Sexuality and gender change efforts in Malaysia - proximal stressors and mental ill-health amongst LGBT+ adults.

Despite growing international criticism of actions and efforts to change sexual orientation and gender identity, such efforts remain prevalent in Malaysia. Using data from a nationwide community-based survey, this study examined the prevalence of these efforts amongst LGBT+ adults and the association between exposure to them and mental health outcomes. Participants (n = 521) completed an online survey assessing exposure to efforts to change their sexual orientation and/or gender identity, internalised LGBT-phobia, negative future expectations, and several mental health variables. Just under sixty-four percent (n = 333) of participants reported having experienced change efforts, with the most common perpetrators being family members, friends and religious organisations or people. Recent (past year) and past exposure to change efforts (over one year ago) were each associated with significantly higher odds of suicidal ideation, non-suicidal self-injury, and suicide attempts. Participants with recent exposure to change efforts also reported elevated internalised LGBT-phobia and negative future expectations compared to those who lacked such experience. A content analysis of participants' open-ended responses documented the perceived impact of change efforts on proximal stressors and mental health and wellbeing. Recommendations are made for national authorities and healthcare bodies to ban efforts to change sexual orientation and gender identity in Malaysia.