Methodology

Our work is rooted in community-based and trauma-informed approaches to research. Community-based research involves community members in all aspects of the research process—from formulating research questions to sharing research findings—to ensure research conducted is grounded in lived experiences, and benefits and empowers communities first and foremost [15; 16]. Our team included members of 2SLGBTQIA+, BIPOC, and immigrant communities to ensure that these lived experiences were centred in our work, including by training community researchers with relevant lived experience to co-lead all project activities (e.g., conducting interviews and analysing interview data).

CBRC’s 2021-2022 national SOGIECE/CT Survivor Support project highlights that conversion ‘therapy’ and SOGIECE are “traumatic and deeply internalised, and the act of recognizing the harm done is a crucial part of the recovery process” [13]. Recognizing the traumatic nature of conversion ‘therapy,’ this project took a trauma-informed approach, as without it, the research could perpetuate harm, as Alessi and Kahn emphasise:

Without a grasp of how trauma affects human beings and their social interactions, qualitative researchers may find themselves inadvertently re-traumatizing participants or misusing their power during the research process. At the same time, they may worry about causing participants psychological distress and therefore not feel comfortable asking sensitive but important questions. This can result in data that is superficial or does not fully capture the nuances related to a particular experience, phenomenon, or process. Moreover, if researchers are unprepared to engage research participants affected by trauma, participants may lose the opportunity to tell their whole stories and thus may feel silenced or even ashamed. [19, p.122]

Applying a trauma-informed approach within this project required first recognizing that conversion ‘therapy’-related trauma is unlikely to be the only kind of traumatic experience among participants. Given the population focus of this project, the study team recognized that historical and intergenerational trauma, insidious trauma,^{Footnote 2} complex trauma, and other forms of trauma impact BIPOC, immigrant, newcomer, and refugee communities differently. By selecting community researchers with lived experiences similar to those of participants, and through participatory dialogue with the community researchers on the impact of trauma on this work, the project team prepared for the implementation of a trauma-informed approach.

The recruitment process was focused on creating a safer space for participants, giving participants the option to use a pseudonym; allowing them to choose which community researcher they would like to speak with for the interview; providing resources including grounding techniques before and after the interview; a meaningful consent process where participants could stop at any time during or after the interview (before analysis is conducted); and following up post-interview, with the option of connecting with a conversion ‘therapy’ survivor for support. Community researchers were prepared to honour the needs of participants during interviews, including pausing or skipping questions, as needed. Community researchers were also provided with weekly debrief sessions, attuned to the risk of vicarious trauma.

The project commenced with consultations with community members and organisations serving 2SLGBTQIA+ people who are BIPOC and/or immigrants, newcomers, or refugees across Canada to refine our interview guide, recruitment process, and methods. This included consultations with a project advisory committee composed of survivors of conversion ‘therapy’; representatives from key 2SLGBTQIA+ and immigrant, newcomer, and refugee community organisations; individuals from affirming faith groups and organisations; 2SLGBTQIA+-affirming mental health professionals; legal experts; and academics with expertise in this area of work. Since BIPOC and immigrant 2SLGBTQIA+ people’s conversion ‘therapy’ experiences have been systemically overlooked, these preliminary conversations were crucial in identifying the types of questions to ask, forms of support to offer, and appropriate methods for reaching communities of interest.

Through the consultation process with community organisations supporting BIPOC and migrant 2SLGBTQIA+ individuals, the project team learned about unique considerations for research on conversion ‘therapy’ with BIPOC and immigrant 2SLGBTQIA+ communities, that helped frame our research, including:

1. the English term, conversion ‘therapy’ is not commonly used, nor is it easily translated into other languages;
2. for many immigrant, newcomer, and refugee 2SLGBTQIA+ individuals who left their countries of origin to escape persecution based on their sexuality or gender identity, the fact that conversion ‘therapy’ exist in Canada has been surprising and distressing;
3. resources specific to BIPOC, immigrant 2SLGBTQIA+ people who have experienced conversion ‘therapy’ are limited (or non-existent), which means community organisations are unable to make referrals, find supports or resources;
4. 2SLGBTQIA+ individuals who are international students, refugees and those without immigration status face distinct challenges, including financial dependency on those who are perpetuating change efforts, fear of reporting, and limited access to mental health resources such as counselling.

The study was approved by the Human Research Ethics Boards at Simon Fraser University and the University of Victoria (protocol #H22-03543). Recruitment was conducted through social media and print ads posted by CBRC and other 2SLGBTQIA+ community organisations. Individuals who clicked on ads were sent to a page on the CBRC website with additional information about the study, including information about the study team, research questions, risks and benefits, and funding source. Individuals were then directed to an online recruitment screener on the survey platform, Qualtrics, to determine eligibility and to prioritise participants for interviews. To be eligible, participants had to identify as Two-Spirit, lesbian, gay, bisexual, trans, queer, questioning, intersex, asexual, or another diverse sexuality or gender (i.e., be a 2SLGBTQIA+ person); be Black, Indigenous or a person of colour (BIPOC) and/or an immigrant, newcomer, or refugee; be living in Canada; have experienced conversion ‘therapy’ and/or SOGIECE (using the definition provided earlier); be 16 years of age or older; and be able to complete an interview in French, English, or Spanish. All participants who completed the screener were provided with a list of mental health resources, regardless of their eligibility or whether they were selected for an interview.

Participants were selected to reflect a diversity of sociodemographic characteristics and a range of conversion ‘therapy’ experiences (i.e., purposive sampling). Although all of the participants experienced what is generally recognized as formal conversion ‘therapy,’ we encouraged participants to share their experiences beyond formal conversion ‘therapy,’ including SOGIECE, as these practices are no less harmful. They were given information about the study, along with a brief description of interviewers on the research team and were informed that they could choose which community researcher they wished to speak with. Participants were able to bring a support person of their choosing to their interview, if desired. Support persons were required to sign a confidentiality agreement to ensure that the information shared in the interview was not communicated outside of the interview context.

Interviews took place over the phone or using Zoom and were conducted by community researchers between February and August 2023. Participants received a copy of the consent form prior to the interview, which was also reviewed verbally by the interviewer, and provided verbal consent to participate. Interviews were semi-structured [17] and focused on exploring participants’ experiences of conversion ‘therapy’ and potential areas of program, policy, or resource supports. Interviews ranged in length from 27 to 125 minutes. Participants were given an honorarium of $100 CAD for their time.

Interviews were audio-recorded, transcribed verbatim, and transcripts were stripped of identifiers (e.g., names, dates, locations, details of conversion ‘therapy’ experiences) prior to analysis. Participants were given the opportunity to review their transcript. Study data were stored on secure, encrypted University of Victoria servers. Transcripts were thematically analysed using a combination of deductive and inductive coding, seeking first to understand dominant themes of the locales of conversion ‘therapy’ and the supports desired [18]. The analysis process was led by community researchers. First, the research team open-coded four transcripts and met to discuss emergent themes. Based on team consensus, a codebook was produced containing 10 large themes with 70 sub-themes and was applied to the remaining transcripts. Coding was conducted in Microsoft Word. Finally, the team met to discuss the findings.