Pinto, D., Andrade-Romo, Z., Zeng, Z., Abramovich, A., Salway, T., Ross, L. E. 2022; 235: 109433

  Abstract

  Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts.A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity.Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men.These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.

  View details for DOI 10.1016/j.drugalcdep.2022.109433

  View details for PubMedID 35395502

• "Conversion Therapy" Experiences in Their Social Contexts: A Qualitative Study of Sexual Orientation and Gender Identity and Expression Change Efforts in Canada. Canadian journal of psychiatry. Revue canadienne de psychiatrie Kinitz, D. J., Goodyear, T., Dromer, E., Gesink, D., Ferlatte, O., Knight, R., Salway, T. 2022; 67 (6): 441-451

  Abstract

  To describe in what forms, with whom, where, when, and why Canadians experience sexual orientation and gender identity and expression change efforts (SOGIECE).This qualitative study is grounded in a transformative paradigm. We conducted semi-structured interviews with a purposive sample of 22 adults recruited from across Canada who have experienced "conversion therapy." Directed content analysis was used, employing deductive and inductive coding approaches, to synthesize the findings and address 5 policy-relevant questions.What are SOGIECE? Formal and informal methods of SOGIECE were used, including pharmacologic interventions, denial of gender-affirming care, and coaching to repress sexual orientation and/or gender identity and expression. With whom did SOGIECE occur? Practitioners included religious leaders, licenced health-care professionals (e.g., psychiatrists and psychologists), peers, and family members. Where did SOGIECE occur? SOGIECE occurred in 3 predominant settings: faith-based, health care, and social life. When did SOGIECE occur? SOGIECE rarely occurred over a restricted time frame; often, SOGIECE began while participants were adolescents or young adults and continued multiple years under various forms. Others described SOGIECE as a context in which their life was embedded for many years. Why did people attend SOGIECE? Cisheteronormative social and religious expectations taught participants that being non-cisgender or non-heterosexual was incompatible with living a good and respectable life.SOGIECE are not a circumscribed set of practices. Our study shows that SOGIECE are a larger phenomenon that consists of intentional and explicit change efforts as well as heterosexual- and cisgender-dominant social norms expressed and enforced across a wide range of settings and circumstances. This study provides critical context to inform contemporary social and health policy responses to SOGIECE. Policies should account for the overt, covert, and insidious ways that SOGIECE operate in order to effectively promote safety, equity, and health for sexually diverse and gender-diverse people.

  View details for DOI 10.1177/07067437211030498

  View details for PubMedID 34242106

  View details for PubMedCentralID PMC9152241

• "They Want You to Kill Your Inner Queer but Somehow Leave the Human Alive": Delineating the Impacts of Sexual Orientation and Gender Identity and Expression Change Efforts. Journal of sex research Goodyear, T., Kinitz, D. J., Dromer, E., Gesink, D., Ferlatte, O., Knight, R., Salway, T. 2022; 59 (5): 599-609

  Abstract

  Sexual orientation and gender identity and expression change efforts (SOGIECE) aim to suppress the sexual and gender identities of Two-Spirit, lesbian, gay, bisexual, trans, and other queer (2SLGBTQ+) people. Exposure to SOGIECE is associated with significant psychosocial morbidity. Yet, there is a dearth of knowledge specifying the ways in which these psychosocial impacts are produced and experienced. This qualitative interpretive description study aimed to delineate the impacts of SOGIECE. To do so, we thematically analyzed data from in-depth interviews, conducted between January and July 2020, with 22 people with lived experience of SOGIECE. Study participants indicated that feelings of shame and brokenness related to their sexual and gender identities were deeply implicated in and shaped by experiences with SOGIECE. SOGIECE also had socially isolating effects, which had restricted participants' opportunities for meaningful connection with others, including romantic partners and 2SLGBTQ+ communities. Further, SOGIECE had contributed to experiences of profound emotional distress, mental illness (e.g., anxiety, depression), and suicidality. These findings underscore the need for several responsive policy and programmatic interventions, including legislation to prevent SOGIECE, enhanced sexuality- and gender-related educational efforts with the families and support persons of 2SLGBTQ+ people, and targeted mental health screening and supports for SOGIECE survivors.

  View details for DOI 10.1080/00224499.2021.1910616

  View details for PubMedID 33871297

  View details for PubMedCentralID PMC8557955

• Pronouns Are a Public Health Issue. American journal of public health Ross, L. E., Kinitz, D. J., Kia, H. 2022; 112 (3): 360-362

  View details for DOI 10.2105/AJPH.2021.306678

  View details for PubMedID 35196057

  View details for PubMedCentralID PMC8887152

• Health of two-spirit, lesbian, gay, bisexual and transgender people experiencing poverty in Canada: a review. Health promotion international Kinitz, D. J., Salway, T., Kia, H., Ferlatte, O., Rich, A. J., Ross, L. E. 2022; 37 (1)

  Abstract

  Two-spirit, lesbian, gay, bisexual and transgender (2SLGBTQ+) people are disproportionately represented among those experiencing poverty. Both 2SLGBTQ+ people and people experiencing poverty face poorer health outcomes and greater difficulty accessing healthcare. Evidence of intersectional impacts of 2SLGBTQ+ status and poverty on health can help to inform economic and health policy. The objective of this review is to determine what is known about the health of 2SLGBTQ+ people in Canada experiencing poverty. Following the PRISMA framework, we searched and summarized Canadian literature on 2SLGBTQ+ poverty indexed in Medline, Sociological Abstracts, PsycInfo and EconList (N = 33). 2SLGBTQ+ poverty-related literature remains sparse but is expanding as illustrated by the fact that most (31/33) studies were published in the past decade. Half the studies analysed poverty as a focal variable and half as a covariate. Intersectionality theory assists in understanding the three health-related themes identified-healthcare access, physical health and mental health and substance use-as these outcomes are shaped by intersecting social structures that result in unique forms of discrimination. Those at the intersection of poverty and 2SLGBTQ+ status face poorer health outcomes than other 2SLGBTQ+ people in Canada. Discrimination was an overarching finding that explained persistent associations between 2SLGBTQ+ status, poverty and health. Research that directly interrogated the experiences of 2SLGBTQ+ populations experiencing poverty was sparse. In particular, there is a need to conduct research on underrepresented 2SLGBTQ+ sub-groups who are disproportionately impacted by poverty, including transgender, bisexual and two-spirit populations.

  View details for DOI 10.1093/heapro/daab057

  View details for PubMedID 34148086

• "It's Just More Complicated!": Experiences of Adults With Intellectual Disabilities When Navigating Digital Sexual Fields CYBERPSYCHOLOGY-JOURNAL OF PSYCHOSOCIAL RESEARCH ON CYBERSPACE Martino, A., Kinitz, D. J. 2022; 16 (2)

  View details for DOI 10.5817/CP2022-2-6

  View details for Web of Science ID 000789499500002

• Overcoming Conversion Therapy: A Qualitative Investigation of Experiences of Survivors SSM - Qualitative Research in Health Dromer, E., Ferlatte, O., Goodyear, T., Kinitz, D. J., Salway, T. 2022; 2

  View details for DOI 10.1016/j.ssmqr.2022.100194

• Mapping low-wage and precarious employment among lesbian, gay, bisexual, and transgender people in Organization for Economic Co-operation and Development countries: A scoping review protocol University of Toronto Journal of Public Health Kinitz, D. J., MacKinnon, K., Kia, H., MacEachen, E., Gesink, D., Ross, L. E. 2022; 3 (2)

  View details for DOI 10.33137/utjph.v3i2.37455

• The scope and nature of sexual orientation and gender identity and expression change efforts: a systematic review protocol. Systematic reviews Kinitz, D. J., Salway, T., Dromer, E., Giustini, D., Ashley, F., Goodyear, T., Ferlatte, O., Kia, H., Abramovich, A. 2021; 10 (1): 14

  Abstract

  Sexual orientation and gender identity and expression change efforts (SOGIECE) are a set of scientifically discredited practices that aim to deny and suppress the sexual orientations, gender identities, and/or gender expressions of sexual and gender minorities (SGM). SOGIECE are associated with significant adverse health and social outcomes. SOGIECE continue to be practiced around the world, despite denouncements from professional bodies and survivors, as well as calls for legislative advocacy to prohibit SOGIECE and protect SGM. There are substantial gaps in the availability of consolidated international research to support and refine legislative proposals related to SOGIECE, including those currently underway to enforce bans in Canada and elsewhere. We therefore propose the first systematic review of international data on SOGIECE that will outline the scope and nature of these practices worldwide. Specifically, we aim to estimate how many SGM have been exposed to SOGIECE, which sub-groups of SGM experience higher rates of SOGIECE, and how estimates of SOGIECE vary over time and place. In addition, we aim to describe when, where, how, and under what circumstances SGM are exposed to SOGIECE.To locate an interdisciplinary swath of papers, nine (9) bibliographic databases will be searched: Medline (OVID), Embase (OVID), PsycInfo and Social Work Abstracts via EBSCO, CINAHL, Web of Science Core Collection, LGBTQ+ Source, and Proquest Dissertations & Theses Global and Sociology Collection (ProQuest). A gold standard search will be developed for Medline and adapted to the other databases. Grey literature will be searched at relevant websites, and reference harvesting will be performed in relevant SOGIECE scientific consensus statements. Two authors will independently screen abstracts/titles, screen full texts, abstract data, and apply risk of bias assessments. A narrative synthesis will be implemented to summarize findings.This review will address the gap in synthesized data regarding the prevalence of SOGIECE, social correlates of SOGIECE, variations of SOGIECE over time and place, and the circumstances, settings, and time-points of SOGIECE exposure. Findings from this review will directly inform ongoing and new legislative efforts to ban SOGIECE and other interventions that aim to stem SOGIECE practices and support SOGIECE survivors.Registration with PROSPERO can be found under the registration number: CRD42020196393 .

  View details for DOI 10.1186/s13643-020-01563-8

  View details for PubMedID 33419475

  View details for PubMedCentralID PMC7796537