"Extremely toxic and evil" reflections on gender identity change efforts by Christian religious leaders: Implications for therapy with transgender and nonbinary clients.

Given the religious groundings that support the practice of gender identity change efforts (GICE), we sought to explore the beliefs of Christian religious leaders about this practice and their understanding of marginalized gender identities. Nineteen religious leaders mainly from diverse Mainline Christian Protestant traditions were interviewed. Queer theory-informed thematic analysis revealed two themes related to participants' beliefs about transgender and nonbinary identities: (1) Transgender and nonbinary identities are normative and authentic and (2) God created gender diversity. The analyses also highlighted two themes reflecting the pastors' beliefs about GICE: (1) GICE is harmful and (2) Therapy should affirm transgender and nonbinary identities. Finally, the thematic analysis exploring participants' messages for couple and family therapists could be organized into two themes: (1) Christian religious beliefs do not justify the use of GICE and (2) Therapists should be helpful and not harmful. Implications for couple and family therapists are also discussed.

Measuring Allyship: Development and Validation of Two Measures to Assess Collegiate Athlete Department Staff Engagement in LGBTQ Allyship and Ally Behaviors.

This pilot quantitative study sought to explore lesbian, gay, bisexual, transgender, and queer (LGBTQ) ally engagement by collegiate coaches and athletic department staff. In particular, this study sought to investigate the psychometric properties for two adapted measures: the Ally Identity Scale-Athletic Staff Version and the Engagement in LGBTQ Ally Actions in Sports Scale-Athletic Staff Version. These measures could provide a means to assess the degree to which coaches and athletic department staff identify as allies and engage in actions that support a welcoming and inclusive climate for LGBTQ student-athletes and athletic department staff. The sample for this study was 87 coaches and athletic department staff who completed an online survey. The results of this study provide preliminary psychometric support for two adapted measures and provide insights into the next steps scholars can take in exploring the intersection of LGBTQ identities and collegiate athletics.

The effects of gender identity change efforts on Black, Latinx, and White transgender and gender nonbinary adults: Implications for ethical clinical practice.

Gender identity change efforts (GICE) and sexual orientation change efforts (SOCE) continue to be practiced by mental health professionals and religious organizations. It is frequently sought out by families who are rejecting loved ones with marginalized sexual orientations and gender identities. This study explored the impact of religious and nonreligious GICE on the mental health of transgender and nonbinary adults through a secondary data analysis of the U.S. Transgender Survey. Results found that both nonreligious and religious GICE were associated with increased odds of suicidal ideation and attempts. Only nonreligious GICE was associated with severe psychological distress. Black individuals showed increased odds of binge alcohol consumption when exposed to nonreligious change efforts, while White individuals showed decreased odds with both nonreligious and religious GICE. This study supports ethical and legal bans on GICE.

Deconstructing cissexism: The journey of becoming an affirmative family therapist for transgender and nonbinary clients.

This article proposes a model for family therapists to become more competent, inclusive, and affirmative in their clinical work with transgender and nonbinary clients. In particular, this article details: (1) barriers to transgender and nonbinary affirmative therapy, (2) impacts of these barriers on transgender and nonbinary people's mental health, (3) a three-step model for becoming an affirmative therapist for transgender and nonbinary clients, and (4) strategies for deconstructing cissexism in therapy. This goal of this article is to invite family therapists to join in on a lifelong journey of "becoming" an affirmative therapist for transgender and nonbinary clients, a journey on which none of us will ever "arrive". We can, however, take continual action to minimize the negative impacts of cissexism on therapists and clients; this article offers ideas for a place to start.

Christian Mainline Protestant Pastors' Beliefs About the Practice of Conversion Therapy: Reflections for Family Therapists.

Efforts to change the sexual orientation of lesbian, gay, and bisexual (LGB) individuals to heterosexual are referred to as conversion therapy. Given the religious groundings that support the practice of conversion therapy, we sought to explore the beliefs of Christian religious leaders about this practice and what they want family therapists to know about the practice of conversion therapy. Twenty-one pastors from diverse Mainline Christian Protestant traditions were interviewed. Queer theory-informed thematic analysis revealed four themes that reflect the participants' perspectives on conversion therapy: (a) Conversion Therapy Is an Abomination, (b) Conversion Therapy Is Similar to Other Abusive Practices, (c) Conversion Therapy Represents A Misuse of Religion, and (d) Ethical Concerns About Therapists Who Practice Conversion Therapy. Implications of this study include a need for self-of-the-therapist work to address religious biases and heteronormative assumptions in order to examine beliefs that support practicing conversion therapy.

Firefighters Are More Physically Active On-Duty Compared to Off-Duty.

Physical inactivity, coupled with increasing obesity levels, in firefighters plays a key role in aggregated cardiovascular events. The purpose of this study was to investigate device-measured physical activity (PA) for firefighters while on- and off-duty to have a clearer understanding of their overall PA level. METHODS: Twenty-nine career firefighters participated in this non-experimental, within-subjects study by wearing an accelerometer to assess PA intensities and step-count. Obesity was classified using body mass index (BMI). Dependent t-tests were used to examine mean differences in PA intensities when on- and off-duty. Pearson product-moment correlations were used to assess the association between PA intensities when on and off-duty. RESULTS: According to the World Health Organization BMI categorizations, 20 firefighters were overweight, 9 were obese, and, thus, none were normal weight. Only light PA (LPA) was statistically significant (p = 0.026) for on- and off-duty days with a small-to-medium effect size (d = 0.47), meaning that on average, firefighters performed more minutes of LPA when on-duty compared to off. There was a significant difference between on- (9060.2 ± 2636.4) and off-duty (7495.3 ± 2835.8) daily step counts (p = 0.011). CONCLUSION: As the results demonstrate, there is a dire need for increased PA levels in firefighters while on- and off-duty.

Firefighters' Physical Activity and Waist Circumference as Predictors of VO2max.

OBJECTIVE: To examine associations among objectively measured physical activity (PA), body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) in firefighters. METHODS: Career firefighters (n = 29; male = 100%) wore accelerometers to assess PA. BMI and WC classified obesity. Each participant completed a stage-graded exercise test to determine maximal oxygen uptake ((Equation is included in full-text article.)). RESULTS: Two linear regression models were used to investigate whether PA intensities, step count, BMI, or WC were predictive of "true" (Equation is included in full-text article.). Vigorous physical activity (VPA) was predictive of "true" (Equation is included in full-text article.)(F[1,27] = 7.89, R = 0.23, P < 0.01). Additionally, when BMI and WC were added, only WC was predictive of "true" (Equation is included in full-text article.)(F[1,27] = 11.76, R = 0.30, P < 0.01). CONCLUSION: Fire departments should be cognizent of ways to increase PA levels, decrease excess weight gain, and maintain CRF to adequately perform job-specific tasks.

Are we there yet? Faculty Members' Beliefs and Teaching Practices Related to the Ethical Treatment of Lesbian, Gay, and Bisexual Clients.

The purpose of this study was to explore (a) faculty members' beliefs about the ethics of reparative therapy and referring lesbian, gay, and bisexual (LGB) clients, (b) course content related to reparative therapy and referral of LGB clients, and (c) positions taken by programs associated with reparative therapy and referral of LGB clients. A total of 117 faculty members from accredited family therapy programs completed an online survey for this study. While the vast majority of faculty members reported that reparative therapy is unethical, there was less agreement related to the ethics of referring LGB clients, which may highlight the need for clearer ethical guidelines to regulate this potentially harmful practice. Implications for clinical training and future research are discussed.

To Refer or Not to Refer: Exploring Family Therapists' Beliefs and Practices Related to the Referral of Lesbian, Gay, and Bisexual Clients.

This study explored how negative beliefs toward lesbian, gay, and bisexual (LGB) individuals and LGB clinical competence influenced family therapists' beliefs and practices regarding referring based on the sexual orientation of the client. The sample consisted of 741 experienced clinicians. The results of this study indicated that the majority of the participants believe it is ethical to refer LGB clients; however, most had never made such a referral. Furthermore, participants who had referred based solely on the client's sexual orientation reported higher levels of negative beliefs toward LGB individuals and lower levels of LGB clinical competence. Finally, negative beliefs toward LGB persons not only predicted the practice of referring, but also the belief that it is ethical to refer an LGB client.

The State of Lesbian, Gay, and Bisexual Affirmative Training: A Survey of Faculty from Accredited Couple and Family Therapy Programs.

This study explored the state of lesbian, gay, and bisexual (LGB) affirmative training in the couple and family therapy field. LGB affirmative refers to holding positive views of LGB identities and relationships. A total of 117 faculty members completed the online survey for this study. Participants were asked to respond to items on the following topics: LGB affirmative stances, LGB affirmative program environment, LGB affirmative course content, self-of-the-therapist work, and professional opportunities to work with LGB topics and clients. The findings of this study were encouraging as participants reported holding positive beliefs about LGB individuals, that their training programs had fairly affirmative program environments, and that LGB affirmative course content was included in their program curriculum.

Assessing lesbian, gay, and bisexual affirmative training in couple and family therapy: establishing the validity of the Faculty Version of the Affirmative Training Inventory.

This study established the validity and factor structure of the Faculty Version of the Affirmative Training Inventory (ATI-F), which assesses faculty members' perceptions of the level of lesbian, gay, and bisexual (LGB) affirmative training that occurs in clinical programs. Additionally, this study examined the latent associations among the subscales of the ATI-F and three convergent validity items utilizing a sample of 117 faculty members from accredited family therapy programs. The findings provide empirical support for the relationship between including classroom content on LGB affirmative therapy and faculty members' beliefs about LGB individuals and relationships. Specifically, faculty members who report more positive beliefs about LGB clients appear to be more likely to include LGB affirmative therapy content in the courses they teach.

An exploration of family therapists' beliefs about the ethics of conversion therapy: the influence of negative beliefs and clinical competence with lesbian, gay, and bisexual clients.

The majority of the literature on conversion therapy has focused on clients' experiences and rationales for seeking such therapy. This study sought to explore differences in the beliefs and clinical competence of therapists who practice and believe in the ethics of conversion therapy and those who do not. The sample for this study included 762 family therapists who were members of the American Association of Marriage and Family Therapy. Data were collected using electronic surveys that assessed participants' negative beliefs about and perceived clinical competence with lesbian, gay, and bisexual (LGB) individuals. Results indicate that those who believe in the ethics of and/or practice conversion therapy report statistically higher levels of negative beliefs about LGB individuals and lower levels of clinical competence working with LGB clients. Implications for clinical practice and organizational policy are discussed.

Does affirmative training matter? Assessing CFT students' beliefs about sexual orientation and their level of affirmative training.

This study examined couple and family therapy (CFT) students' beliefs about sexual orientation, their self-reported competency working with lesbian, gay, and bisexual (LGB) clients, and the level of affirmative training students received in their CFT programs. One hundred and ninety students from accredited CFT programs completed the study. While participants reported feeling only somewhat competent to work with LGB clients and less than half reported receiving any training on affirmative therapy, the majority of the participants did appear to hold positive attitudes toward LGB clients. The results support the literature arguing for CFT programs to include specific training on affirmative therapy practices, as the level of affirmative training was directly related to participants' self-reported clinical competency working with LGB clients.