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Experiences, Motivations, and Impacts of Sexual Orientation Change Efforts: Effects on Sexual Identity Distress and Mental Health Among Sexual Minorities



While accumulating evidence shows that sexual orientation change efforts (SOCE) are harmful and ineffective, SOCE is still highly prevalent in some regions where homosexuality is heavily stigmatized. This study investigated the experiences, motivations, and impacts of SOCE among sexual minorities in Hong Kong and examined the mediating role of sexual identity distress in the relationship between SOCE and mental health.


A total of 219 sexual minority individuals completed a questionnaire on SOCE in 2020–2021. They were asked to report their experiences, motivations, perceived effectiveness, benefits, and harms of SOCE. They were also assessed on sexual identity distress, depressive and anxiety symptoms, and suicidality.


Religious beliefs and interpersonal concerns were the primary motivations for SOCE. Participants who had experienced SOCE showed significantly higher levels of internalized homonegativity, identity uncertainty, and difficult process than their counterparts who had not experienced SOCE. They were also at a greater risk of developing depressive symptoms and suicidal ideation. Such discrepancy in mental health could be explained by heightened levels of sexual identity distress experienced by individuals who had experienced SOCE.


This study was the first to characterize the experiences and impacts of SOCE in Hong Kong and provided empirical evidence for the role of sexual identity distress as a key mechanism mediating the relationship between SOCE and mental health.                                                                                                                                                                                                                                                     

Policy Implications

The study concludes with recommendations for legislation, psychological interventions, and public education in Hong Kong to reduce the prevalence and negative impacts of SOCE.

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Fig. 1

Availability of Data and Material

The original dataset is available upon written request to the corresponding author.


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The research was supported by the Early Career Scheme of the Research Grants Council of Hong Kong (Ref. No.: 28609019).

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Authors and Affiliations



RC was primarily responsible for study conceptualization, data collection, data analysis, and the writing of the manuscript. JL was responsible for the writing and editing of the manuscript. DW was responsible for study design and data acquisition and supported the editing of the manuscript.

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Correspondence to Randolph C. H. Chan.

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Chan, R.C.H., Leung, J.S.Y. & Wong, D.C.K. Experiences, Motivations, and Impacts of Sexual Orientation Change Efforts: Effects on Sexual Identity Distress and Mental Health Among Sexual Minorities. Sex Res Soc Policy (2022).

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  • Sexual orientation change efforts
  • Sexual identity distress
  • Depressive symptoms
  • Anxiety symptoms
  • Suicidal ideation