COMING OUT MORMON:
AN EXAMINATION OF RELIGIOUS ORIENTATION, SPIRITUAL TRAUMA, AND PTSD
AMONG MORMON AND EX-MORMON LGBTQQA ADULTS
by
BRIAN WILLIAM SIMMONS
(Under the Direction of Shari E. Miller)
ABSTRACT
Participation in organized religion has been correlated with various negative mental
health outcomes for LGBTQQA persons, including shame, anxiety, depression, suicidal ideation,
and substance abuse. However, previous research has not fully examined the impact of specific
religious events on these outcomes. The purpose of this study was to explore the relationships
between Allport & Ross’ (1967) religious orientations, orthodoxy, spiritual trauma, and PTSD in
LGBTQQA Mormons and ex-Mormons. Mormonism was selected as the study’s focus
population given its centralized governing structure as well as its strong doctrinal and policy
restrictions against homosexuality and transgenderism.
The study used a cross-sectional online survey design. Two-hundred and seventy-eight
participants were recruited primarily through LDS-affiliated LGBTQQA support and discussion
groups on Facebook. Existing measures were used to collect data on religious orientation and
PTSD, while the researcher developed questions to quantify spiritual trauma specific to Mormon
doctrine and policies. The majority of participants (85.6%) were raised in an LDS family and
half (51.8%) indicated they still attend LDS services at least monthly.

 On average, participants identified 13.8 religious beliefs, teachings, or experiences as
“damaging” or “extremely damaging.” A majority of participants (89.2%) likely met criteria for
PTSD diagnosis related to their religious experiences. Respondent’s perception of religious
experiences as damaging had a statistically significant positive effect on PTSD symptomology.
Conditional process analysis did not show any significant relationship between religious
orientation and orthodoxy on spiritual trauma or PTSD. Overall, the findings of this study
indicate LGBTQQA Mormon and ex-Mormon adults experience a substantial amount of spiritual
trauma and PTSD related to their religious experiences. Thus, it is recommended social workers
incorporate religious and spiritual dimensions into assessment efforts to assess both positive and
negative impacts of religious participation, with social work education providing additional
training in the topics of spirituality and spiritual trauma. Implications for future research,
including continued efforts to build a conceptual consensus of spiritual trauma, are also shared.

INDEX WORDS:

LGBTQQA, LGBT, Queer, Gay, Lesbian, Bisexual, Transgender,
Religious Orientation, Spiritual Trauma, Orthodoxy, PTSD, Mormon,
LDS, Conditional Process Analysis, Survey Research

 COMING OUT MORMON:
AN EXAMINATION OF RELIGIOUS ORIENTATION, SPIRITUAL TRAUMA, AND PTSD
AMONG MORMONS AND EX-MORMON LGBTQQA ADULTS

by

BRIAN WILLIAM SIMMONS
B.S., Brigham Young University, 2006
M.S.W., University of Utah, 2008

A Dissertation Submitted to the Graduate Faculty of The University of Georgia in Partial
Fulfillment of the Requirements for the Degree

DOCTOR OF PHILOSOPHY

ATHENS, GEORGIA
2017

  2017
Brian William Simmons

All Rights Reserved

COMING OUT MORMON:
AN EXAMINATION OF RELIGIOUS ORIENTATION, SPIRITUAL TRAUMA, AND PTSD
AMONG MORMONS AND EX-MORMON LGBTQQA ADULTS

by

BRIAN WILLIAM SIMMONS

Electronic Version Approved:
Suzanne Barbour
Dean of the Graduate School
The University of Georgia
December 2017

Major Professor:

Shari E. Miller

Committee:

Mary A. Caplan
Brian E. Bride

 iv

DEDICATION
For anyone who has ever been taught that who they are is abhorrent to God. May we
build a future where “all are alike unto God” (2 Nephi 26:33).

 v

ACKNOWLEDGEMENTS
I would like to thank everyone who participated in this study. Without willing
participants, this study would have never been possible. Behind every data point and statistical
computation is a person with a face, story, and heart. Thank you for entrusting me with a part of
your story; I hope the chapters that follow shine light on the experiences you’ve shared.
I extend my deepest appreciation to my committee members. Every interaction with my
committee members left me feeling inspired and motivated. Dr. Miller, thank you for helping me
navigate the space between conceptual and concrete. Your mentorship showed me how to take
vague questions and translate them into a concrete research plan. Thank you for encouraging me
to always go a step deeper and wider. Mostly, thank you for your patience, while also offering
motivation through the way. This process took much longer than either of us anticipated, but you
never gave up on me. Your feedback and direction made this study stronger than it would have
otherwise been. Dr. Bride, thank you for staying on my committee even though you left UGA;
learning from you has been an honor. Thank you for helping me to keep my head above water
when it seemed that the methodological Gods were conspiring against me. Also, thank you for
being responsive and kind when inundated by my emails. Finally, Dr. Caplan, thank you for
being a champion of this project. I will always remember passion in your voice during the
prospectus defense – I knew at that moment that you truly understood what this project meant.
I must also thank my family at the Carl Vinson Institute of Government. Without the
support of the Institute of Government leadership, I would not have been able to balance this
project and my work responsibilities. Dr. Theresa Wright, Dr. Laura Meadows, and David

 vi
Tanner were all key in my success. Dr. Theresa Wright helped me develop from a graduate
research assistant to a full-time research professional. Her support and encouragement kept me
committed to my doctoral program. Dr. Laura Meadows and David Tanner have demonstrated
what it truly means to support professional development. My professional training in survey
research while employed at the Institute of Government was an immense benefit through every
phase of this project. Additionally, my work at the Institute of Government has opened my eyes
to the varied opportunities for applied research in public service.
To my PhD cohort, Dr. Debra Lubar, Dr. Soonok An, and Dr. Melinda Moore, thank you
for your friendship. When I moved to Georgia to start the PhD program I didn’t know a single
soul; however, I quickly gained three of the greatest friends I could ever imagine. Deb, thank you
for welcoming Julie and me into your home. I have thoroughly enjoyed watching your children
grow these last seven years. You have been a source of keen advice, in both academic and
professional arenas. I never will understand how you balanced parenthood, full-time
employment, and writing your dissertation simultaneously with such apparent ease. You set the
bar high for the rest of the cohort, but you also showed me that it could be done. Soonok,
고맙습니다. Thank you for appeasing my desire for Korean food and conversation. Thank you
for your kind heart and warm smile. Thank you for being my 누나, in every sense of the word.
Mostly, I want to thank you for being my son’s 이모. We are family, now and forever. Melinda,
thank you for being my sounding board and helping me to grow more comfortable in my own
skin. Whether it be personal, academic, or professional, I knew I could count on you for honest
counsel. Thank you for introducing me to Doctor Who, TJ Klune books, and other much needed
mental respites. You always knew I could do this, even when I wasn’t certain. I look forward to

 vii
many continued years of profound friendship. In reflecting on my time as a doctoral student, I
cannot think of having a better team than Deb, Soonok, and Melinda.
I would not be where I am today without the amazing Julie Rae Simmons by my side. I
don’t think either of us really understood what we were getting into when we moved to Georgia
seven years ago. She looked forward with excitement as we left our families and all our friends
to start a new chapter across the country. Being much more pleasant than myself, she was
instrumental in building a support network for us in Georgia. She has shown the greatest amount
of patience and love through this progress. Despite her frustrations at my periods of
procrastination, never once did she question my abilities. She’s seen my tears and soothed my
broken heart as this process uncovered my own emotional wounds. Her words “you can do this”
will be seared eternally on my soul. We’ve traveled this road together, finding our son William
along the way. I’ve watched her grow into the most beautiful of mothers and a fierce advocate
for those she loves. Through this process she’s played breadwinner, cheerleader, and single
mother to give me the time and space I needed to work. She puts up with my flaws, accepts me
for who I am, and encourages me to become a better husband, father, and person. I will never be
able to repay her for her continued love and support.
And finally, to William. You are my everything. My world awakens every morning in
your smile and sleeps every night on your brow. From the moment you were placed in my arms
to my dying breath, I will forever be grateful for the opportunity to be your Dadda. You give me
passion; you give me purpose. Never question your worth or how much you are loved. I hope
only to build for you a world more loving and kind than the one I inherited.

 viii

TABLE OF CONTENTS
Page
ACKNOWLEDGEMENTS .............................................................................................................v
LIST OF TABLES ...........................................................................................................................x
LIST OF FIGURES ...................................................................................................................... xii
CHAPTER
1

INTRODUCTION .........................................................................................................1
Statement of the Problem .........................................................................................4
Mormonism as a Study Population ..........................................................................6
Sexuality from a Mormon Framework ....................................................................8
Purpose of the Study ..............................................................................................18
Summary ................................................................................................................18

2

REVIEW OF THE LITERATURE AND CONCEPTUAL FRAMEWORK .............20
Religious Orientation .............................................................................................20
Orthodoxy ..............................................................................................................32
Trauma and Posttraumatic Stress Disorder ............................................................33
Spiritual Trauma ....................................................................................................38
Conceptual Framework and Hypotheses ...............................................................44
Summary ................................................................................................................45

3

METHODOLOGY ......................................................................................................47
Research Design.....................................................................................................47

 ix
Sample and Data Collection...................................................................................48
Measures and Instruments......................................................................................50
Data Analysis .........................................................................................................57
Summary ................................................................................................................59
4

FINDINGS ...................................................................................................................60
Descriptive Analyses .............................................................................................62
Inferential Analyses ...............................................................................................78
Summary ................................................................................................................83

5

DISCUSSION ..............................................................................................................85
Religious Orientation and Spiritual Trauma ..........................................................87
Spiritual Trauma and PTSD ...................................................................................92
Overall Findings.....................................................................................................98
Study Limitations ...................................................................................................99
Implications for Social Work Practice .................................................................101
Suggestions for Future Research .........................................................................103
Summary ..............................................................................................................104

REFERENCES ............................................................................................................................106
APPENDICES
A SAMPLE SOCIAL MEDIA MESSAGES ................................................................130
B RECRUITMENT EMAIL .........................................................................................134
C SURVEY INSTRUMENT .........................................................................................136

 x

LIST OF TABLES
Page
Table 1: DSM-5 PTSD Clusters and Symptomology ....................................................................36
Table 2: Study Measures by Concept, Number of Items, and Number of Required Valid
Responses for Scale Summation ........................................................................................62
Table 3: Intrinsic Orientation Item Responses...............................................................................67
Table 4: Social-Extrinsic Orientation Item Responses ..................................................................68
Table 5: Personal-Extrinsic Orientation Item Responses ..............................................................69
Table 6: Quest Orientation Item Responses...................................................................................70
Table 7: Orthodoxy Item Responses (Particularistic Orthodoxy and Fundamentalism) ...............72
Table 8: Orthodoxy Item Responses (Church Commitment) ........................................................72
Table 9: Spiritual Trauma Item Responses (Retained) ..................................................................74
Table 10: Spiritual Trauma Item Responses (Dropped) ................................................................75
Table 11: PTSD Item Responses ...................................................................................................77
Table 12: Model Summary and Regression Coefficients for Religious Orientations and
Orthodoxy Regressed on Spiritual Trauma........................................................................81
Table 13: Model Summary and Regression Coefficients for Spiritual Trauma on PTSD.............82
Table 14: Direct Effects of Religious Orientation on PTSD .........................................................82
Table 15: Index of Moderated Mediation of Religious Orientation on PTSD through Spiritual
trauma and Orthodoxy .......................................................................................................83

 xi
Table 16: Ten Most Commonly Experienced LDS Beliefs, Teachings, or Ecclesiastical Counsel
Regarding Sexual or Gender Identity ................................................................................93

 xii

LIST OF FIGURES
Page
Figure 1: Proposed conceptual framework of religious orientation on PTSD through a moderated
mediation by orthodoxy and spiritual trauma ....................................................................44
Figure 2: PROCESS version 2.16 Model 7 conceptual and statistical diagrams...........................59

 1

CHAPTER 1
INTRODUCTION
According to the National Association of Social Workers’ (NASW) Code of Ethics, “the
primary mission of the social work profession is to enhance human well-being . . . with particular
attention to the needs and empowerment of people who are vulnerable [or] oppressed” (NASW,
2008, Preamble section, para. 1). Historically, lesbian, gay, bisexual, transgender, queer,
questioning, and asexual (LGBTQQA) persons have experienced varied types of oppression and
bias, including hate crimes, sexual orientation violence, antigay harassment, gay slurs, and
familial and social rejection (see Bourassa & Shipton, 1991; Burn, 2000; D’Augelli & Rose,
1990; DiPlacido, 1998; Herek, 1989, 2000; Herek, Cogan, & Gillis, 2002; Plummer, 2001;
Thurlow, 2001). National surveys have estimated anywhere from 3.4% to 16.5% of adults in the
United States (U.S.) either identify as lesbian, gay, bisexual, transgender, or have engaged in
same-sex sexual behavior (Gates & Newport, 2012; Herbenick et al., 2010; Ward, Dahlhmer,
Galinsky, & Joestl, 2014), suggesting that up to 52,000,000 adults are potential targets of
LGBTQQA oppression. In order to effectively work to enhance human well-being for
LGBTQQA persons, and to enhance their compassion, social workers must first educate
themselves on the various systems that can cause conflict or contribute to the oppression of the
client group (NASW, 2008).
One area of conflict for LGBTQQA persons that has received increased research
attention is the intersection between religion and sexual identity. Many Protestant, Catholic,
Islamic, and Judaic traditions strictly prohibit homosexuality and view non-heterosexual

 2
sexualities as sinful and immoral (Lease, Horne, & Noffsinger-Frazier, 2005; see also Clark,
Brown, & Hochstein, 1990; LeVay & Nonas, 1995; Melton, 1991; Sherkat, 2002). This
prohibitive position can lead to emotional and social distress for LGBTQQA individuals as they
attempt to integrate their spiritual and sexual selves (Lease et al., 2005; Schuck & Liddle, 2001).
Even in religions where non-heteronormative sexualities are not strictly forbidden, they are
rarely publically embraced (Barret & Barzan, 1996; Dworkin, 1997). In the process of fortifying
an LGBTQQA identity, individuals may feel their sexual identity is incompatible with their
religious beliefs, resulting in cognitive dissonance and potentially the forfeiture of their religious
beliefs and community (Dahl & Galliher, 2009; Lease et al., 2005; Ryan & Rees, 2012; Schuck
& Liddle, 2001; Sherkat, 2002). LGBTQQA individuals who participate in organized religion
can experience decreased mental health outcomes (Gage Davidson, 2000; Mahaffy, 1996;
Rodriguez & Ouelette, 2000), including shame, depression, suicidal ideation, and difficulty
accepting their sexual identity (Schuck & Liddle, 2001). Additionally systemized anti-gay
discrimination has been connected with increased symptoms of post-traumatic stress disorder
(PTSD) among LGBTQQA persons (Alessi, Meyer, & Martin, 2011; Roberts, Rasario, Corliss,
Koenen, & Austin, 2012; Szymanski & Balsam, 2011). Roberts et al. (2012) found sexual
minorities’ risk for PTSD was between 1.6 to 3.9 times greater than their heterosexual
counterparts, with childhood abuse victimization accounting for one-third to one-half of this
disparity.
In situations where tension between the client’s religion and LGBTQQA identity appears
to be causing emotional distress, social workers may find it challenging to affirm both identities
of the client (Jacobsen & Wright, 2014), as is encouraged by the NASW Code of Ethics (2008).
Thus, social workers and other mental health professionals should be aware of the impact various

 3
religious traditions can have on the experiences of LGBTQQA clients (Jacobsen & Wright,
2014). Social workers can intervene through micro practice efforts, like individual or family
therapy, as well as through macro practice efforts, like policy practice and advocacy. However,
interventions are seldom mutually exclusive, with advocacy often being a component of micro
practice efforts.
The Encyclopedia of Social Work defines social work advocacy as “the exclusive and
mutual representation of a client(s) or a cause in a forum, attempting to systematically influence
decision-making in an unjust or unresponsive system(s)” (Schneider, Lester, & Ochieng, 2008,
para. 1). Advocacy can be either cause or case focused. Cause advocacy is concerned with
macro-level change, such as working to change existing discriminatory and heterosexist policies
or laws (Epstein, 1981; Ezell, 1991, 2001). As the policies and beliefs of religious organizations
are generally not related to democratic processes, efforts to pressure religious leaders to change
biased policies might be seen as hostile, and result in forced removal of an individual from the
religious community (see Dias, 2013; Montgomery, 2015; Zavadski, 2015). Thus, when working
with LGBTQQA clients and their religious organizations, case advocacy to address the needs of
a particular client (Ezell, 1991) may be more appropriate. Case advocacy with LGBTQQA
clients can take the form of providing LGBTQQA clients connections to affirming support
networks, and providing family members or congregation leaders accurate information about
sexuality and gender (Morrow, 1993). When clinically appropriate and desired by the client,
social workers can also help LGBTQQA persons to become more visible within their religious
and social networks, which can potentially lead to changes in attitudes and belief of their
reference group (Griffin, Lee, Waugh, & Beyer, 2004; Penney, 2013; Woodford, Atteberry, Derr,
& Howell, 2013).

 4
The Church of Jesus Christ of Latter-day Saints (also referred to as the Mormon or LDS
Church) is among those conservative religions that doctrinally refute homosexual relationships
and same-sex sexual behaviors. The LDS Church is also a highly centralized organization that
emphasizes uniformity of doctrine and policies worldwide, likely resulting in increased
homogeneity in the indoctrination of church members to a degree not present within
decentralized religious traditions. While LGBTQQA involvement in religion has been connected
to a variety of mental health impairments (see Gage Davidson, 2000; Mahaffy, 1996; Rodriguez
& Ouelette, 2000; Schuck & Liddle, 2001; Sowe, Taylor & Brown, 2017), this study will focus
specifically on religious-based posttraumatic stress disorder (PTSD) in LGBTQQA Mormons.
Through focusing on the experiences of LGBTQQA Mormons and ex-Mormons, the purpose of
the current study is to examine the intersection of religious orientation, spiritual abuse, and
PTSD in order to provide knowledge, insight, and recommendations for social workers and other
mental health professionals.
Statement of the Problem
Unlike their heterosexual counterparts, religious activity for LGBTQQA identified people
has been shown to result in negative outcomes rather than functioning as a potentially protective
mechanism (Schuck & Liddle, 2001). Dahl and Galliher (2010) found negative religious
experiences impacted mental health outcomes more strongly than positive religious experiences
for sexual minority youth; indeed, those who experienced a fear of God and shame regarding
their sexual orientation were more likely to have decreased self-esteem. LGBTQQA identified
people can experience a variety of consequences from the challenges associated with reconciling
spiritual and religious identities, including loss of family and friends, loss of an “afterlife” or
expected salvation, and the need to readdress one’s life purpose (Halderman, 2004). In

 5
experiencing the loss of one’s faith or religious foundation, individuals may doubt their personal
identity constructed through religious experiences, leading to “a pervasive sense of meaningless,
self-doubt, confusion, and disintegration” (Lucas, 2003, p. 24).
The reaction of LGBTQQA Mormons’ families and communities can impact their wellbeing and behavior. In their work on LGBTQQA acceptance with LDS families, Ryan and Rees
(2012) indicated that supportive family reactions to a child’s LGBTQQA identification acted as a
protective factor against risky behaviors and mental health problems, while rejecting messages
correlated with increased risk for suicide, substance use, HIV infection, and other serious mental
health problems. LGBTQQA youth who felt rejected by their families experienced decreased
self-esteem and increased social isolation. In fact, those who experienced family rejection were
over eight times more likely to attempt suicide, six times more likely to have high levels of
depression, three times more likely to use illegal drugs, and three times more likely to be at high
risk for HIV and other STDs. LDS parents might forbid children from having LGBTQQA
friends in an attempt to prevent them from being gay; the child might view this then as rejection
of their core identity, and a belief the parent does not love, or is ashamed of, them (Ryan & Rees,
2012). Given the immense impact LGBTQQA clients may face as they navigate self-identifying
or publically disclosing their sexual orientation or gender identity in a religious environment,
social workers and other mental health professionals would benefit from an increased
understanding of the client’s religious tradition to understand any unique needs and context.
The following section will provide an overview of LDS Church structure, LDS teachings
on homosexuality, gender, and transgenderism to provide the reader with additional contextual
insight.

 6
Mormonism as a Study Population
While the LDS Church is not alone in its religious prohibition against homosexuality, the
centralized structure of the church makes current and former church members a meaningful and
useful research group. As will be identified in this section, this centralized structure of beliefs
and policies likely creates an increased homogeneity in the experiences and indoctrination of
church members, which might not be present among members of more decentralized religious
traditions. A brief history of the evolution in LDS Church doctrine and policies regarding
homosexual attractions, behaviors, orientation, identity, and transgenderism is provided in this
section to offer clarity of context.
Correlation of LDS Doctrine and Culture
During the 1950s and 1960s, as the LDS Church experienced rapid national and
international growth away from the headquarters in Utah, church leaders “realized that an
organization was needed at the general Church level to correlate the teaching of doctrines in the
varied priesthood auxiliary quorums and organizations” (Church Education System, 2003,
p.562). In 1961, church apostle Harold B. Lee established a council to correlate curriculum and
activities for all church members (called the All-Church Coordinating Council and later the
Correlation Program) (Church Education System, 2003). Under Lee’s guidance, the Correlation
Program developed and promoted shared policies and curriculum suitable for “Mormons in Utah
and Uganda, Arizona and Austria” (Bowman, 2012, p. 196). Thus, the hierarchical nature of
Mormonism endeavored to create uniformity in belief and practice among members worldwide.
Through establishment of the Correlation Program church administration started
addressing the fragmentation, overlap, and sometimes contradiction between curricula produced
by the various church auxiliaries. The Correlation Program brought the development and

 7
publication of all official church manuals, magazines, and other materials under the direction of
the faith’s headquarters. The curriculum was designed for “accessibility, to speak to the newest
convert as well as those raised in the church” (Bowman, 2012, p. 196), and to prevent church
teachers from “accept[ing] too readily the views of uninspired educators’” (Church Education
System, 2003, p. 567). Similarly, the Correlation Program established regional representatives to
oversee local church units under the direction of church general authorities (Church Education
System, 2003), thus creating a clear church governing structure from local congregation leaders
to the upper echelons of church leadership.
The Correlation Program brought not only uniformity of church doctrine and hierarchy,
but also uniformity in church culture. For example, in 1964 families were directed to set aside
Monday evenings for family-based, in-home religious instruction (referred to as Family Home
Evening or FHE), using church-created manuals (Church Education System, 2003), and in 1980
all weekly church meetings were consolidated into a uniformed three-hour block of meetings on
Sunday (The Church of Jesus Christ of Latter-day Saints, 1980). Other later efforts to provide a
uniform worship environment and experience included specific directives for local congregation
leaders on the structure of weekly worship services for adults, children, and youth; approved
church curriculum; church social activities; appropriate music in worship meetings; and even
identification of approved artwork for display in church buildings (The Church of Jesus Christ of
Latter-day Saints, 2010). Thus, one could anticipate the content, emotion, and tone of worship
services would be consistent regardless of geographic location.
Church leaders were instructed to rely on approved church curriculum and not “teach
their own rules or interpretations regarding the commandments” (The Church of Jesus Christ of
Latter-day Saints, 2010, p. 132). While church hierarchy utilized approved curriculum as an

 8
effort to ensure accurate doctrine is taught worldwide, the content of this curriculum has been
met with criticism. Bowman (2012) indicated correlated curricula downplayed theology while
emphasizing the revelatory power of church leadership, and strict personal adherence to church
tenets. Additionally, skepticism of academia, philosophy, and theological innovation replaced
early Mormon thinkers’ intellectual pursuits. As such, Bowman (2012) states correlated curricula
were “designed not to promote theological reflection but to produce Mormons dedicated to living
the tenets of their faith” (p. 197). Bowman (2012) adopted the term “retrenchment Mormonism”
(p. 191), which he attributes to other unnamed scholars, to define this culture of strict obedience
to conservative tenets and church leadership.
It is this highly correlated culture of retrenchment Mormonism that creates a unique
research population for the purposes of this study. Under the hierarchal nature of the LDS
Church, it is expected members worldwide have received similar messages and instructions
regarding homosexuality and gender. As will be described in the next section, official statements
regarding homosexuality and gender have become increasingly focused on behavioral obedience
to a strict moral code. While local congregation leaders and instructors will undoubtedly hold
varying interpretations of religious theology, they are continually instructed to align their
messages with approved curriculum, and not present personal opinion or interpretation as official
doctrine (The Church of Jesus Christ of Latter-day Saints, 2010). Therefore, it is anticipated
LGBTQQA Mormons will present as a homogenous group in their religious experiences and
indoctrination.
Sexuality from a Mormon Framework
As of December 31, 2016, the LDS Church a reported worldwide membership of
15,882,417 (Hales, 2017), with 41.5% (6,592,195) of those members living within the United

 9
States. The church does not keep an accounting of the number of LGBTQQA members. So,
though an exact accounting of LGBTQQA members does not currently exist, population
estimates can be used to approximate the number of LGBTQQA members in the United States.
Recent national surveys have estimated up to 3.4% of U.S. adults identified as lesbian, gay,
bisexual, or transgender (Gates & Newport, 2012; Ward et al., 2014), and 3.4% of adolescent
males to 9.5% of adolescent females identified as gay, lesbian, bisexual, or “other” (Herbenick et
al., 2010). However, when behavior was examined, up to 13.8% of men and 16.5% of women
reported having engaged in a same-sex oral sex (Herbenick et al., 2010). Thus, when sexual
activity is considered, a greater number of individuals report a lifetime experience of same-sex
sexual activity than those who identify as lesbian, gay, bisexual, or other. Given a total U.S. LDS
membership of 6,592,159, one could estimate an approximate 200,000 to 1,000,000 Mormons in
the U.S. might either identify as gay, lesbian, bisexual, or other, or have engaged in same-sex
sexual activities, respectively. A 2012 It Gets Better video reported an estimated 1,800 lesbian,
gay, bisexual, or transgender students attend LDS-owned Brigham Young University
(Avramenko, Dillard, & Wilcox, 2012), with a student population of approximately 30,000.
LDS Church Teachings on Homosexuality and Transgenderism
Mormonism has a strong heteronormative element. Official LDS scriptures teach that the
highest level of spiritual salvation is reserved for those who “enter into . . . the new and
everlasting covenant of marriage” (Doctrine and Covenants 131:1-4). Church leaders teach
marriage “is not merely a temporary legal contract . . . rather it is a sacred covenant with God
that can be binding in time and throughout eternity” (Bednar, 2006, p. 86), and that when
officiated within a LDS temple, couples and families are thereby “sealed” throughout eternity
(The Church of Jesus Christ of Latter-day Saints, 2009; Eyring, 2012; Hinckley, 2003; Nelson,

 10
2008). Thus, Mormon doctrine and theology see marriage as more than a social experience, but
instead, explicitly tie a person’s ultimate salvation to the experience of marriage. LDS leaders
also teach that members are commanded to “multiply, and replenish the earth” (Genesis 1:28,
KJV; see also Bednar, 2006), thus asexuality or intentional singlehood is not endorsed. However,
Mormon teachings on marriage extend only to heterosexual couples, as the church officially
“affirms defining marriage as the legal and lawful union between a man and a woman” and
teaches sexual relations outside marriage “including those between persons of the same gender,
are sinful and undermine the divinely created institution of the family” (The Church of Jesus
Christ of Latter-day Saints, 2010, p. 196). As of 2015, LDS Church policy designated same-sex
marriage as apostasy (Walch, 2015), indicating the church views those who enter into a same-sex
relationship as being in clear, open, and deliberate opposition to the church (The Church of Jesus
Christ of Latter-day Saints, 1994).
Leadership Attitudes toward Homosexuality
Prior to the 1960s, LDS leadership was relatively silent on the issue of homosexuality,
with the topic appearing infrequently through the 19th and early 20th centuries. However, as the
Gay Rights Movement (1969-1974) brought the issue to national attention, LDS leaders started
publically condemning homosexuality (Phillips, 2005). Through the late 1960s and 1970s,
church apostle (and later prophet) Spencer W. Kimball issued some of the first official
statements on homosexuality (Bowman, 2012). Kimball taught homosexuality was “an ugly sin,
repugnant to those who find no temptation in it” as well as unnatural, wrong, and “deviation
from normal, proper heterosexual relationships” (Kimball, 1969, p. 78). Kimball also stated
“there is no future for a homosexual . . . only futility and disappointment and loneliness lie
ahead” (Kimball & Petersen, 1970). During this time, leaders’ attitudes in discussing

 11
homosexual attractions and behaviors were often harsh, referring to homosexuals as “perverts”
(see Kimball & Petersen, 1970) or to homosexuality as a “perversion” (see Packer, 1976).
Starting in the late 1980s, a softening in leader’s attitudes became visible. Rather than
categorizing homosexuality as a perversion, leaders were more likely to describe it as a serious
or “grievous sin,” similar to pre-marital and extramarital sex (Hinckley, 1987, para. 30).
However, homosexuality was still seen as a “dangerous lifestyle” (Packer, 1990, Three
Dangerous Life-Styles section, para. 2) and one of three dangers to church apostasy, or turning
away from principles of the gospel, (the others being feminism and “so-called scholars or
intellectuals”) (Packer, 1993a). By the mid to late 1990s, church members were being counseled
to respond with kindness, compassion, and love to homosexuals and lesbians as fellow children
of God (Hinckley, 1998; Oaks, 1995). Even while the LDS Church became more vocal in its
opposition to same-sex marriage, members instructed that church policy and doctrine “should
never be interpreted as justification for hatred, intolerance, or abuse of those who profess
homosexual tendencies, either individually or as a group” (Hinckley, 1999, para. 28).
Starting in the early 2000s, church leadership expressed increased empathy for
LGBTQQA Mormons. Leadership acknowledged that reconciling a non-heteronormative
identity and Mormon identity is a trying dilemma (The Church of Jesus Christ of Latter-day
Saints, 2012), and ranks “among the most taxing, most visceral of any of the issues that any
religious group wrestles with” (Whitney, 2007a, Another Anguishing Issue section, para. 1).
Church members were continually encouraged to avoid judgment and reach out to LGBTQQA
Mormons with tolerance and love (Ballard, 2014; The Church of Jesus Christ of Latter-day
Saints, 2007, 2012), While church leaders recognize the topic of homosexuality requires utmost
sensitivity (The Church of Jesus Christ of Latter-day Saints, 2012), homosexual relationships

 12
remained immoral and sinful behaviors. Despite softening messages regarding homosexuality,
following the legalization of same-sex marriage in the U.S. in June 2015, the LDS Church
updated its policies to codify same-sex marriage as both apostasy, and a sin that warrants church
disciplinary council. Additionally, children of same-sex couples are to be restricted from baptism
and other religious ordinances until they are 18 and disavow same-sex marriage and cohabitation
(Walch, 2015).
Homosexual Attractions vs Homosexual Behaviors
Similar to the change in attitude toward homosexuals, statements from church leaders
demonstrate a clarification regarding the morality of homosexual attractions and behaviors. In a
1981 LDS handbook on homosexuality, homosexual attractions and fantasies were seen as sinful
even if not accompanied with sexual acts (Phillips, 2005). However, in a 1991 statement from
the highest governing body of the church, immoral thoughts or feelings were differentiated from
immoral behavior (The Church of Jesus Christ of Latter-day Saints, 1991), with thoughts being
seen as less severe than behaviors (Oaks, 1995). Since the latter part of the 1990s, church
leadership frequently stressed this delineation between homosexual thoughts and homosexual
behaviors, stressing homosexual attractions alone are not sinful and thus not reason for church
disciplinary action (The Church of Jesus Christ of Latter-day Saints, 2006, 2007, 2010, 2012;
Hinckley, 1998). However, as homosexual activities continue to be seen as sinful, persons who
engage in homosexual relationships can face disciplinary action, including excommunication
(The Church of Jesus Christ of Latter-day Saints, 2010; Oaks, 1995). In November 2015, LDS
Church policy was updated to include same-sex marriage as apostasy and thus making church
discipline a requirement for any who enter into same-sex marriage (Walch, 2015).

 13
In addition to delineating between homosexual attractions and behaviors, LDS leaders
have also attempted to delineate between homosexual attractions and identity. Starting in 1995,
church members were encouraged to refrain from the use of the words “homosexual, lesbian, and
gay” when describing people, as it was believed those terms implied a consigned circumstance
“in which he or she has no choice in respect to the critically important matter of sexual behavior”
(Oaks, 1995, emphasis in original, Application of Doctrines and Responsibilities section, para.
5). Leaders instructed LGBTQQA members to interpret homosexuality as “an adjective that
describe feelings or behavior” rather than a noun or identity (The Church of Jesus Christ of
Latter-day Saints, 2006, para. 9). Leaders further taught the use of the labels “homosexual,”
“lesbian,” or “gay” put disproportionate attention on one’s sexual attractions and thus belittled,
depreciated, and disparaged the person’s true identity as a child of God (Holland, 2007;
McMullin, 2010). LGBTQQA members were similarly encouraged to avoid excessive
concentration on or attention to their sexual attractions (The Church of Jesus Christ of Latter-day
Saints, 2007; Hafen, 2009). Rather, church leadership promoted the term same-sex attraction to
refer to a person’s feelings, thoughts, or attractions. As such, much of the church literature
during the past 20 years shows a preference for the term “same-sex attraction,” with the entry for
“homosexuality” on the church’s official website returning the redirection to “see same-sex
attraction.” Similarly, a 2014 study of young adult Mormons’ attitudes on same-sex marriage and
homosexuality conducted by the LDS Church initially provided respondents only three options
for sexuality: “I am heterosexual, but struggle with same-sex attraction,” “I am heterosexual and
do not struggle with same-sex attraction,” or “Other, please specify” (Ring, 2014).

 14
Origins, Nature, and Mutability of Homosexuality
Starting in 1960s, church leaders strongly refuted the concept of inborn homosexuality,
but rather emphasized it as a disease (similar to addiction) to be cured if the person were sincere
and committed enough. LDS Church apostles Spencer Kimball and Mark Petersen (1970) stated
homosexuality could be cured through abandoning previous people, situations, or literature
related to homosexuality and replacing these with scripture study and wholesome thoughts.
Through patient and determined removal of same-sex intimacy, and openness to intimacy with
the opposite gender, “gradually they can move their romantic interests where they belong [and]
marriage and normal life can follow” (p. 6). Whereas homosexual orientation was seen as a
sinful behavior that impeded heterosexual marriage and ultimately eternal salvation, it was
taught that God would not allow a person to be created gay from birth (Faust, 1995; Kimball &
Petersen, 1970; Oaks, 1995; Packer, 1976, 2000). Additionally, it was implied that if
homosexuality were inborn and unchangeable then the LGBTQQA person would be trapped in
sin and not responsible for their behaviors (Packer, 2000).
Church leadership recommended various sexual orientation change efforts, ranging from
increased spirituality to aversion therapy. In his doctoral dissertation at LDS-owned Brigham
Young University, McBride (1976) used a form of aversion therapy where homosexual men
were administered genital electric shock while shown pictures of men in sexual poses (see also
Phillips, 2005). Additionally, homosexual Mormon men were urged by ecclesiastical leaders to
pursue heterosexual dating and marriage under the assumption that “nature will take over”
(Phillips, 2005, p.32). By the late 1980s, church leaders no longer recommended marriage “as a
therapeutic step to solve problems such as homosexual inclinations or practices” (Hinckley,

 15
1987, para. 43) but continued to present homosexuality as a changeable characteristic, similar to
addiction (The Church of Jesus Christ of Latter-day Saints, 1991; Condie, 1993; Oaks, 1995).
By the mid-1990s, church leaders acknowledged sexuality was likely a product of both
nature and nurture (Oaks, 1995), and in the 2000s acknowledged that homosexuality may be a
permanent experience for some gay, bisexual, and lesbian members (The Church of Jesus Christ
of Latter-day Saints, 2007; Holland, 2007; Packer, 2000). Nonetheless, church leaders continued
to encourage gay, bisexual, and lesbian members to attempt sexual orientation change and
marriage when possible; however, in cases where the member is unable to experience a change
in sexuality, leaders strongly urged against marriage as to not create future broken homes and
families (The Church of Jesus Christ of Latter-day Saints, 2006; Holland, 2007). Since the mid2000s, the church has held no official position on the potential origins of sexuality (The Church
of Jesus Christ of Latter-day Saints, 2006), and church leaders have stated homosexuality should
not be viewed as a disease or illness (The Church of Jesus Christ of Latter-day Saints, 2012).
For church members who are unable to marry, either due to sexuality or other reasons,
the church expects complete celibacy (The Church of Jesus Christ of Latter-day Saints, 2006).
While some leaders viewed this expectation of celibacy as being qualitatively equal for both
homosexual and heterosexual single members (The Church of Jesus Christ of Latter-day Saints,
2006), others note acknowledge the expectation of life-long celibacy likely carries greater
emotional impact for homosexual persons. In an interview for the PBS miniseries, The Mormons,
Marlin K. Jensen stated:
“Some people argue sometimes, well, for the gay person or the lesbian person, we're not
asking more of them than we're asking of the single woman who never marries. But I
long ago found in talking to them that we do ask for something different: In the case of

 16
the gay person, they really have no hope. A single woman, a single man who is
heterosexual in their thinking always has the hope, always has the expectation that
tomorrow they're going to meet someone and fall in love and that it can be sanctioned by
the church. But a gay person who truly is committed to that way of life in his heart and
mind doesn't have that hope. And to live life without hope on such a core issue, I think, is
a very difficult thing” (Whitney, 2007b, What is the Official Position section, para. 4).
In consoling homosexual members with the lifetime prospect of singlehood and celibacy,
church leadership often rely on Mormon beliefs regarding premortal and post-mortal existence.
Simply put, Mormon doctrine teaches all humans existed spiritually prior to birth (see Jerimiah
1:5 KJV), and will continue to exist after death, with mortality being a period wherein faith and
obedience in God is tested (Oaks, 1993). As such, homosexuality is conceptualized as a mortal
trial; one that did not exist either before or after this mortal life (The Church of Jesus Christ of
Latter-day Saints, 2006; McMullin, 2010; Whitney, 2007b). Within this theological belief is the
implicit expectation that all persons will experience a heterosexual orientation in a post-mortal
experience and that homosexual, bisexual, and lesbian persons will have the opportunity for
heterosexual marriage in the afterlife (The Church of Jesus Christ of Latter-day Saints, 2012).
Thus, one’s non-heteronormative sexual orientation will no longer be a barrier to spiritual
salvation.
Teachings on Gender and Transgenderism
One’s biological sex greatly impacts one’s experiences and position within the LDS
Church structure and culture. Starting in adolescence, the church provides religious education
and weekly social activities specific to males and females (Young Men and Young Women).
Among the purposes of these programs include preparing young men to “become a worthy

 17
husband and father” (The Church of Jesus Christ of Latter-day Saints, 2010, p. 51) and preparing
young women “for her divine roles as a daughter, wife, mother, and leader” (The Church of
Jesus Christ of Latter-day Saints, 2010, p. 76). Thus socialization of gender roles is deeply
entrenched in weekly religious education and worship. At age 12, boys can be ordained to the
priesthood (The Church of Jesus Christ of Latter-day Saints, 2010) while women are denied this
right indefinitely (Oaks, 2014). Because women are not allowed priesthood ordination, they are
unable to serve as bishops (congregation leaders) or general authorities within the church. Adult
female leadership roles within the church involve oversight of other women and children.
Culturally, women are seen as being responsible for the emotional nurturing of children, while
men are responsible for providing for and presiding over the family (The Church of Jesus Christ
of Latter-day Saints, 1995).
The Family: A Proclamation to the World states “gender is an essential characteristic of
individual premortal, mortal, and eternal identity and purpose”, and affirms men and women
have different gender roles (The Church of Jesus Christ of Latter-day Saints, 1995, para. 2).
Parents are instructed to teach their children that male and female gender roles are eternally
significant (The Church of Jesus Christ of Latter-day Saints, 1985). Within the Mormon belief of
both premortal and post-moral existences, a person’s gender is seen as a fixed, eternal
characteristic (The Church of Jesus Christ of Latter-day Saints, 2012; Packer, 1993b). Church
leaders have taught “there is no mismatching of bodies and spirits. Boys are to become men –
masculine, manly men – ultimately to become husbands and fathers” (Packer, 1976, p. 16; see
also Packer, 2000), and that Satan seeks to confuse gender (Oaks, 1993). Therefore, while church
leadership may not frequently speak about transgenderism, it is strongly implied that a person’s

 18
gender identity and biological sex are unquestionably congruent, and as such the experience of
transgenderism is invalid.
Purpose of the Study
As addressed earlier, religious activity for LGBTQQA people has been linked to negative
outcomes, including shame, decreased self-esteem, loss of community, anxiety depression, and
substance abuse (see Gage Davidson, 2000; Mahaffy, 1996; Rodriguez & Ouelette, 2000;
Schuck & Liddle, 2001; Sowe et al,, 2017). Mormonism is a useful focus for research in this area
due to its centralized, hierarchical structure and stance against homosexuality and transgenderism
in both doctrine and policy. The purpose of this study is to examine the relationship between
religious orientation, orthodoxy, spiritual trauma, and PTSD in adult LGBTQQA Mormons and
ex-Mormons. Specifically, this study will empirically investigate the following research
questions: 1) Does orthodoxy moderate the relationship, if any, between religious orientation and
spiritual trauma? 2) Does spiritual trauma correlate positively with PTSD? And, 3) Does
religious orientation have an indirect impact on PTSD through a moderated mediation with
orthodoxy and spiritual trauma?
Summary
This chapter highlighted social work’s professional commitment to address the needs of
vulnerable and oppressed persons. LGBTQQA persons have historically been systematically
oppressed within the world, including from religious sources. Prior research linking nonaccepting religious involvement to decreased mental health functioning in LGBTQQA persons
was presented. Using the LDS Church as a study population, this chapter reviewed the church’s
teachings on homosexual attractions, behaviors, orientation, identity, and transgenderism. Given
the LDS Church’s centralized hierarchy and focus on correlated doctrine, this chapter justified

 19
using an LDS population as the study focus in order to examine the strain between religious
teachings and LGBTQQA identities.

 20

CHAPTER 2
REVIEW OF THE LITERATURE AND CONCEPTUAL FRAMEWORK
As seen in the preceding chapter, religious contexts have great propensity to impact client
outcomes as they navigate the intersection between their spiritual identity and sexual orientation
and/or gender identity. The following chapter will present a comprehensive review of the
literature for the variables to be used in the current study. First, Allport’s (1963) religious
orientation framework will be presented, including conceptualization of intrinsic, personalextrinsic, social-extrinsic, and quest orientations. Additionally, the concept of orthodoxy will be
reviewed, as previous research has shown this concept to be of importance when utilizing
Allport’s (1963) religious orientation framework. Concepts of trauma, PTSD, and spiritual
trauma will then be presented, with a conceptualization of spiritual trauma within an LDS
context provided. The final section of this chapter will present the conceptual framework and
study hypotheses.
Religious Orientation
The study of religion, faith, and spirituality has produced a variety of definitions,
theories, and conceptualizations. This is unsurprising given both the variety of religious and
spiritual traditions that exist worldwide, and the individual nature of faith and spirituality. The
impacts of religion and spirituality have been studied in connection with many health, mental
health, and well-being outcomes, although spirituality has rarely been used as the primary
outcome variable (Hill & Pargament, 2003). While the terms spirituality, faith, and religion
might be used interchangeably by some, increasingly religion denotes an organized or fixed

 21
belief system while spirituality is characterized by highly individualized beliefs and views (Hill
& Pargament, 2003). As such, it is possible to engage with religion with little spirituality, and
similarly to possess great spirituality without being religious. For the purposes of this study, the
terms faith and spirituality will be used to describe individual beliefs or values, and the term
religion will be used to describe an organized institution and belief system.
Fowler (1986) described faith as a founding principle for one’s entire worldview,
attachments to others, and highly held values. As such, one’s faith development permeates all
aspects of one’s life and identity, as it impacts how one views oneself, others, and the world. Hill
and Pargament (2003) noted that religion and spirituality “are not a set of beliefs and practices
divorced from everyday life, to be applied only at special times and on special occasions.
Instead, religion and spirituality are ways of life to be sought, experienced, fostered, and
sustained consistently” (p. 68). This is certainly true for Mormonism where members are
encouraged to “never check your religion at the door,” and to be constantly loyal to church
commandments (Holland, 2012, Lesson 1 section, para. 2).
Embracing a Mormon identity has far-reaching impacts in one’s personal and public life.
As stated by a LDS apostle, “[M]embers of The Church of Jesus Christ of Latter-day Saints have
what we call a gospel culture. It is a distinctive way of life, a set of values and expectations and
practices common to all members . . . It guides us in the way we raise our families and live our
individual lives” (Oaks, 2012, A Distinct Way of Life section, para. 1). When members’ cultural
or familial traditions contradict with official church teachings, church members are encouraged
to eschew those traditions for adherence to church guidance (Oaks, 2012). Church members are
encouraged to participate in daily family scripture study and prayers (The Church of Jesus Christ
of Latter-day Saints, 1987; Groberg, 1982); daily personal scripture study and prayers (Davies,

 22
2013); weekly Family Home Evening (Perry, 2003); weekly church attendance (Doctrine and
Covenants 59:9-12; Oaks, 2012); pay a tithe of 10% of their income (Doctrine and Covenants
119:4; Oaks, 2012); and refrain from alcohol, coffee, tea, tobacco, and illicit drugs (Doctrine and
Covenants 89; Packer, 1996). Youth are also encouraged to engage in weekday religious
education from age 14 through college (called seminary and institute) (Perry, 1997), and to
prepare for missionary service in young adulthood (two years for males, 18 months for females)
(Monson, 2012).
Forms of Religious Orientation
Religious orientation has been identified as the “single most dominant research paradigm
in the psychology of religion”, and “did more than anything else to foster the empirical
investigation of how one approaches religion” (Hill & Hood, 1999, p. 119; see also Donahue,
1985; Kirkpatrick, 1989). Allport and Ross (1967) lamented that despite recurrent teachings of
equality, brotherhood, compassion, and human kindness within a variety of religions, existing
research, at that time, had shown religious people to be less humanitarian than nonreligious
people, particularly in their attitudes toward criminals, delinquents, prostitutes, homosexuals, and
those with mental health challenges. By establishing a taxonomy of religious orientations,
Allport (1963) hoped to explain religion’s paradoxical position as both a “therapeutic
community” (p. 188), and its use of pathogenic appeals wherein “religion instills an abnormal
degree of terror” (p. 189).
Allport (1963) theorized that religious sentiment varied from person to person, being
superficial or trivial for some, yet deep and pervasive for others. The resulting framework placed
extrinsic and intrinsic religious orientations at opposing ends of a continuum. The extrinsic
orientation characterized religion as “something to use, but not to live” (Allport, 1963, p. 193),

 23
potentially using religion to improve status, bolster self-esteem, gain power, or influence.
Although the intrinsic orientation was not as clearly defined initially, Allport and Ross (1967)
stated the intrinsic religious orientation subordinates all needs to an overarching religious
commitment. Through embracing and internalizing a religious creed, the intrinsic religious
person “lives his religion” (p. 434, emphasis in original). Allport and Ross (1967) also included a
potential third religious orientation – the indiscriminately proreligious – who endorse “any or all
items that to them seem favorable to religion in any case” (p. 437). As seen from this original
taxonomy, religious orientation speaks to the motivation for, or orientation to, religion rather
than differing types or forms of religion (Allport & Ross, 1967).
Additional expansion of Allport’s framework was driven by the results of scale
development. The first religious orientation measure, Wilson’s (1960) Extrinsic Religious Values
Scale, examined extrinsic religious orientation, but did not define the opposing end of the
continuum beyond the absence of an extrinsic orientation. Feagin’s (1964) Intrinsic/Extrinsic
(I/E) Scale showed intrinsic and extrinsic orientations as two separate, orthogonal concepts, and
not opposing ends of a bipolar continuum as Allport (1963) had initially proposed. Additionally,
Feagin (1964) found the separate concept subscales were more useful than the combined
measure score. Allport and Ross’ (1967) Religious Orientation Scale maintained Feagin’s (1964)
conceptualization of intrinsic and extrinsic orientation as separate concepts.
Following Allport’s death in 1967, “research by others mushroomed so much that the
religious orientation scale and its various spin-offs . . . are among the most frequently used
measures in the psychology of religion” (Hill & Hood, 1999, p. 120). The primary developments
have been regarding an expansion of extrinsic faith into two subtypes (see Amón & Yela, 1968;
Hoge, 1972; Hunt & King, 1971). Kirkpatrick (1989) concluded the Intrinsic/Extrinsic Scale

 24
(Feagin, 1964), and the Religious Orientation Scale (Allport & Ross, 1967) produced three
factors rather than two: intrinsic, social-extrinsic, and personal-extrinsic. Social-extrinsic was
concerned with social rewards, such as social gain or power provided by religion, while socialpersonal viewed religion as a pathway to personal relief, protection, and comfort. Based on these
conclusions, Gorsuch and McPherson (1989) developed the Religious Orientation Scale-Revised
to measure intrinsic, social-extrinsic, and personal-extrinsic orientations. The Religious
Orientation Scale-Revised also incorporated previous work by Gorusch and Venable (1983) to
make Allport and Ross’ (1967) scale more amenable to lower educational levels.
Intrinsic orientation. While the intrinsic orientation was not originally well defined, but
rather viewed as the absence of an extrinsic orientation at times (see Hunt and King, 1971;
Wilson, 1960), this orientation gained additional conceptual clarity with continued research.
Allport (1963) described the intrinsic orientation as one wherein religious commitment is a major
motive in life – “subordinate to no other motives” (p. 193). Religion acts as an end in itself and
not an instrument for other need fulfillment. Persons with an intrinsic orientation hold religion as
a master motive, “covering everything in experience and everything beyond experience . . . it is a
hunger for, and a commitment to, an ideal unification of one’s life, but always under a unifying
conception of the nature of all existence” (Allport, 1963, p. 195). Intrinsic orientation was
beyond a “mere mode of conformity, nor a crutch, nor a tranquilizer, nor a bid for status”
(Allport & Ross, 1967, p. 441), but was a deeply internalized creed wherein the person fully
“lives his religion” (Allport & Ross, 1967, p. 434). Donahue (1985) stated intrinsic religiousness
is an appropriate measure for religious commitment, separate from religious belief, and is
useable with most Christian denominations.

 25
Early studies found lower levels of racial and ethnic prejudice among the intrinsic
religious orientation (Allport & Ross, 1967; Wilson, 1960); however, later research has shown
the intrinsic orientation to be positively correlated with discrimination against homosexuals
(Herek, 1987; McFarland, 1989). As such, Herek (1987) suggested the need to consider the
religious system that serves as a primary motivation. As mentioned in the prior section, many
religions view homosexuality as an immoral behavior (Lease et al., 2005; see also Clark et al.,
1990; LeVay & Nonas, 1995; Melton, 1991; Sherkat, 2002). When controlling for orthodoxy,
McFarland (1989) found the positive correlation between intrinsic orientation and discrimination
against homosexuals disappeared, indicating orthodoxy might have been the source of sexual
orientation prejudices.
Extrinsic orientation. Allport’s earlier writings stated persons with an extrinsic religious
orientation view religion as a “dull habit” (Allport, 1963, p. 193) connected to ceremony, family
convenience, or personal comfort. As such, the extrinsically oriented person sees religion as
“something to use, but not to live” (Allport, 1963, p. 193, emphasis in original). Allport and Ross
(1967) indicated that within this orientation, religion serves the other, more ultimate interests of
the person, whether it be status, self-confidence, power, or influence. Thus, religion is a means to
an end. In terms of developmental psychology, Allport (1963) described the extrinsic religious
orientation as having immature formation (p. 194), wherein one “turns to God, but without
turning away from self” (Allport & Ross, 1967, p. 434). Unsurprisingly, Hunt and King (1971)
found measures of extrinsic faith tended to emphasize instrumental and selfish characteristics.
Additionally, Allport (1963) thought the pathogenic strains in religion, “such as excessive terror,
superstition, a built-in hostility to science, or a palliative defensiveness” (p. 195), were not
inherent components of religious doctrine but rather extrinsic additions.

 26
Personal-extrinsic and social-extrinsic. Given the view of extrinsic orientation as the use
of religion as a means to another end, Kirkpatrick (1989) theorized a variety of ends could be
identified. Kirkpatrick provided psychometric support for the identification of two extrinsic
factors: 1) social-extrinsic, and 2) personal-extrinsic. These extrinsic subscales were uncorrelated
with intrinsic faith, indicating they continued to be separate concepts. Additionally, the lack of
correlation suggested individuals can potentially endorse intrinsic faith as well as social-extrinsic
and/or personal-extrinsic faith.
Kirkpatrick (1989) described the personal-extrinsic orientation as one that facilitates
personal relief, protection, and comfort from religion. This subscale was shown to have a
positive relationship with God-control and orthodoxy. Personal-extrinsic was more strongly
related to frequency of prayer, suggesting prayer acted as a form of personal comfort rather than
an institutional activity. Social-extrinsic orientation was concerned with social rewards and was
more strongly related to feelings of social isolation and church attendance. Thus, Kirkpatrick
(1989) indicated those who use religion for social gain “tend to be those who feel socially
isolated, and they are more frequent church attenders” (p. 23).
Although the personal-extrinsic and social-extrinsic factors were not fully integrated into
studies of religious orientation until the late 1980s, studies since that time have shown great
benefit in including these components. Kirkpatrick (1989) found that in instances of near-zero
correlations between the complete extrinsic scale and another variable, examination of socialextrinsic and personal-extrinsic orientations would identify strong, opposing relationships with
the variable. Thus, potentially significant relationships can be overlooked or incorrect
conclusions reached when the extrinsic items are combined (Kirkpatrick, 1989). This was

 27
supported by McFarland (1989), who stated, “The real power of extrinsic religion to predict
discrimination is in its subscales” (p, 334).
Indiscriminately proreligious and indiscriminately nonreligious. In their study of 309
churchgoers, Allport and Ross (1967) found that the endorsement of extrinsically worded items
did not necessarily equate to a rejection of intrinsically worded items or vice versa. While there
were subjects who were consistently intrinsic or consistently extrinsic, other respondents did not
endorse only one religious orientation, but rather appeared to endorse “any or all items that to
them seem favorable to religion in any case” (p. 437). Allport and Ross labeled this group as
indiscriminately proreligious, and found indiscriminately proreligious churchgoers displayed
greater ethnic prejudice than the consistently extrinsic type. Allport and Ross also hypothesized
the existence of an indiscriminately antireligious or nonreligious group who show a strong
tendency to disagree with both scales; however, as their sample included only churchgoers they
did not identify any indiscriminately nonreligious individuals in their study.
In his factor analysis of Feagin’s (1964) and Allport and Ross’ (1967) measures,
Kirkpatrick (1989) found extrinsic scale items that did not relate to either the social-extrinsic and
personal-extrinsic factors. Of these remaining “residual” extrinsic items, three items appeared to
be essentially reverse-coded intrinsic items that expressed “an explicit denial of an intrinsic or
committed orientation toward religion” (p. 26). Indeed, Kirkpatrick indicated these three residual
items would act as ideal items for measuring the absence of an intrinsic orientation. As such,
Kirkpatrick (1989) theorized these three items are what “Allport had in mind when he referred to
his indiscriminately proreligious subjects . . . as ‘muddleheads’” (p. 26).
Although Allport and Ross (1967) viewed the indiscriminately proreligious as being
“provokingly inconsistent” (p. 437), Echemendia and Pargament (1982) viewed the

 28
indiscriminately proreligious categorization as individuals who both “live” and “use” their
religion (as cited in Pargament et al., 1987). To gain additional conceptual clarity, Pargament et
al. (1987) developed a two-factor measure for indiscriminate proreligiousness. In development of
their measure, Pargament et al. operationalized indiscriminate proreligiousness as “a positive
response to religious material regardless of its plausibility” (p. 185). Using two samples (261
church members, and 305 churchgoing students), Pargament et al. found their measure had
sufficient content validity, reliability, construct validity, and generalizability. Additionally,
indiscriminate proreligiousness was found to be related to social desirability, rather than identical
constructs. Given these results, Pargament et al. (1987) suggested indiscriminate
proreligiousness as a valid construct, and recommend measuring it directly as opposed to being a
by-product of the intrinsic/extrinsic scales (see also Kirkpatrick & Hood, 1990).
Quest orientation. In examination of Allport and Ross’ (1967) Religious Orientation
Scale, Batson (1976) supported the addition of a third category: religion as a quest. Batson stated
those with a quest orientation “view religion as an endless process of probing and questioning
generated by the tensions, contradictions, and tragedies in their own lives and in society” (p. 32).
This is in contrast to the intrinsic orientation, which Batson (1976) viewed as “a compulsive,
conforming, and unquestioning ‘true believer’. . . who identified with religious dogma, persons,
or institutions with a rigid, unthinking, dependent fashion” (p. 32). Batson indicated the quest
orientation is not necessarily connected with a specific religion, but a continual processing of the
ultimate “whys” of society. Those with a quest orientation recognize that final truth about such
questions may never be discovered; however, the questions are deemed important and answers
are sought (Batson & Schoenrade, 1991b). As such, Batson and Ventis (1982) viewed religion as
“all those ways of coming to grips with existential concerns” (p. 9), thus encompassing both

 29
traditional and nontraditional forms of religion. Studies by Batson (1976), Batson and Ventis
(1982), and Batson and Schoenrade (1991b) found that religion as quest could be identified as a
behaviorally different orientation orthogonal from intrinsic or extrinsic orientations. McFarland
(1989) found that quest orientation predicted less discriminatory attitudes, acting as a “general
anti-discrimination attitude” (p. 333), which was anticipated given previous research showing
quest to be negatively related to racial prejudice.
Concerns and considerations. Although Allport’s intrinsic/extrinsic framework has
been dominant in the psychology of religion (Donahue, 1985; Hill & Hood, 1999; Kirkpatrick,
1989), it has not been free of critique. One concern to be addressed is the issue of conceptual
clarity. As noted previously, the intrinsic orientation was originally ill defined in Allport’s early
writings (see Hunt & King, 1971; Wilson, 1960), at times identified only as the absence of an
extrinsic orientation. Although later writings provided more information regarding the intrinsic
orientation, critics have continued to question the conceptual clarity within Allport’s taxonomy.
Kirkpatrick and Hood (1990) asked, “What precisely does ‘religious orientation mean? As
straightforward as this question may seem, a precise answer proves to be elusive” (p. 443). While
Allport and Ross (1967) described religious orientation as a motivation toward religion,
Kirkpatrick and Hood (1990) found researchers “fill in the blank . . . with a diverse array of
terms . . . sometimes [avoiding] the issue entirely by simply referring to ‘intrinsicness’ or
extrinsicness’” (p. 443). Hunt and King (1971) stated the intrinsic/extrinsic descriptions
increasingly looked more like personality variables, thus measuring pervasive personality
characteristics rather than religiosity (see also Kirkpatrick & Hood, 1990). Gorsuch (1984)
similarly stated the items included in the Religious Orientation Scale (Allport & Ross, 1967)
represented a hodgepodge of attitudes, beliefs, values, and behaviors.

 30
In line with Allport and Ross’ (1967) view of orientation as motivation, Batson and
Ventis (1985) provided a conceptualization of religious orientation that will be applied in the
current study:
“[W]e are more interested in how an individual relates to his or her religious beliefs than
in the specific content of the beliefs . . . we wish to know the degree to which the person
claims to hold these beliefs as (a) an instrumental means to satisfy security and
conformity needs (the extrinsic, means dimension), (b) an intrinsic end in itself and
master motive in life (the intrinsic, end dimension), and (c) a tentatively held view in an
ongoing attempt to make sense of life (the quest dimension)” (p. 400).
The current study is designed to build understanding regarding how sexual minorities
have responded to Mormon beliefs regarding homosexuality and gender identity. Given the
highly correlated nature of retrenchment Mormonism that emphasizes obedience to a strict moral
code, and the authority of the leadership of the LDS Church (Bowman, 2012), the current study
is informed by a highly homogenous set of related beliefs. Therefore, the current study focuses
not on LGBTQQA Mormons and ex-Mormons beliefs (or prior beliefs), but how those beliefs
impacted spiritual trauma and PTSD. Consistent with Herek (1987), the current study provides a
contextual understanding of the religious system involved to help explain potential relationships
between respondents’ religious orientation and outcome variables.
Within the existing literature, there appears to be a tendency to identify some religious
orientations as “good” and others as “bad” (Kirkpatrick & Hood, 1990). For example, Donahue
(1985) stated extrinsic religiousness “does a good job of measuring the sort of religion that gives
religion a bad name” (p. 416). Allport (1963) insinuated many of the negative aspects of religion
were due to extrinsic additions that distracted from the true, intrinsic, qualities of religion. As

 31
such, Kirkpatrick and Hood (1990) considered Allport’s framework to be overly value-laden.
Although most social science researchers have to address personal beliefs and biases, this
challenge is “nowhere more obvious and more challenging than in the psychology of religion”
(Kirkpatrick & Hood, 1990, p. 457). However, Batson and Schoenrade (1991b) attempted to
maintain a value-neutral view of the differing orientations, stressing that attempting to identify
one orientation as “best” is as inappropriate as identifying which dimensional space of height,
weight, and depth is “best.” As noted in Chapter 1, the challenge of reconciling one’s nonheteronormative sexual identity and religious orientation has been acknowledged as “among the
most taxing, most visceral of any of the issues that any religious group wrestles with” (Whitney,
2007a, Another Anguishing Issue section, para. 1); therefore, it is imperative researchers
continually challenge and address personal biases as to respect the varied experiences of
LGBTQQA Mormons and ex-Mormons. This is particularly relevant given the current
researcher’s personal identity as both Mormon and queer.
Existing literature using Allport’s framework has examined correlations between
religious orientation and bias toward women, Blacks, Communism, those of different faiths, and
homosexuality (see Allport & Ross, 1967; Feagin, 1964; Herek, 1987; McFarland, 1989; Wilson,
1960). As such, existing literature has generally focused on the religious person’s views and
attitudes toward the other. Allport (1954) identified prejudice as a stereotyped overgeneralization
and inability to distinguish minority members as individuals. However, in the current study the
minority group member, or “other”, is the respondent’s self. As such, discriminatory attitudes
might be presented as internalized homophobia or decreased self-worth. While Brennan-Ing,
Seidel, Larson, and Karpiak (2013) utilized Allport’s framework in examining older GLBT
adults’ religious adaptation strategies, this classification was related to the adaptation behavior

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and not the individual’s personal religious orientation. Thus, within the existing literature, it
appears that no previous studies have applied Allport’s (1963) intrinsic/extrinsic orientation
framework to examine the relationship between religious orientation and perceived trauma from
religious experiences in a LGBTQQA population. Whereas the current study is the first to
examine the connections between religious orientation and one’s sense of self as “other,” it is
hopeful the results will demonstrate if Allport’s (1963) framework is suitable for use in other
circumstances where one’s in-group identity conflicts with their religious identity, and other
forms of religious identity conflict.
Orthodoxy
Components of religious orthodoxy have been included in several studies utilizing
Allport’s extrinsic/intrinsic orientation (see Batson & Schoenrade, 1991a, 1991b; Feagin, 1964;
Herek, 1987; McFarland, 1989). Within several of these studies, orthodoxy does not appear with
a concise conceptual definition; however, an examination of the measures used assists in
understanding this concept. McFarland (1989) developed six items “stressing the perfection and
authority of the Bible, the necessity of keeping ‘the true teachings of God's word,’ and the
importance of preparing for heaven and avoiding ‘worldly ideas’” (p. 328). Herek (1987)
adapted Putney and Middleton’s (1961) orthodoxy subscale, which includes items regarding the
existence of a physical hell, the Devil as a supernatural being, and a Divine plan and purpose for
every living person and thing. Thus, orthodoxy generally appears to be conceptualized as having
a literal belief in one’s religious teachings. Batson and Schoenrade (1991b) clarified that
orthodoxy is not meant to be seen as an opposition to quest, which is supported by correlations
between these two concepts ranging from .00 to -.20 (p. 422). Batson and Ventis (1985)
differentiated orthodoxy from fundamentalism, stating their orthodoxy scale “assesses amount of

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agreement with belief statements that are not endorsed by only fundamentalists, but also by a
wide range of non-fundamentalist Christians” (p. 401).
Overall, current research suggests orthodoxy is not correlated with either intrinsic or
extrinsic orientation, but is correlated with prejudice (Feagin, 1964; Herek, 1987; McFarland,
1989). Additionally, McFarland (1989) found when orthodoxy was controlled, positive correlates
between intrinsic orientation and discrimination vanished (p. 332). As such, it would appear
orthodoxy is a valuable variable to include in a study of religious orientation.
Trauma and Posttraumatic Stress Disorder
Prior to the Franco-Prussian War (1870-1871), the term “trauma” carried no
psychological connotation, but was generally reserved for open wounds and physical injuries to
the skin (Jones & Wessley, 2007). Physicians working with soldiers and war veterans at this time
started to identify a connection between terrifying events and psychological distress among
veterans; however, it was assumed frightening events were merely triggers for those predisposed
to mental illness – a belief that would remain prevalent until the mid-1960s (Jones & Wessley,
2007). As the understanding of psychological impact from painful and stressful events was
expanded, the term trauma was also expanded. Thus, the current conceptualization of trauma is
far broader, and much more well-defined than that of the 19th and 20th centuries.
Early research on trauma focused on individuals who experienced extreme environmental
stressors, such as war or natural disasters (APA, 1952; Jones & Wessley, 2007). Despite the
severity of these stressors, associated symptoms were considered acute reactions with assumed
short-lived impairment (Brett, Spitzer, & Williams, 1988; Jones & Wessley, 2007). When
posttraumatic stress disorder (PTSD) was first recognized as a mental health diagnosis in the
third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) (APA,

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1980), the existence of chronic or delayed trauma-related psychological impairment was finally
recognized. Although the DSM-III PTSD task force was initially reluctant to endorse a diagnosis
connected with a specific historic event, clinical evidence identified similar stress responses to
rape, natural disasters, life-threatening accidents, or confinement in a concentration camp
(McNally, 2003). Thus, the DSM-III framework identified trauma as a psychologically
distressing event “outside the range of usual human experience” (APA, 1980, p. 236) capable of
inducing “significant symptoms of distress in almost everyone,” (APA, 1980, p. 238). Events
within everyday life, such as divorce, job loss, or developing a chronic illness were not
considered traumatic experiences, as they were within the expected experience for many
individuals (McNally, 2009).
While the DSM-III focused on individuals with a direct experience of combat, rape, lifethreatening accidents, or natural disasters, the list of potentially traumatic experiences grew to
include (but were not limited to) deliberately caused disasters (APA, 1987), robbery, kidnaping,
life-threatening disease diagnosis, and contact with dead bodies/body parts (APA, 1994).
Similarly, the DSM-III-R broadened trauma to include witnessing or hearing about the
experiences of one’s close friends and relatives or witnessing the serious injury or death of
another person (APA, 1987; Brett et al., 1988; McNally, 2003). Thus, a person who is not
physically present for a trauma but is exposed to the details of a traumatic event qualified as
being exposed to trauma and eligible for diagnosis – just as if they had experienced the traumatic
event directly (McNally, 2009; McNally & Breslau, 2008). The DSM-5 includes those who
experience “repeated or extreme exposure to aversive details of the traumatic event” (APA,
2013, p. 271) – such as first responders, police officers, or trauma counselors; however, exposure
via media (such as television, movies, or pictures) was excluded as a potential source of trauma

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(APA, 2013). As such, the generally accepted conceptualization of trauma at the time of writing
encompasses actual or threatened injury, other threat to one’s safety, or learning about such
experiences of one’s close friends and relatives.
Trauma Response and PTSD Diagnosis
Not all individuals who have traumatic experiences develop related psychosocial
impairment. Projected lifetime prevalence for PTSD diagnosis is 8.7%, with a 12-month
prevalence of 3.5% among U.S. adults. Survivors of rape, military combat, interment, and
genocide report the highest rates – from one-third to more than one-half (APA, 2013; Kessler,
Sonnega, Bromet, Hughes, & Nelson, 1995). The trauma response is especially severe or longlasting in the case of human-induced events, such as torture, rape, or terrorism (APA, 1987,
1994, 2000, 2013). Similarly, the propensity toward psychosocial impairment may increase with
the intensity and physical proximity of the event (APA, 1994, 2013). Osterman and de Jong
(2007) theorize PTSD is a psychobiological response, rising from humans’ protective fight or
flight response; however in PTSD the reactivity lasts beyond the interpreted danger. From a
classical conditioning perspective, the traumatic event acts as a conditioned event that produces
toxic levels of fear, guilt, and/or shame (McNally, 2003).
Several response features have been consistent since PTSD was officially recognized in
the DSM-III. These core features include re-experiencing (recurrent recollections or dreams),
numbing (diminished interest), avoidance of stimuli, and hypervigilance (see APA 1980, 1987,
1994, 2000, 2013). Other responses include intense fear, hopelessness, horror, recurrent dreams,
flashbacks, memory difficulties, sleep disturbances, anger, depression, detachment, substance
use, and other self-harming behaviors (APA, 1994, 2000, 2013; McNally, 2003). These

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symptoms result in clinically significant distress or impairment in social, occupational, academic,
or other important areas of functioning (APA, 1994, 2000, 2013).
DSM-5 diagnostic criteria for PTSD include direct exposure to or witnessing a traumatic
event (or learning about such experiences of a loved one), in addition to a minimum of six
symptoms from the four identified clusters (see Table 1). Diagnosis requires one (or more) reexperiencing symptoms, one (or both) avoidance symptoms, two (or more) negative alterations
in cognition and mood, and two (or more) increased arousal symptoms. Symptoms must persist
for over one month, and cause clinically significant impairment in functioning (APA, 2013).
Table 1
DSM-5 PTSD Clusters and Symptomology
Cluster

Re-experiencing

Avoidance

Negative alterations in
cognition and mood

Increased arousal

Symptom
Recurrent, involuntary, intrusive distressing recollections of the event
Recurrent dreams of the event
Acting or feeling as if the traumatic event were recurring
Psychological distress at exposure to events associated with the trauma
Physiologic reactivity by exposure to events associated with the event
Efforts to avoid thoughts or feelings associated with the trauma
Efforts to avoid external reminders that arouse recollections of the trauma
Inability to recall an important aspect of the trauma
Exaggerated negative beliefs about oneself, others, or the world
Persistent negative emotional state (fear, horror, anger, guilt, or shame)
Markedly diminished interest in significant activities
Feeling of detachment or estrangement from others
Persistent inability to experience positive emotions
Irritability behavior and angry outbursts
Reckless or self-destructive behavior
Hypervigilance
Exaggerated startle response
Problems with concentration
Sleep disturbances

Diagnostic Concerns and Limitations
Not all researchers have viewed the expanding range of qualifying events as a positive
outcome, but rather consider this conceptual “bracket creep” as a confounding factor (McHugh
& Triesman, 2007; McNally, 2003, 2009). While the initial PTSD framework was only invoked

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when people directly experienced a traumatic stressor, this expanded to include experiences of
witnessing, and later, being presented with information regarding, a stressor. Thus, conceptual
“bracket creep” equates the experience of being subjected to artillery bombardment with those
who learn of such events. McNally (2009) rejects this assumption, indicating it would be absurd
to equate first-hand lived experiences with those who obtain second-hand knowledge. Indeed,
McNally (2012) remarked the expanded conceptualization and increased coverage of violence
and war on television designates “nearly everyone in America” a trauma survivor (p. 597).
McNally (2012) recommended eliminating indirect exposure from being a qualifying traumatic
event, which appears to have been partially addressed in the removal of exposure via media in
the DSM-5 (APA, 2013).
A similar problem discussed by McNally (2003, 2012) is that of an adequate doseresponse model. The frequency of traumatic events does not always equate with trauma severity,
with some persons with extensive trauma history reporting less impairment than those with
relatively few experiences (McNally, 2003). Additionally, other studies have shown that
stressors which do not meet PTSD diagnostic criteria can produce more pronounced PTSD
symptoms than those included in the criteria (see Alessi et al., 2011; Gold, Marx, Soler-Baillo, &
Sloan, 2005; Long et al., 2008; Mol et al., 2005; Van Hooff, McFarlane, Baur, Abraham, &
Barnes, 2009). With a weakened causal relationship between the traumatic event and PTSD
symptomology, researchers must then turn to emphasize vulnerability factors (McNally, 2012).
Previous literature has attempted to identify risk factors for developing PTSD, however
these studies have been scarce (McNally, 2003). Several factors correlated with later
development of PTSD include decreased levels of social support (Keane, Scott, Chavoya,
Lamparski, & Fairbank, 1985), lower intelligence (McNally & Shin 1995; Vasterling, Brailey,

 38
Constans, Borges, & Sutker, 1997; Vasterling et al., 2002), neuroticism (Breslau, Davis,
Andreski, & Peterson, 1991; McFarlane, 1989), unstable family of origin (King, King, Foy, &
Gudanowski, 1996), mood or anxiety disorder (Breslau et al., 1991; Smith, North, McCool, &
Shea, 1990), and a family history of anxiety or mood disorder (Breslau et al., 1991; Davidson,
Swartz, Storck, Krishnan, & Hammett, 1985). A history of childhood physical and/or sexual
abuse has also been correlated with adult PTSD diagnosis (Bremner, Southwick, Johnson,
Yehuda, & Charney, 1993; Engel et al., 1993; Nishith, Mechanic, & Resick, 2000). Even when
accounting for childhood abuse victimization, sexual orientation minorities have demonstrated
an elevated risk for PTSD (Roberts et al., 2012), thus it is likely LGBTQQA persons experience
additional trauma beyond their heterosexual counterparts. As religious activity has been shown
to result in negative outcomes for LGBTQQA people (Schuck & Liddle, 2001), it is plausible
that spiritual trauma accounts for a portion of this elevated PTSD risk.
Spiritual Trauma
When trauma and religion are examined in social science research, it is often under the
assumption that religion is a tool of recovery from trauma rather than a potential source of
trauma (Smith, 2004; Stone, 2013; Ward, 2011). Although peer reviewed research has not yet
given significant attention to religion as a source of trauma, popular literature includes many
books on this subject (see Plante, 2004; Purcell, 2008; Winell, 1993; Wright, 2001). Thus, this
appears to be an area where rigorous scientific study lags behind more mainstream media.
Conceptual Definition
Scholarly publications focused on spiritual trauma grew out of research on the cult
phenomenon, which emphasized observational behavior with little insight into the psychological
impact of the affected (Ward, 2011). Spiritual trauma (also called spiritual abuse) as a distinct

 39
phenomenon slowly started gaining attention through the 1990s and 2000s (Purcell, 1998a),
resulting in a variety of conceptual definitions. Johnson and VanVoderen (1991) were among the
first to define spiritual abuse, describing it as mistreatment of a person in spiritual need by a
religious leader that results in weakening, undermining, or decreasing the person’s spiritual
empowerment. Ward (2011) similarly indicated spiritual abuse is a misuse of power and
distortion of authority in a spiritual context that results to the detriment of the individual.
Although Stone (2013) utilized a definition emphasizing the “pervasive psychological damage”
(p. 324) caused by spiritual trauma, this definition identifies the source of the trauma as religious
messages, beliefs, and experiences rather than religious leaders. Purcell (1998a, 1998b) defined
spiritual abuse as the fear an individual experiences when they are brought to believe, either
through overt statements or merely implication, that they will experience punishment and/or
eternal torment in hell if they fail to live according to the standards required for admission to
heaven. Like Stone’s (2013), this definition highlights religious messages or beliefs as the
potential source of spiritual abuse, but directly connects this to teachings of judgment and
punishment in the afterlife.
For the purposes of this study, spiritual trauma will be defined as intentional or
unintentional psychological or emotional harm resulting from religious messages, beliefs, and
experiences, thus combining components from both Purcell (1998a, 1998b) and Stone (2013).
Within LDS theology, messages and teachings from church leadership (such as apostles,
prophets, or other general authorities) can be viewed as equivalent to directives from God (see
Doctrine and Covenants 1:38). Additionally, LDS scripture encourages members to place greater
reliance on God and church teachings than one’s own understanding or instincts (see 2 Nephi

 40
4:34; Proverbs 3:5 KJV). Thus, an inherent authority can be ascribed to messages from LDS
religious leaders.
Unlike other trauma that occurs in relationship to distinct events or incidents, spiritual
trauma often involves long-term exposure – sometimes from birth – to messages and beliefs that
can impair mental health (Stone, 2013). The severity of the trauma and resulting impairment is
determined by intensity, age of onset, duration, and individual reaction (Purcell, 1998b).
Individuals who are born into a religious environment might find those teachings and beliefs
become influential as they develop views of themselves and the world. Additionally, unlike other
forms of trauma where the individual may have the ability to potentially escape or defend
themselves from the abuser, spiritual trauma includes concepts of God, “who has all knowledge
all power, and is present everywhere” (Purcell, 1998a, p. 167), thus the spiritually abused may
feel they have no escape. Purcell (1998a, 1998b) theorized spiritual trauma as a continuum from
“from terroristic to zero abuse” (Purcell, 1998b, p. 227), with the extreme being identified as
spiritual terrorism. Whereas spiritual trauma may result from unintentional messages, spiritual
terrorism is obvious, “like a flashing neon sign” (p. 227), and emphasizes “a strong dose of
eternal hell-fire and damnation” (p. 228). While the current study does not differentiate between
intentional and unintentional trauma, this presents opportunities for future research in this area.
Causes and themes of spiritual trauma. In addition to conceptualizing spiritual trauma
as being on a continuum from subtle abuse to spiritual terrorism, Purcell (1998b) identified three
causes of spiritual trauma: 1) legalism, 2) literalism, and 3) mixed messages. Legalism is
described as the belief that admission to heaven is reliant upon obedience to a system of “dos”
and “don’ts,” with the taboo list often being much more extensive. Literalism is identified as a
literal interpretation of the Bible (for the case of Mormonism, this would include The Book of

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Mormon, Doctrine and Covenants, and Pearl of Great Price as these are accepted canonical
scripture). Mixed messages involves the receipt of messages including God’s unconditional love,
yet God’s love is contingent on personal obedience, commitment, and submission.
In a qualitative study of individuals who had exited “Bible-based” groups, Ward (2011)
identified six core themes of spiritual trauma: 1) leadership representing God, 2) spiritual
bullying, 3) acceptance via performance (or obedience), 4) spiritual neglect, 5) expanding
external/internal tension, and 6) manifestation of internal states. Of these core themes, three have
particular relevance in conceptualizing spiritual trauma for the purposes of the current study.
Leadership representing God aligns with the designation of the church president and apostles as
“prophets, seers, and revelators” and as such are commissioned by God to be his mouthpiece
(Doctrine and Covenants 1:38; Holland, 2004). Therefore, as Ward (2011) states, “essentially to
obey them is to obey God; to disagree is to be in opposition to God” (p. 903). Spiritual bullying
includes fears of separation from family, which would connect to the higher prevalence of
homelessness for LGBT youth (Ray, 2006; Ryan & Rees, 2012). Expanding external/internal
tension relates to one’s suppression of individuality and emotional pain to conform to the
demands of the group milieu, resulting in tension between their inner and outer worlds. For
LGBTQQA Mormons, they might feel compelled to suppress or hide their sexual orientation or
gender identity for fear of church discipline, or loss of relationships.
Outcomes associated with spiritual trauma. Spiritual trauma is a “multi-faceted and
multi-layered experience that is both process and event, affecting the bio/psycho/social and
spiritual domains of an individual” (Ward, 2011, p. 899). Gubi and Jacobs (2009) indicated
spiritual abuse can be associated with character assassination, psychological abuse, and
emotional abuse (see also Chrnalogar, 2000; Howard, 1996; Parsons, 2000). Purcell (1998a)

 42
stated spiritual trauma can produce anger, anxiety, fear of God, guilt, low self-esteem, panic,
hopelessness, shame, and a feeling of never being good enough. Spiritual trauma can also lead
persons to disaffiliate from religious communities due to doctrinal inconsistencies,
mental/emotional exhaustion, and stifled self-expression (Lucas, 2003). If the abused leaves the
religion, they may experience a spiritual crisis where they may come to doubt previous spiritual
experiences, and their personal identity constructed through these experiences “can begin to
fracture and implode,” leading to a “pervasive sense of meaningless, self-doubt, confusion, and
disintegration” (Lucas, 2003, p. 24). Hill and Pargament (2003) stated religious conflicts can
challenge one’s self-worth, self-control, and self-efficacy. These conflicts can be particularly
upsetting as they challenge the most sacred aspects of life, and the mental and psychological
well-being of may never fully recover (Gubi & Jacobs, 2009).
When faced with unrealistic expectations of religion, followers of dogmatic religions can
develop unhealthy coping strategies, “including repression, denial, projective identification,
reaction formation, and splitting . . . driven by fear of the consequences of failure to comply with
legalistic religious standards” (Stone, 2013, p. 325). Stone (2013) noted that clients rarely seek
treatment for spiritual trauma directly. However, the related negative emotional, intellectual,
developmental, or interpersonal impacts from such trauma can be a component of the presenting
issues leading to therapy. Individuals who have experienced spiritual trauma may manifest
symptoms of PTSD, such as avoidance of religious stimuli, environments, people, and materials.
These people may avoid religion completely, and may engage in a therapeutic relationship for
years without disclosing their religious history and experiences. As such, Stone (2013) urged that
spiritual trauma “deserves careful attention” (p. 324) among mental health clinicians and
researchers.

 43
Spiritual Trauma in an LDS context
As noted earlier, the LDS Church views homosexual behaviors and relationships as sinful
(The Church of Jesus Christ of Latter-day Saints, 2010). Within The Book of Mormon, sexual
sins are identified as “abominable above all sins save it be the shedding of innocent blood or
denying the Holy Ghost” (Alma 39:3-5). Thus, within Mormon theology sexual sins are seen as
near equivalent with murder and apostasy. While church teachings have delineated between
homosexual attractions and homosexual behaviors since 1991, LGBT members who pursue
same-sex romantic relationships are presented with the belief that their relationship is spiritually
akin to murder. Mormon scriptures further teach that sin results in the separation from God’s
influence, resulting in “spiritual death” (Alma 12:16; Alma 40:26; Helaman 14:18). As such,
persons who have same-sex sexual relationships are seen as being involved in particularly
serious transgressions, and are at risk of eternal damnation and torment, introducing threats to
their spiritual well-being and integrity.
When members of the LDS Church confess homosexual relationships, they can face
disciplinary action (The Church of Jesus Christ of Latter-day Saints, 2010; Oaks, 1995). Since
November 2015, official LDS policy requires church disciplinary action for those who enter a
same-sex marriage (Walch, 2015). Disciplinary action can range from probation to disfellowship
or excommunication. Formal probation is considered a temporary discipline, where the person
may be asked to refrain from participating in ordinances, volunteering in church positions, or
participating in church meetings. Disfellowship is also a temporary discipline, generally lasting
at least one year. During this time the person is not permitted to pray publically, partake of the
sacrament, participate in ordinances, or give sermons in public settings. Excommunication is a
formal loss of church membership. While those who have been excommunicated are still allowed

 44
to attend public church services, they are placed under similar participation restrictions as those
who have been disfellowshipped. Should an excommunicated person desire to return to church
membership, rebaptism would be required (The Church of Jesus Christ of Latter-day Saints,
n.d.). With this model of church discipline, LGBTQAA Mormons risk loss of faith community
and social connections. Additionally, LDS doctrine teaches that family relationships can
continue eternally, if individuals are worthy – meaning obedient and faithful to church teachings
(Faust, 1997). Thus, persons in same-sex relationships further risk eternal exclusion and isolation
from family relationships.
Conceptual Framework and Hypotheses

Figure 1. Proposed conceptual framework of religious orientation on PTSD through a moderated
mediation by orthodoxy and spiritual trauma.

 45
As seen in Figure 1, it is hypothesized that the various religious orientations will have a
direct effect on spiritual trauma, with orthodoxy moderating this effect. Religious orientation will
thus have an indirect effect on PTSD, through a mediated moderation of orthodoxy and spiritual
trauma. Whereas religious orientation, sexuality, and trauma are multi-faceted concepts, the
research questions and hypotheses for the current study are:
1. Does orthodoxy moderate the relationship, if any, between religious orientation and
spiritual trauma?
a. It is hypothesized that intrinsic orientation will be negatively correlated with
spiritual trauma.
b. It is hypothesized that social- and personal-extrinsic orientations will be
positively correlated with spiritual trauma.
c. It is hypothesized that quest orientation will be negatively correlated with
spiritual trauma.
d. It is hypothesized that orthodoxy will be positively correlated with spiritual
trauma.
2. Does spiritual trauma correlate positively with PTSD?
3. Does religious orientation have an indirect impact on PTSD through a moderated
mediation with orthodoxy and spiritual trauma?
a. It is hypothesized that no religious orientations will have a direct effect on
PTSD.
Summary
This chapter reviewed the existing literature for the variables included in this study.
Allport’s (1963) taxonomy of religious orientation was reviewed, as well as Batson’s (1976)

 46
addition of quest orientation. Based on the previous work of Allport & Ross (1967), Kirkpatrick
(1989), and Batson (1976), the four religious orientations reflected in the conceptual framework
(intrinsic, social-extrinsic, personal-extrinsic, and quest orientation) served as the antecedent
variables in the current study. Literature on orthodoxy was also presented, with this variable
being used as the study’s moderating variable. The existing literature on spiritual trauma and
PTSD were reviewed. In the current study, respondent’s perception of spiritual trauma from their
LDS experiences are conceptualized as the mediating connection between religious orientation
and PTSD.

 47

CHAPTER 3
METHODOLOGY
This chapter details the methodology of this study, including the 1) research design, 2)
sample and data collection, 3) measures and instruments, and 4) data analysis.
Research Design
This study employed cross-sectional online survey design with convenience sampling to
examine the impact of religious orientation on spiritual trauma and PTSD among LGBTQQA
Mormons and ex-Mormons. As the primary focus of the current study was the impact of
religious orientation on spiritual trauma, the relationships for consideration are: 1) Does
orthodoxy moderate the relationship, if any, between religious orientation and spiritual trauma?
2) Does spiritual trauma correlate positively with PTSD? And, 3) Does religious orientation have
an indirect impact on PTSD through a moderated mediation with orthodoxy and spiritual
trauma?
Data analysis was conducted via conditional process analysis (Hayes, 2013). Conditional
process analysis utilizes ordinary least squares (OLS) regression analyses to quantify and
examine relational pathways between an independent (or antecedent) variable and a dependent
(or consequent) variable. Inclusion of a mediating variable allows consideration of direct and
indirect pathways, while inclusion of a moderating variable examines the interaction effect of the
antecedent variable at varying levels of the moderating variable. Conditional process analysis
allows researchers to combine both mediation and moderation analyses to examine “the
conditional nature (the moderating component) of the indirect and/or indirect effects (the

 48
mediation component) of X on a Y in a causal system” (Hayes, 2013, p. 10). In terms of the
present study, conditional process analysis allowed for examination and interpretation of the
conditional nature of orthodoxy on religious orientation in concurrence with the direct and
indirect effects of religious orientation on PTSD via spiritual trauma.
The resulting conditional process model looks similar to a path diagram used in structural
equation modeling (SEM). While conditional process analysis shares conceptual similarities with
SEM, there are some differences worth noting. First, SEM performs parameter estimations for
the entire system simultaneously through iteration (Kline, 2011; Pek & Hoyle, 2016) while
conditional process analysis estimates OLS regression equations separately, meaning the
estimations of one equation have no impact on other equations (Hayes, Montoya, & Rockwood,
2017). While these different estimation methods can produce varying results, Hayes et al. (2017)
have shown these differences to be minor, and indicated that they do not alter overall statistical
significance even in studies with small sample sizes. Second, SEM allows for estimation of
random measurement error through use of multiple indicators for latent variables (Kline, 2011).
Conditional process analysis requires observed variables (including sum scores or averages of
indicators) and thus cannot address latent variable measurement error (Hayes et al., 2017).
Finally, SEM programs rely on large asymptotic theory and thus is generally regarded as a large
sample technique (Hayes et al., 2017).
Sample and Data Collection
Participants were required to be 1) a current or former member of The Church of Jesus
Christ of Latter-day Saints, 2) at least 18 years old, and 3) identify as lesbian, gay, bisexual,
transgender, queer, questioning, asexual, or same-sex (same-gender) attracted. Because no
complete census of LGBTQQA Mormons and non-Mormons exists (Phillips, 2005) to support

 49
probability-based sampling, the current study utilized a convenience sample of LGBTQQA
Mormons and ex-Mormons through a variety of sources.
Similar to the method utilized by Dehlin, Galliher, Bradshaw, Hyde, and Crowell (2014),
the researcher posted recruitment messages and survey links in 12 LDS-affiliated LGBTQQA
support and discussion groups on Facebook. Recruitment messages were posted by the
researcher to these groups three times from October 6, 2016 to January 31, 2017. Additionally,
the researcher contacted known members or administrators of seven additional LDS-affiliated
LGBTQQA support and discussion groups on Facebook; however, the researcher was unable to
confirm the distribution of recruitment messages for these groups. Efforts were made to include
groups both supportive of the LDS Church as well as those for former members. The researcher
also shared recruitment messages on his personal social media profiles (Facebook and Twitter,
see Appendix A), and encouraged those within his personal networks to re-share the messages.
Prior to the study, the researcher had existing connections to the Mormon LGBTQQA
community through his personal experiences as a queer person raised within Mormonism. In
order to avoid presenting undue personal biases during recruitment, the researcher either
removed or restricted personal information on social media sites, removed prior posts regarding
sexuality from a Mormon framework, and avoided online discourse in LDS-affiliated
LGBTQQA support and discussion groups. Additionally, to not oversaturate the sample with the
former member perspective, the researcher avoided posting recruitment messages in forums that
did not have a substantive focus on the intersection of Mormonism and LGBTQQA identities, or
in forums that were exclusively focused on the ex-Mormon experience, such as reddit’s exMormon subreddit.

 50
In addition to online social media recruitment, the researcher sent recruitment
information to non-religiously affiliated LGBTQQA organizations in areas of substantial
Mormon populations, including Equality Utah, Utah Pride Center, University of Utah LGBT
Resource Center, Weber State University LGBT Resource Center, Salt Lake Community College
LGBTQ+ Resource Center, Dixie State University Gay Straight Alliance, and Utah Valley
University Gay Straight Alliance (see Appendix B). While the researcher was unable to
guarantee the dissemination of the invitation through these agencies, attempts were made to
utilize a variety of recruitment sources to result in a diverse sample, including active and exMormons, as well publically self-identified (“out”) people, and those who do not publically
identify as LGBTQQA.
Data were collected through an online survey via Qualtrics Research Suite (2016).
Surveys were self-administered through an anonymous link. Survey completion was anticipated
to take 30-45 minutes. Participation was voluntary, and respondents could chose to terminate the
survey at any point without penalty. Additionally, respondents were allowed to skip any question
should they feel uncomfortable answering. Prior to data collection, the study was approved by
the Institutional Review Board at the University of Georgia. An informed consent statement
describing the study, participants’ rights, and potential risks was included on the first page of the
survey. Participants were asked to provide their year of birth to both indicate they were 18 years
of age or older and consented to participate.
Measures and Instruments
Preference was given to existing measures where available, primarily to operationalize
religious orientation and PTSD consistently with other studies. Additional questions examining
relevant demographics, experiences of coming out, and LDS Church involvement were built on

 51
prior research with this population group (Alper, Feit, & Sanders, 2013; Dehlin et al., 2014; The
Fenway Institute, 2013; The Williams Institute, 2009). The following measures were included in
the survey instrument (see Appendix C for the full survey instrument).
Measures
Religious Orientation.
The Intrinsic/Extrinsic – Revised scale (I/E–R; Gorsuch & McPherson, 1989) consists of
14 items assessed on a five-point bidirectional Likert scale covering three subscales (intrinsic,
personal-extrinsic, and social-extrinsic) (see items 39-56 in Appendix C). Items are scored from
“strongly disagree” (1) to “strongly agree” (5), with “am not sure” as the midpoint (3). This scale
is based on Allport and Ross’s (1967), and Kirkpatrick’s (1989) concepts of intrinsic and
extrinsic religion, and includes Gorsuch and Venable’s (1983) revision to accommodate lower
educational levels. Individuals with an intrinsic orientation internalize their religious beliefs and
prescriptions (Markstrom-Adams & Smith, 1996) wherein the person “lives his religion” (Allport
& Ross, 1967, p. 434, emphasis in original). Those with extrinsic religious orientations are
“disposed to use religion for their own ends” (Allport & Ross, 1967, p. 434), with those with the
personal-extrinsic orientation seeking personal relief, protection, and comfort from religion and
those with the social-extrinsic orientation seeking social rewards (Kirkpatrick, 1989). Since its
inception in 1967, Allport and Ross’s Religious Orientation Scale has been widely used in the
psychological study of religiosity (Batson, Schoenrade, & Ventis, 1993; Gorsuch & McPherson,
1989; Kirkpatrick & Hood, 1990; Leak, 2009). Internal consistency reliability ranges from .57 to
.83 (Kirkpatrick & Hood, 1990).
While scores from the I/E-R have been used to categorize respondents into discrete
religious orientation(s) through the use of sample median cutoff points (Donahue, 1985; Hood,

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1970), this has not been without criticism. As sample median cutoff points undoubtedly vary
from sample to sample, resulting inconsistencies in final classifications limit comparability and
replicability of findings. To address these inconsistencies, Donahue (1985) encouraged
implementation of a consistent score cutoff points be used by all researchers. However, when
testing theoretical median criteria with students at LDS-owned Brigham Young University,
Donahue found 90% of the sample were identified as intrinsic. This uneven distribution of
religious orientations resulted in the inability to examine interactions due to empty nonreligious
cells (Donahue, 1985, p. 410). Conversely, Batson and Ventis (1982) recommended treating the
different religious orientations as dimensions, and not mutually-exclusive types. As such,
respondents get individual dimension scores. Given the current sample’s potential homogeneity
(similar to Donahue’s sample at Brigham Young University), the current study will follow
Batson and Ventis’ (1982) recommendations to examine the religious orientations as nonexclusive dimensions.
Quest Scale (Batson & Schoenrade, 1991b) is a 12-item measure designed to identify the
extent to which a person’s religious orientation is an ongoing dialogue with existential questions
raised by the contradictions of life (see items 67-81 in Appendix C). This measure contains three
factors, “readiness to doubt,” “doubt as positive,” and openness to change.” All items are scored
on a 10-point bidirectional Likert scale from “strongly disagree” (0) to “strongly agree” (9). This
measure has a satisfactory internal consistency reliability of .75 (Batson & Schoenrade, 1991b).
Orthodoxy.
Dimensions of Religiosity Scale (DOR; Cornwall, Albrecht, Cunningham, & Pitcher,
1986) was developed by researchers at the University of Utah, LDS Church-owned Brigham
Young University (BYU), and the LDS Church Correlation Department, and thus incorporates

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questions specific to the Mormon faith. The DOR consists of 31 items assessed with Likert-type
questions scored on either a five-point unidirectional scale (from “not at all” to “exactly”) or a
five-point bidirectional scale (from “strongly disagree” to “strongly agree”), and frequency
questions scored on a seven-point scale (from “never” to “daily”). Cross-classification provided
six initial dimensions, with a seventh dimension (home religious observance) identified through
psychometric analysis (Cornwall et al., 1986). The split-half reliability correlation coefficient for
this instrument has been calculated at .95 (Kirkpatrick & Hood, 1990). For the current study,
particularistic orthodoxy and church commitment dimensions were included as Mormon-specific
components of religious orthodoxy (see items 57-61 and 82-87 in Appendix C).
Fundamentalism Scale consists of six items adapted from McFarland (1989). While
McFarland (1989) identified this as a fundamentalism scale, the questions contained fit the
current study’s conceptualization of orthodoxy. These items stress the perfection of scriptural
authority, the necessity of following God’s word, and the importance of avoiding worldly ideas.
All items were scored on the same five-point bidirectional Likert scale as the I/E-R instrument.
Wording of these questions was slightly altered by the researcher to incorporate particular
features of Mormonism, including The Book of Mormon and living prophets. Several items from
the Fundamentalism Scale duplicated items from the DOR home religious observance subscale;
in these instances the DOR scale items were retained as they were initially written for a Mormon
population (see items 62-66 in Appendix C).
Trauma.
Secondary Traumatic Stress Scale (STSS; Bride, Robinson, Yegidis, & Figley, 2004) is
a 17-item self-report measure to assess intrusion, avoidance, and arousal symptoms related to
PTSD. Items are scored on a five-point Likert scale indicating how frequently the symptom was

 54
experienced in the recent seven days. While the STSS was developed to assess symptoms
associated with secondary traumatic stress, the researcher determined this would be an
appropriate instrument in the current study. Items on the STSS each correlate with DSM-IV-TR
(APA, 2000) PTSD symptomology, and are clearly worded without complicated jargon. As
secondary traumatic stress is related to the knowledge of trauma experienced by a significant
other, it was determined this item would likely have sufficient sensitivity to measure the impact
of unintentional as well as intentional traumatic experiences. For use in the current study, the
researcher modified the language of the STSS items replacing references to work with clients for
references to one’s religious experiences (see items 197-217 in Appendix C). Internal
consistency reliability for the STSS is very good, ranging from .80 to .93 (Bride et al., 2004)
Spiritual Trauma. Unlike the other primary concepts, there was no existing measure for
spiritual trauma at the time instrument design and suffers from conceptual clarity. However, the
newness of this concept presents “a fertile area” for research (Purcell, 1998b, p. 229). For the
current study, the researcher developed items to quantitatively measure this concept. Whereas
previous research on spiritual trauma has emphasized both the mistreatment by religious leaders
(Johnson & VanVoderen, 1991; Ward, 2011) as well as punitive messages, beliefs, and
experiences (Purcell, 1998a, 1998b; Stone, 2013), consistent with the conceptual definition noted
earlier, questions were developed to measure both potentially abusive experiences from
ecclesiastical leadership, and potentially abusive religious teachings or beliefs. Twelve items
were developed to measure ecclesiastical spiritual trauma, such as being counseled not to speak
to others about one’s sexual or gender identity, being encouraged to seek professional treatment
to change one’s sexual or gender identity, and threatening one’s church membership because of
one’s gender or sexual identity (see items 157-171 in Appendix C). Additionally, 20 items were

 55
developed to measure punitive or traumatic teachings and beliefs, such as labeling
homosexuality as a sin, requiring heterosexual marriage for exaltation, and being punished by
God for one’s sexual attractions (see items 172-196 in Appendix C). These items were reviewed
by several self-identified LGBTQQA Mormons or ex-Mormons prior to survey data collection.
All spiritual trauma items were rated on a 5-point bidirectional Likert scale from “extremely
beneficial” (1) to “extremely damaging” (5), with “neither damaging or beneficial” as the
midpoint (3). Additionally, respondents were provided an option for “not applicable” in the event
they never experienced the teaching, belief, or ecclesiastical response. Respondents were
provided the possibility to rate items as beneficial in an attempt to accurately measure the
response LGBTQQA Mormons and ex-Mormons have to the various experiences, and to ensure
the survey instrument was not perceived as overly biased.
Survey Flow
Given the sensitivity of the subject, it was important for the survey flow to progress in
such a way that earlier questions built rapport, and logically led into the next section.
Additionally, to avoid respondent fatigue it was important to not reserve mentally taxing
questions for the final sections (Ben-Nun, 2008). Thus, the survey flow progressed from
relatively benign concepts (age of LDS baptism, prior and current LDS involvement) to more
emotionally intimate concepts (religious orientation, spiritual trauma, PTSD) before deescalating with potentially positive (religious-based coping) or neutral concepts (demographic
information). Within survey concepts, items that shared a common response set were randomized
to avoid unintended question order effects. In most cases, response sets were unique for each
survey instrument; however, I/E-R, DOR particularistic orthodoxy, and fundamentalism items
shared a common response set and collectively represented similar concepts. Therefore, items

 56
within I/E-R, DOR particularistic orthodoxy, and fundamentalism were allowed to randomize
across instruments (see items 40-66 in Appendix C). By allowing this multi-instrument
randomization, the current study not only protected against artificial item dependency within
instruments, but also ensured participants’ responses to intrinsic, social-, personal-extrinsic,
particularistic orthodoxy, and fundamentalism did not have artificial dependency with each other
due to contrast or assimilation effects (Dillman, Smyth, & Christian, 2014). The final survey
question page included an open text box inviting participants to share any additional experiences
they had regarding being LGBTQQA and Mormon, as well as an opportunity to provide contact
information should they want to be included in future studies on this topic. To protect
anonymity, respondents’ contact information was collected through redirection to a separate
survey and thus contained in a separate database from survey responses.
While the current study was cross-sectional in design, the conceptual framework placed
religious orientation as an antecedent variable predicting later perceptions of spiritual trauma and
PTSD symptomology. Thus, respondents were asked to identify the period of their life where
they felt the greatest concern about being LGBTQQA and Mormon, including their “fit” with
church doctrines, acceptance from other church members, standing with God, or future as a LDS
church member. Respondents were then asked to answer items regarding religious orientation,
and orthodoxy during this identified period of greatest concern. Sections regarding spiritual
trauma and PTSD were framed as lifetime experiences, thus spiritual trauma and PTSD can be
conceptualized as consequent, or dependent, variables. While this method introduced possible
biases due to memory and later life experiences, it was important to understand the religious
orientation the respondent held at the time of greatest conflict.

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Data Analysis
Since the survey instrument was comprised nearly entirely of close-ended questions,
analysis was principally quantitative in nature. Descriptive statistics were computed using IBM
SPSS Statistics version 24.0 (2016). Conditional process analysis was completed with PROCESS
macro for SPSS version 2.16 (hereto referred to as PROCESS) (Hayes, 2013). Whereas previous
research using Allport and Ross’ (1967) taxonomy of religious orientation among LDS students
found 90% of respondents scored highly on intrinsic faith (Donahue, 1985, p. 410), the current
study examined religious orientation as four distinct items, and not mutually-exclusive types (as
recommended by Batson and Ventis (1982)). Thus, conditional process analysis was repeated
four times, once for each religious orientation per analysis with the other three orientations
controlled for as additional covariates (Hayes, 2013).
Univariate descriptive statistics including means and standard deviations of the
distributions were run for each of the observed variables included in the study analysis. Measure
scores were relatively normal, with slight skewing in social-extrinsic religious orientation,
orthodoxy, and spiritual trauma. However, Hayes (2013) indicated the assumption of normality
is one of the least important in linear regression analysis. Residuals plots did not show any
violations of homoscedasticity for any antecedent variables when regressed on spiritual trauma
or PTSD. Thus, the data showed no substantive violations of the assumptions required for OLS
and conditional process analyses.
PROCESS provides estimation of unstandardized model coefficients, standard errors, t
and p-values, and confidence intervals using OLS or maximum likelihood logistic regression (for
dichotomous outcomes) (Hayes, 2013, p. 419). PROCESS also provides estimations for both
direct and indirect mediation for mediation models, as well as conditional effects in moderation

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models. Confidence intervals for statistical inference of indirect effects can be produced using a
normal theory approach (i.e., the Sobel test), bootstrap confidence intervals, and Monte Carlo
confidence intervals (Hayes, 2013, p. 430).
While PROCESS can be used with a combination of multiple mediators and moderators,
PROCESS does not allow for more than one antecedent variable (referred to as x-var) at one
time (Hayes, 2013, p. 426). Thus, when proposed models involve multiple antecedent variables,
conditional process analyses are conducted repeatedly for the individual antecedent variables
with the remaining antecedent variables controlled as covariates (Hayes, 2013, p. 428). With
each iteration for the current study, orthodoxy was w-var, spiritual trauma was m-var, and PTSD
was y-var. Indirect effects were examined through 95% bias-corrected bootstrap confidence
intervals with 10,000 samples. Additionally, bootstrap samples were seeded with a randomly
selected number (seed=164709440) so the sets of random samples could be replicated with each
analysis. As of version 2.16, PROCESS is capable of analyzing 74 different models; the current
study used Model 7 (Figure 2).

 59
Conceptual Diagram

Statistical Diagram

Conditional indirect effect of X on Y through
𝑀𝑀𝑖𝑖 = (𝑎𝑎1𝑖𝑖 + 𝑎𝑎3𝑖𝑖 𝑊𝑊)𝑏𝑏𝑖𝑖 .
Direct effect of X on Y=c′.
Figure 2. PROCESS version 2.16 Model 7 conceptual and statistical diagrams. Note: Model 7
allows up to ten mediators operating in parallel.
Summary
This chapter outlined study methodology, including the research design, data collection,
instrumentation, and data analysis. The study utilized a cross-sectional online survey design with
convenience sampling. Recruitment was primarily through LDS-affiliated LGBTQQA support
and discussion groups on Facebook, with supplemental recruitment through non-religiously
affiliated LGBTQQA organizations in areas of substantial Mormon populations via email.
Surveys were open to adults identifying as LGBTQQA (or same-sex attracted) who are or have
been members of the LDS Church. The survey instrument was primarily comprised of existing
measures to examine religious orientation, orthodoxy, and PTSD, while the researcher developed
items to measure spiritual trauma. Data analysis was computed using IBM SPSS Statistics
version 24.0 and PROCESS macro for SPSS version 2.16.

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CHAPTER 4
FINDINGS
Data were collected over 17 weeks from October 2016 to January 2017. A total of 407
surveys were initiated. Four respondents opted-out of participation at the consent page. An
additional 18 were identified as duplicate responses through an examination of recorded IP
address and demographic information (year of birth and sex) and removed from analysis. Of the
385 valid responses retained, 278 (72.2%) progressed through all relevant study measures. Prior
research on online survey drop-out rates for gay and bisexual men found 33% of respondents
dropped-out from a 158-item online survey (Evans, Wiggins, Bolding, & Elford, 2008). Thus,
the current study’s drop-out rate of 27.8% is appropriate for a 263-item survey with an
LGBTQQA population.
Missing data is often a concern for social science researchers (Raghunathan, 2004; Rubin,
1976). Within cross-sectional survey data item nonresponse occurs when a participant fails to
answer a survey item, resulting in missing data (Raghunathan, 2004). In the current study, item
nonresponse ranged from 0.4% to 1.1% for items measuring intrinsic orientation, personalextrinsic orientation, social-extrinsic orientation, orthodoxy, and PTSD. Item nonresponse was
slightly higher for quest orientation items, ranging from 2.5% to 13.3%. Spiritual trauma items
showed a great deal of missing data, with item nonresponse ranging from 6.5% to 71.9%. A
visual examination of the data identified nonresponse on items for religious orientation,
orthodoxy, and PTSD were due to the respondent seeing the item, but not providing a response.
For all spiritual trauma items, missing data was due to respondents selecting “not applicable” in

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all but one to three cases. The inclusion of “not applicable” allowed the respondent to report the
absence of the event or belief in question; however, this response cannot be mapped on the
item’s bidirectional Likert scale and was thus coded as missing data. The selection of “not
applicable” would indicate data were missing not at random (MNAR) (Rubin, 1976), and cannot
be corrected by statistical techniques like multiple imputation and maximum likelihood
estimation (Allison, 2000; Raghunathan, 2004).
Only 18 respondents provided a valid response to all 32 spiritual trauma items, thus use
of listwise deletion in scale scoring would have eliminated at least 93.5% of respondents from
conditional process analyses. Additionally, 21.2% (n=59) of survey respondents provided valid
responses on less than half of the measure items. Thus, scale scoring without accounting for “not
applicable” responses would likely result in skewed estimates. In order to avoid skewed scoring,
it was determined to eliminate spiritual trauma items with high incidence of “not applicable”
from the scale summation. Over 50% of respondents selected “not applicable” on seven spiritual
trauma items, including three items specific to the transgender experience. Additionally, only
15.5% (n=43) of respondents identified as non-cisgender, indicating other items specific to
transgender experiences or teachings were potentially incongruent to the respondent group. Thus,
of the original 32 items developed, 11 spiritual trauma items were excluded from scale
summation. To further account for missing data and “not applicable” responses, all score
summations were calculated for only cases with a minimum of 50% valid responses on the
measure. Thus, the current study incorporated partial listwise, and partial pairwise deletion in
calculating scale scores to be used in conditional process analysis. Table 2 outlines the study
measures by concept, number of items, and number of valid responses required to calculate a
total score.

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Table 2
Study Measures by Concept, Number of Items, and Number of Required Valid Responses for
Scale Summation
Measure(s)
Intrinsic/Extrinsic – Revised
Quest Scale
DOR
Fundamentalism Scale (Adapted)
Researcher-developed
STSS (Adapted)

Concept
Intrinsic
Social-Extrinsic
Personal-Extrinsic
Quest

# Items
8
3
3
12

# Required
4
2
2
6

Orthodoxy

13

7

Spiritual Trauma
PTSD

21
17

11
9

Descriptive Analyses
Sample Demographics
Respondents were between 18 to 71 years of age, with an average age of 33.2 years.
Respondents were predominantly White (88.5%, n=246); while 5.8% (n=16) of respondents
identified as Multiracial, all of these included White in addition to another racial group. Only
2.5% (n=7) identified solely as Black, Asian, or some other race. Race was unknown for 3.2%
(n=9) of respondents. Few respondents (4.0%, n=11) reported being of Hispanic, Latino, or
Spanish origin. Nearly all respondents were located in the United States (94.2%, n=262), with
half of those living in Utah (51.5%, n=134). An additional 22.9% (n=60) reported living in other
states with large Mormon populations (Arizona, California, Idaho).
Respondents most commonly identified as male (45.0%, n=125) or female (39.2%,
n=109), with only 15.5% (n=43) identifying as transgender, genderqueer, agender, or other
genders. Assigned sex at birth was equally distributed between male (49.3%, n=137) and female
(48.9%, n=136). In regards to sexual orientation, just over half of respondents identified as
lesbian or gay (53.2%, n=148), while approximately one-quarter (23.7%, n=66) identified as
bisexual. An additional 9.7% (n=27) identified as same-sex attracted and 10.4% (n=29)

 63
identified as another sexuality, including queer, trisexual, omnisexual, pansexual, and asexual.
Very few respondents (1.4%, n=4) identified as straight (non-cisgender), and sexual orientation
was unknown or unreported for 1.4% (n=4) of respondents.
Just over half of respondents (51.1%, n=142) were mostly or totally open about their
sexual orientation, while just over one-quarter (28.1%, n=78) have never disclosed or only
disclosed their sexual orientation to a few trusted people. Non-cisgender respondents seemed to
be less open about their gender identity, with 43.2% (n=19) having never disclosed or only
disclosed their gender identity to a few trusted people. On average, respondents were 11.2 years
old when they first began to sense a difference between themselves and others regarding their
sexuality, and 15.3 years old when they first realized they had same-sex sexual or romantic
attractions. For those who reported same-sex sexual experiences (78.4%, n=218), the average
age of first same-sex sexual experience was 20.7 years old. On average, self-identifying as gay,
lesbian, bisexual, queer, or same-sex attracted occurred at approximately the same age as first
disclosing this to others (23.4 and 23.0 years old, respectively). The average age non-cisgender
respondents first sensed a difference relating to their gender identity was 9.1 years old; however,
average age of self-identification and first disclosure to others was in early adulthood (24.6 and
24.5 years old, respectively).
LDS Church Engagement
The majority of respondents (85.6%, n=238) reported they were born into an LDS
family. Age of baptism (for those not born into LDS families) ranged from eight to 41, with an
average of 17.9 years old. Approximately half of respondents (51.8%, n=144) indicated they still
attend LDS Church services at least monthly. Most respondents (65.5%, n=182) indicated they
were currently a member of the LDS Church in good standing (not under current church

 64
discipline), while 14.7% (n=41) indicated they had resigned from the church, and 1.8% (n=5)
had been excommunicated. Few respondents indicated they were members under church
discipline (including probation (4.0%, n=11) or disfellowship (1.4%, n=4)). An additional
11.2% (n=31) reported “other” involvement with the church, with many of these indicating they
no longer attended or affiliated with the church but have not officially resigned or been
excommunicated. The inclusion of respondents who both still attend and identify as Mormon, as
well as those who no longer engage with the LDS Church addresses criticisms of prior studies
that do not include or apply to both religious and nonreligious LGBTQQA persons (Sowe et al.,
2017).
Respondents were asked several questions regarding their past and current involvement
with the LDS Church. For those born as male, 96.4% (n=132) were ordained to the Aaronic
Priesthood (which customarily occurs at age 12) and 88.3% (n=121) were ordained to the
Melchizedek Priesthood (which customarily occurs at or after age 18). Women are not ordained
to either priesthood in the LDS Church. Over half of respondents (69.4%, n=193) reported they
had engaged in temple ordinances, which are seen as the penultimate rites in the church. Almost
half (48.2%, n=134) of all respondents had previously been a full-time missionary; however, this
was much higher for those born as male (75.9%, n=104) as is customary in the LDS Church.
Nearly one-third (32.0%, n=89) of respondents had been married to (or “sealed” to) a spouse
through an LDS temple ordinance. Since only 1.4% (n=4) of respondents identified as straight,
these marriages would likely have been mixed-orientation marriages endorsed by the LDS
Church. Most respondents (71.2%, n=198) reported being involved in youth leadership positions
during adolescence, while less than half (42.8%, n=119) reported similar leadership positions as
an adult.

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Regarding current LDS Church involvement, 33.1% (n=92) reported they had a current
temple recommend, which would allow them to participate in temple ordinances. In order to hold
a current temple recommend, a person must attest to their ecclesiastical leaders that they
maintain faith in the LDS Church, and live according to the standards (including no sexual
activity outside of heterosexual marriage and abstaining from coffee, tea, alcohol, tobacco, and
illicit drugs). Only 6.1% (n=17) reported currently being involved in an adult leadership
position, while 41.4% (n=115) reported they had no official responsibilities in their
congregation. Whereas the LDS Church does not have any paid clergy in the local congregations,
members are generally expected to have a specific responsibility (or “calling”) in the
congregation either through teaching various Sunday School classes or overseeing various
auxiliary programs (like programs for children, youth, and adults). Overall, data indicate
participants were highly involved in the LDS Church previously, predominantly during
adolescence and into early adulthood.
Period of Greatest Concern
Respondents were asked to identify approximately how old they were when they felt the
most concern about being LGBTQQA and Mormon. Respondents were between 10 to 60 years
old during this period of greatest concern, with an average of 23.9 years old. Thus, the average
age at time of greatest concern over one’s LGBTQQA identity and Mormonism seems to align
with the average age of self-identifying as non-straight, and average age of first disclosure to
others. Using the respondents’ provided year of birth and age of greatest concern, the
corresponding decade was calculated. Just over half of the respondents (58.3%, n=162) were
experiencing this period of concern after 2010 and approximately one-quarter (23.4%, n=65)
experienced this concern between 2000 and 2009. While this is primarily a function of the age of

 66
the respondent group, it is noteworthy that the LDS Church was actively involved in opposing
legalized same-sex marriage in several states during this period (most prominently in California
in 2008). Overall, less than 20% of respondents reported experiencing their greatest concern
regarding their LGBTQQA identity and Mormonism during the 1990s (7.6%, n=21), 1980s
(6.2%, n=17), 1970s (3.2%, n=9), and 1960s (0.7%, n=2).
During this period of greatest concern, approximately one-third (35.3%, n=98) of
respondents were not “out” to anyone. Respondents were most likely to have disclosed their
LGBTQQA identity to friends (46.0%, n=128), followed by parents (30.6%, n=85), LDS
Church leaders (29.1%, n=81), and siblings (27.7%, n=77). Respondents were less commonly
“out” to coworkers or classmates (13.3%, n=37), others in their LDS congregation (7.6%, n=21),
or someone else (15.1%, n=42).
Variable Characteristics
This study explored four antecedent variables, one mediator, one moderator, and one
consequent variable. The next section summarizes the descriptive statistics of each variable
involved in the conditional process analysis.
Antecedent Variables.
Intrinsic orientation. Intrinsic orientation is one of three religious orientations measured
by the I/E-R (Gorsuch & McPherson, 1989). Intrinsic orientation has been conceptualized as the
internalizing of one’s religious beliefs and prescriptions (Markstrom-Adams & Smith, 1996)
wherein the person “lives his religion” (Allport & Ross, 1967, p. 434, emphasis in original). The
intrinsic orientation subscale is comprised of eight items, all scored from “strongly disagree” (1)
to “strongly agree” (5), with “am not sure” as the midpoint (3), thus higher scores relate to higher
intrinsic orientation. Three items were reverse-coded prior to scale summation. For the current

 67
study, intrinsic orientation scores ranged from 13 to 40, with a mean of 28.9 (SD=6.01, n=276).
The intrinsic orientation subscale was found to have a Cronbach’s alpha of .77 (n=276) with the
current study sample. Table 3 shows the response distribution for the eight intrinsic orientation
variables.
Table 3
Intrinsic Orientation Item Responses
Item
I enjoyed reading about my religion.
It didn't much matter what I believed so long as I
was good.*
It was important to me to spend time in private
thought and prayer.
I often had a strong sense of God's presence.
I tried hard to live all my life according to my
religious beliefs.
Although I was religious, I didn't let it affect my
daily life.*
My whole approach to life was based on my
religion.
Although I believed in my religion, many other
things were more important in life.*
*Item was reverse coded for scale summation

I strongly I tend to I am not I tend to I strongly
N
disagree disagree
sure
agree
agree
(Missing)
(%)
(%)
(%)
(%)
(%)
276
15
58
32
93
78
(2)
5.4%
21.0% 11.6% 33.7%
28.3%
276
38
90
49
71
28
(2)
13.8%
32.6% 17.8% 25.7%
10.1%
276
19
31
24
114
88
(2)
6.9%
11.2%
8.7%
41.3%
31.9%
276
25
56
44
77
74
(2)
9.1%
20.3% 15.9% 27.9%
26.8%
276
12
21
8
81
154
(2)
4.3%
7.6%
2.9%
29.3%
55.8%
276
107
103
23
36
7
(2)
38.8%
37.3%
8.3%
13.0%
2.5%
277
12
43
27
89
106
(1)
4.3%
15.5%
9.7%
32.1%
38.3%
276
30
79
43
79
45
(2)
10.9%
28.6% 15.6% 28.6%
16.3%

Social-extrinsic orientation. Social-extrinsic orientation is also measured by the I/E-R
(Gorsuch & McPherson, 1989). Social-extrinsic orientation is conceptualized as being “disposed
to use religion for their own ends” (Allport & Ross, 1967, p. 434), primarily seeking social
rewards (Kirkpatrick, 1989). The social-extrinsic orientation is measured by three items, all
scored from “strongly disagree” (1) to “strongly agree” (5), with “am not sure” as the midpoint
(3), thus higher scores relate to higher social-extrinsic orientation. In the current study, scores
ranged from three to 15, with a mean of 7.6 (SD=3.14, n=276). The social-extrinsic subscale

 68
produced a Cronbach’s alpha of .80 (n=276). Table 4 shows the response distribution for the
three social-extrinsic orientation variables.
Table 4
Social-Extrinsic Orientation Item Responses
Item
I went to church because it helped me to
make friends.
I went to church mostly to spend time with
my friends.
I went to church because it helped me to
make friends.

I strongly I tend to
N
disagree disagree
(Missing)
(%)
(%)
276
60
102
(2)
21.7%
37.0%
276
77
106
(2)
27.9%
38.4%
276
42
117
(2)
15.2%
42.4%

I am not
sure
(%)
32
11.6%
22
8.0%
32
11.6%

I tend to I strongly
agree
agree
(%)
(%)
59
23
21.4%
8.3%
50
21
18.1%
7.6%
70
15
25.4%
5.4%

Personal-extrinsic orientation. Personal-extrinsic orientation is the final religious
orientation measured by the I/E-R (Gorsuch & McPherson, 1989). Like social-extrinsic
orientation, personal-extrinsic orientation is also conceptualized as being “disposed to use
religion for their own ends” (Allport & Ross, 1967, p. 434). However the personal-extrinsic
orientation seeks personal relief, protection, and comfort from religion (Kirkpatrick, 1989).
Personal-extrinsic orientation is measured by three items, all scored from “strongly disagree” (1)
to “strongly agree” (5), with “am not sure” as the midpoint (3), thus higher scores relate to higher
personal-extrinsic orientation. In the current study, scores ranged from three to 15, with a mean
of 10.3 (SD=2.63, n=276). The social-extrinsic subscale produced a Cronbach’s alpha of .53
(n=276). While the internal reliability was lower for personal-extrinsic orientation than for
social-extrinsic or intrinsic orientations, the reliability score is consistent with prior studies
(Kirkpatrick & Hood, 1990). Table 5 shows the response distribution for the three personalextrinsic orientation variables.

 69
Table 5
Personal-Extrinsic Orientation Item Responses
Item
I prayed mainly to gain relief and protection.
What religion offered me most was comfort
in times of trouble and sorrow.
Prayer was for peace and happiness.

I strongly I tend to
N
disagree disagree
(Missing)
(%)
(%)
276
18
44
(2)
6.5%
15.9%
276
44
67
(2)
15.9%
24.3%
277
15
40
(1)
5.4%
14.4%

I am not
sure
(%)
26
9.4%
44
15.9%
43
15.5%

I tend to I strongly
agree
agree
(%)
(%)
124
64
44.9%
23.2%
83
38
30.1%
13.8%
113
66
40.8%
23.8%

Quest orientation. Quest orientation is measured by the Quest Scale (Batson &
Schoenrade, 1991b), and examines the extent to which a person’s religious orientation is an
ongoing dialogue with existential questions raised by the contradictions of life. All 12 items are
scored on a 10-point bidirectional Likert scale from “strongly disagree” (0) to “strongly agree”
(9). Two items were reverse-coded prior to score summation. Similar to other religious
orientation measures, a greater score indicates a higher quest orientation. Scores for quest
orientation ranged from six to 95, with an average of 50.0 (SD=19.06, n=271). Internal
reliability with the current sample was satisfactory, with a Cronbach’s alpha of .83 (n=211).
Table 6 shows the response distribution for the 12 quest orientation variables.

 70
Table 6
Quest Orientation Item Responses
Strongly Disagree
N
0-1
2-3
Item
(Missing)
(%)
(%)
I was not very interested in religion until I
242
101
61
began to ask questions about the meaning and
(36)
41.7%
25.2%
purpose of my life
I was driven to ask religious questions out of
264
27
24
a growing awareness of the tensions in my
(14)
10.2%
9.1%
world and in my relation to my world.
My life experiences led me to rethink my
268
23
30
religious convictions.
(10)
8.6%
11.2%
God wasn't very important for me until I
241
98
66
began to ask questions about the meaning of
(37)
40.7%
27.4%
my own life.
It might be said that I valued my religious
258
53
53
doubts and uncertainties.
(20)
20.5%
20.5%
For me, doubting was an important part of
263
68
53
what it meant to be religious.
(15)
25.9%
20.2%
268
21
40
I found religious doubts upsetting.*
(10)
7.8%
14.9%
Questions were far more central to my
257
38
45
religious experience than were answers.
(21)
14.8%
17.5%
As I grew and changed, I expected my
254
69
45
religion also to grow and change.
(24)
27.2%
17.7%
I was constantly questioning my religious
269
41
51
beliefs.
(9)
15.2%
19.0%
I did not expect my religious convictions to
271
18
40
change in the next few years.*
(7)
6.6%
14.8%
There were many religious issues on which
269
25
35
my views were still changing.
(9)
9.3%
13.0%
*Item was reverse coded for scale summation

4-5
(%)
33
13.6%

Strongly Agree
6-7
8-9
(%)
(%)
30
17
12.4%
7.0%

30
11.4%

82
31.1%

101
38.3%

28
10.4%
34
14.1%

67
25.0%
28
11.6%

120
44.8%
15
6.2%

50
19.4%
44
16.7%
28
10.4%
68
26.5%
52
20.5%
44
16.4%
43
15.9%
45
16.7%

64
24.8%
59
22.4%
73
27.2%
62
24.1%
44
17.3%
64
23.8%
54
19.9%
89
33.1%

38
14.7%
39
14.8%
106
39.6%
44
17.1%
44
17.3%
69
25.7%
116
42.8%
75
27.9%

Moderating Variable.
Orthodoxy. For the current study, orthodoxy was measured by 13 items from two
existing measures. Nine items were taken from the DOR (Cornwall et al., 1986), which was
developed by researchers at the University of Utah, LDS Church-owned BYU, and the LDS
Church Correlation Department. For the current study, particularistic orthodoxy (four items) and
church commitment dimensions (five items) were included as Mormon-specific components of
religious orthodoxy. Particularistic orthodoxy items are scored on a five-point Likert-type scale

 71
from “strongly disagree” (1) to “strongly agree” with “am not sure” as the midpoint (3). Church
commitment items were scored on a five-point unidirectional Likert-type scale from “not at all”
(1) to “exactly” (5). Four of the five church commitment items were reverse scored prior to scale
summation. Four items were taken from McFarland’s (1989) Fundamentalism Scale. Items on
this scale stress the perfection of scriptural authority, the necessity of following God’s word, and
the importance of avoiding worldly ideas. Item wording was altered to emphasize particular
beliefs in Mormonism, including The Book of Mormon and living prophets. Two items from the
Fundamentalism Scale were not included as they duplicated content with particularistic
orthodoxy and church commitment items on the DOR. Fundamentalism scale items were scored
on the same bidirectional five-point Likert-type scale as the I/E-R instrument. All items included
to measure orthodoxy are scored in such a way that higher overall scores indicate higher
orthodoxy beliefs. Scores ranged from 13 to 65, with an average of 47.2 (SD=11.76, n=276).
This concept had a high internal reliability, with a Cronbach’s alpha of .92 (n=276). Tables 7
and 8 show the response distribution for the 13 orthodoxy variables.

 72
Table 7
Orthodoxy Item Responses (Particularistic Orthodoxy and Fundamentalism)
Item
I believed the president of the LDS Church
was a prophet of God.
I believed The Book of Mormon was the
word of God.
I believed The Church of Jesus Christ of
Latter-day Saints was the only true church on
earth.
I believed Joseph Smith actually saw God the
Father and Jesus Christ.
I believed The Book of Mormon contained no
errors or contradictions
I believed Mormons should not let themselves
be influenced by worldly ideas.
I believed living prophets imparted true
teachings of God.
I believed Mormons must know and follow
the teachings of God’s ancient and modern
prophets.

I strongly I tend to
N
disagree disagree
(Missing)
(%)
(%)
277
14
17
(1)
5.1%
6.1%
276
11
17
(2)
4.0%
6.2%
276
25
34
(2)
9.1%
12.3%
276
(2)
277
(1)
276
(2)
276
(2)
276
(2)

8
2.9%
35
12.6%
17
6.2%
15
5.4%
10
3.6%

16
5.8%
54
19.5%
57
20.7%
31
11.2%
30
10.9%

I am not
sure
(%)
39
14.1%
35
12.7%
44
15.9%
34
12.3%
50
18.1%
53
19.2%
37
13.4%
39
14.1%

I tend to I strongly
agree
agree
(%)
(%)
73
134
26.4%
48.4%
82
131
29.7%
47.5%
68
105
24.6%
38.0%
84
30.4%
81
29.2%
96
34.8%
89
32.2%
89
32.2%

134
48.6%
57
20.6%
53
19.2%
104
37.7%
108
39.1%

Somewhat Moderately
(%)
(%)
39
54
14.1%
19.6%
35
11
12.7%
4.0%
35
44
12.7%
15.9%
57
68
20.7%
24.6%
38
66
13.8%
23.9%

Exactly
(%)
105
38.0%
9
3.3%
51
18.5%
39
14.1%
102
37.0%

Table 8
Orthodoxy Item Responses (Church Commitment)
N
Item
(Missing)
Some doctrines of the LDS Church
276
were hard for me to accept.*
(2)
I didn't really care about the LDS
276
Church.*
(2)
I didn't accept some of the standards
276
of the LDS Church.*
(2)
The LDS Church put too many
276
restrictions on its members.*
(2)
Church programs and activities were
276
an important part of my life.
(2)
*Item was reverse coded for scale summation

Not at all
(%)
25
9.1%
179
64.9%
78
28.3%
65
23.6%
35
12.7%

Slightly
(%)
53
19.2%
42
15.2%
68
24.6%
47
17.0%
35
12.7%

Mediating Variable.
Spiritual trauma. At the time of study development, the researcher was unable to identify
any existing quantitative measures of spiritual trauma. Therefore, the researcher developed 32

 73
items to examine potential mistreatment by religious leaders (Johnson & VanVoderen, 1991;
Ward, 2011) as well as potentially punitive messages, beliefs, and experiences (Purcell, 1998a,
1998b; Stone, 2013). All items were rated on a five-point bidirectional Likert scale from
“extremely beneficial” (1) to “extremely damaging” (5), with “neither damaging or beneficial”
as the midpoint (3). Although items were reviewed by several self-identified LGBTQQA
Mormons or ex-Mormons prior to survey data collection, items on this measure suffered from
substantial missing data in the form of “not applicable” responses. To address this missing data,
11 items were removed from score summation (four from leadership trauma and seven from
traumatic beliefs). To address item nonresponse in the remaining 21 items, total scores were
calculated only for respondents with valid responses to at least 11 items. Scores for spiritual
trauma ranged from 15 to 105, with an average of 77.5 (SD=18.96, n=236). Higher scores
indicate a greater perception of harm from experiences with ecclesiastical leaders or religious
beliefs. The amended 21-item spiritual trauma measure produced a satisfactory Cronbach’s alpha
of .95 (n=61). Table 9 shows the response distribution for the 21 spiritual trauma variables
retained for score creation. While not included in inferential analysis, the response distributions
for the excluded 11 spiritual trauma items are presented in Table 10. Despite being uncommon
experiences in the study respondents, these events were still predominantly seen as “damaging”
or “extremely damaging” when experienced.

 74
Table 9
Spiritual Trauma Item Responses (Retained)

Item
Counsel you to not focus on your
sexual or gender identity.
Counsel you to not speak to others
about your sexual or gender identity.
Counsel you to not identify as gay,
lesbian, bisexual, homosexual, or
transgender.
Counsel you to separate your sexual
attractions from your sexual behaviors.
Associate your gender or sexual
identity with an addiction or other
temptation.
Encourage you to seek professional
treatment to change your sexual or
gender identity.
Encourage heterosexual marriage as a
solution for your sexual or gender
identity.
Encourage you to increase your
religious participation to change your
sexual or gender identity.
God would punish me for my sexual
attractions.
I would be excommunicated for my
sexual attractions.
I would be eternally separated from my
family for my sexual attractions.
God would punish me for my same-sex
sexual behaviors.
I would be excommunicated for my
same-sex sexual behaviors.
I would be eternally separated from my
family for my same-sex sexual
behaviors.
Heterosexual marriage would change
my sexual or gender identity.
I would not be exalted without
heterosexual marriage.
Homosexuality was a sin.
A stronger belief in God would change
my homosexuality or gender identity.
I needed to change my sexual or gender
identity to be acceptable before God.
My sexual or gender identity would be
changed after death.
Life-long celibacy was required for me
to return to God.

Neither
damaging or
Beneficial Damaging
(%)
(%)

N
(Missing)

Extremely
Beneficial
(%)

Beneficial
(%)

Extremely
Damaging
(%)

228
(50)
179
(99)
201
(77)

6
2.6%
2
1.1%
3
1.5%

15
6.6%
2
1.1%
5
2.5%

42
18.4%
18
10.1%
12
6.0%

103
45.2%
77
43.0%
99
49.3%

62
27.2%
80
44.7%
82
40.8%

208
(70)
226
(52)

10
4.8%
3
1.3%

29
13.9%
2
0.9%

41
19.7%
12
5.3%

76
36.5%
97
42.9%

52
25.0%
112
49.6%

161
(117)

5
3.1%

9
5.6%

22
13.7%

52
32.3%

73
45.3%

199
(79)

3
1.5%

4
2.0%

29
14.6%

76
38.2%

87
43.7%

206
(72)

5
2.4%

11
5.3%

39
18.9%

72
35.0%

79
38.3%

206
(72)
189
(89)
192
(86)
241
(37)
224
(54)
208
(70)

2
1.0%
2
1.1%
4
2.1%
4
1.7%
5
2.2%
5
2.4%

0
0.0%
2
1.1%
2
1.0%
8
3.3%
6
2.7%
2
1.0%

8
3.9%
11
5.8%
9
4.7%
18
7.5%
18
8.0%
15
7.2%

69
33.5%
67
35.4%
48
25.0%
76
31.5%
77
34.4%
49
23.6%

127
61.7%
107
56.6%
129
67.2%
135
56.0%
118
52.7%
137
65.9%

206
(72)
253
(25)
260
(18)
229
(49)
212
(66)
222
(56)
221
(57)

2
1.0%
5
2.0%
5
1.9%
4
1.7%
3
1.4%
6
2.7%
3
1.4%

3
1.5%
6
2.4%
2
0.8%
2
0.9%
0
0.0%
9
4.1%
4
1.8%

23
11.2%
24
9.5%
19
7.3%
7
3.1%
9
4.2%
36
16.2%
15
6.8%

74
35.9%
70
27.7%
68
26.2%
91
39.7%
71
33.5%
66
29.7%
66
29.9%

104
50.5%
148
58.5%
166
63.8%
125
54.6%
129
60.8%
105
47.3%
133
60.2%

 75
Table 10
Spiritual Trauma Item Responses (Dropped)

Item
Associate your sexual or gender
identity with pedophilia.
Out you to your family, friends or
other church members.
Threaten your church membership
because of your gender or sexual
identity.
Threaten your church membership
because of your same-sex
relationships or gender nonconforming appearance/behavior.
God would punish me for not
identifying as my assigned gender.
I would be excommunicated for not
identifying as my assigned gender.
I would be eternally separated from
my family for not identifying as my
assigned gender.
Satan seeks to confuse gender and
gender roles.
Gender roles were ordained of God.
Gender was a fixed, eternal
characteristic.
God intended me to live as the gender
I was assigned at birth.

Neither
damaging or
Beneficial Damaging
(%)
(%)

N
(Missing)

Extremely
Beneficial
(%)

Beneficial
(%)

Extremely
Damaging
(%)

124
(154)
103
(175)
135
(143)

3
2.4%
3
2.9%
2
1.5%

1
0.8%
8
7.8%
3
2.2%

5
4.0%
13
12.6%
8
5.9%

20
16.1%
32
31.1%
34
25.2%

95
76.6%
47
45.6%
88
65.2%

133
(145)

4
3.0%

2
1.5%

8
6.0%

46
34.6%

73
54.9%

91
(187)
78
(200)
90
(188)

3
3.3%
3
3.8%
6
6.7%

1
1.1%
1
1.3%
1
1.1%

16
17.6%
17
21.8%
12
13.3%

31
34.1%
23
29.5%
22
24.4%

40
44.0%
34
43.6%
49
54.4%

226
(52)
237
(41)
211
(67)
155
(123)

10
4.4%
15
6.3%
14
6.6%
12
7.7%

9
4.0%
10
4.2%
16
7.6%
11
7.1%

28
12.4%
43
18.1%
67
31.8%
52
33.5%

73
32.3%
70
29.5%
59
28.0%
38
24.5%

106
46.9%
99
41.8%
55
26.1%
42
27.1%

To examine the incidence of potentially traumatic spiritual events, responses of
“damaging” or “extremely damaging” were assessed for the retained 21 items. Overall, nearly all
of the study respondents (94.6%, n=263) indicated experiencing at least one damaging event.
Experiencing multiple “damaging” or “extremely damaging” spiritual events was common;
17.3% (n=48) reported two to nine events, 20.5% (n=57) reported 10 to 14 events, 47.5%
(n=132) reported 15 to 20 events, and 9.0% (n=25) reported all 21 events. On average,
respondents reported 13.8 ecclesiastical interactions or religious beliefs/teachings as being
“damaging” or “extremely damaging.” As noted previously, this study did not attempt to

 76
measure perceived intent to harm; thus, it is impossible to ascertain if respondents felt these
messages were with any malicious purpose. It should be noted that while not included in the list
of potential spiritual trauma events, several respondents noted the November 2015 policy
specifying same-sex marriage as apostasy as having a strong negative influence.
Consequent Variable.
PTSD. The STSS (Bride et al., 2004) was used to assess intrusion, avoidance, and arousal
symptoms related to PTSD. All items were scored on a five-point Likert scale on how frequently
the symptom was experienced in the recent seven days from “never” (1) to “very often” (5). As
noted previously, this measure was utilized as the items were directly connected to DSM-IV-TR
(APA, 2000) PTSD diagnostic criteria and are clearly worded without complicated jargon. The
STSS measures secondary traumatic stress through assessing PTSD symptoms associated with
working with traumatized clients; however, for the current study wording was modified by the
researcher to focus on PTSD symptomology associated with the respondents’ religious
experiences. Given the retrospective nature of the current study, participants were asked to
answer these items for any period in their life and not the most recent seven days. Unlike
questions regarding religious orientation, respondents were not instructed to restrict responses
regarding PTSD or spiritual trauma to the identified period of greatest concern; this was done to
conceptually allow earlier religious orientation to impact later life events and responses. Total
scores for the current sample ranged from 17 to 85, with an average of 53.9 (SD=14.42, n=276).
This measure also had a strong internal reliability for the current sample (Cronbach’s alpha=.92,
n=273). Table 11 shows the response distribution for the 17 PTSD items.

 77
Table 11
PTSD Item Responses
N
(Missing)
276
I felt emotionally numb.
(2)
276
I felt discouraged about the future.
(2)
I had little interest in being around others,
276
particularly those from the LDS community.
(2)
276
I was less active than usual.
(2)
I avoided people, places, or things that
276
reminded me of my religious beliefs or
(2)
experiences.
I wanted to avoid aspects of my religious
276
beliefs or experiences.
(2)
I noticed gaps in my memory about religious
276
experiences.
(2)
My heart started pounding when I thought
275
about my religious beliefs or experiences.
(3)
It seemed as if I was reliving previous
276
religious experiences.
(2)
Reminders of my religious beliefs or
276
experiences upset me.
(2)
I thought about my religious beliefs or
275
experiences when I didn't intend to.
(3)
I had disturbing dreams about my religious
276
beliefs or experiences.
(2)
276
I had trouble sleeping.
(2)
275
I felt jumpy.
(3)
275
I had trouble concentrating.
(3)
276
I was easily annoyed.
(2)
276
I expected something bad to happen.
(2)
Item

Never
(%)
22
8.0%
8
2.9%
27
9.8%
36
13.0%
54
19.6%

Rarely
(%)
27
9.8%
15
5.4%
42
15.2%
43
15.6%
48
17.4%

Occasionally
(%)
57
20.7%
40
14.5%
68
24.6%
57
20.7%
63
22.8%

Often
(%)
74
26.8%
59
21.4%
63
22.8%
77
27.9%
51
18.5%

Very often
(%)
96
34.8%
154
55.8%
76
27.5%
63
22.8%
60
21.7%

28
10.1%
132
47.8%
49
17.8%
107
38.8%
50
18.1%
26
9.5%
89
32.2%
31
11.2%
43
15.6%
24
8.7%
20
7.2%
20
7.2%

26
9.4%
55
19.9%
56
20.4%
59
21.4%
47
17.0%
40
14.5%
70
25.4%
50
18.1%
60
21.8%
35
12.7%
49
17.8%
37
13.4%

62
22.5%
49
17.8%
76
27.6%
76
27.5%
71
25.7%
75
27.3%
64
23.2%
66
23.9%
83
30.2%
72
26.2%
71
25.7%
72
26.1%

73
26.4%
18
6.5%
50
18.2%
18
6.5%
50
18.1%
78
28.4%
26
9.4%
55
19.9%
53
19.3%
72
26.2%
86
31.2%
68
24.6%

87
31.5%
22
8.0%
44
16.0%
16
5.8%
58
21.0%
56
20.4%
27
9.8%
74
26.8%
36
13.1%
72
26.2%
50
18.1%
79
28.6%

Bride (2007) identified three possible methods for interpreting scores from the STSS, two
of which were used to estimate likely PTSD prevalence for the study respondents. The first
method based on a recommended cutoff score of 38, with scores greater than 38 indicating a
likely PTSD diagnosis. Using this cutoff method, 86.0% (n=239) of the study participants would

 78
have likely met criteria for PTSD diagnosis. The second method is an algorithm approach to
identify potential PTSD diagnosis based on DSM-IV-TR diagnostic criteria (APA, 2000). For
this method, a response of “occasionally,” “often,” or “very often” is interpreted as endorsing the
symptom. In the current study, 94.6% of participants indicated at least one event from the
spiritual trauma measure was “damaging” or “very damaging,” which was seen as meeting
DSM-IV-TR Criterion A1 and Criterion A2. A large majority of respondents (89.2%, n=248)
endorsed at least one intrusion criteria (Criterion B), with similar percentages endorsing at least
three avoidance criteria (86.3%, n=240) (Criterion C) or endorsing at least two arousal criteria
(85.6%, n=238) (Criterion D). Using this algorithm approach, approximately three-quarters
(73.4%, n=204) of respondents would have likely met criteria for PTSD diagnosis based on the
presence of a religious-based Criteria A event, and combination of intrusion, avoidance, and
arousal symptoms. An additional four participants reported likely PTSD symptomology, but did
not endorse any spiritual trauma items as being “damaging” or “extremely damaging.” Those
who no longer currently attend LDS services were significantly more likely to meet criteria for
PTSD diagnosis than those who currently attend at least monthly (83.8% vs. 64.6% respectively,
χ2(1, n=274) = 13.09, p >.000). According to the DSM-IV-TR (APA, 2000), lifetime prevalence
for PTSD in the U.S. adult population is approximately 8%, substantially lower than the likely
prevalence for the study respondents.
Inferential Analyses
Univariate descriptive analyses and regression residual plots did not show any
substantive violations of normality or homoscedasticity required for OLS and conditional
process analysis. To accommodate for the four antecedent variables, conditional process analysis
was conducted four times with one religious orientation as the x-var and the remaining three as

 79
covariates. With each iteration for the current study, orthodoxy was w-var, spiritual trauma was
m-var, and PTSD was y-var. Conditional process analysis was run via PROCESS through three
main steps: 1) OLS regression analysis of the antecedent, moderator, and mediator variables, 2)
OLS regression analysis of the mediator and consequent variables, and 3) testing for direct and
conditional process effects (including moderated mediation) through bootstrapping confidence
intervals. This next section will present the findings for each of these three steps by specified
religious orientation.
OLS Regression of Religious Orientation, Orthodoxy, and Spiritual Trauma
PROCESS was used to compute OLS regressions of each religious orientation on
spiritual trauma, with orthodoxy as a moderator. Because PROCESS allows for only one
antecedent variable at a time, the model was computed four times. Inferential statistics, the
overall model summary, and regression coefficients are presented in Table 12.
Intrinsic orientation. When regressed on spiritual trauma, intrinsic orientation did not
show any significant effect (B = -1.20, t(224) = -1.60, p = .111) when controlling for socialextrinsic, personal-extrinsic, and quest orientations. Orthodoxy had a near significant effect (B =
-.87, t(224) = -1.94, p = .053); however, the mediated interaction of orthodoxy on intrinsic
orientation was non-significant (B = .03, t(224) = 1.89, p = .060). Overall, this model had poor
predictive value (R2 = .04, F(6, 224) = 1.583, p = .153).
Social-extrinsic orientation. Social-extrinsic orientation also had a significant effect on
spiritual trauma (B = -1.85, t(224) = -1.22, p = .225) when controlling for intrinsic, personalextrinsic, and quest orientation. Orthodoxy did not have a significant effect on spiritual trauma
independently (B = -.54, t(224) = -1.79, p = .075) or as a mediator on social-extrinsic orientation

 80
(B = .06, t(224) = 1.82, p = .071). This model did not provide significant predictive value (R2 =
.04, F(6, 224) = 1.536, p = .167).
Personal-extrinsic orientation. Although this model did not have significant predictive
value (R2 = .04, F(6, 224) = 1.705, p = .121), personal-extrinsic orientation did have a significant
effect on spiritual trauma (B = -3.47, t(224) = -2.03, p < .000) when controlling for intrinsic,
social-extrinsic, and quest orientation. Orthodoxy was also found to have a significant
independent effect on spiritual trauma (B = -.74, t(224) = -2.07, p = .040). Additionally,
orthodoxy was found to significantly moderate the effect of personal-extrinsic orientation on
spiritual trauma (B = .07, t(224) = 2.07, p = .040). However, since the overall model summary
did not provide statistical significance, the effects between personal-extrinsic orientation and
orthodoxy on spiritual trauma should be seen as correlational and not predictive.
Quest orientation. Quest orientation failed to provide a significant effect on spiritual
trauma (B = .42, t(224) = 1.46, p = .146) when controlling for intrinsic, social-extrinsic, and
personal-extrinsic orientation. Orthodoxy had no significant effect on spiritual trauma, either
independently (B = .33, t(224) = .95, p = .345) or as a moderating variable (B = -.01, t(224) = 1.37, p = .173). As with the models above, this model did not have significant predictive value
(R2 = .03, F(6, 224) = 1.292, p = .262).

 81
Table 12
Model Summary and Regression Coefficients for Religious Orientations and Orthodoxy
Regressed on Spiritual Trauma
Model
Predictor
Intrinsic Orientation Model
Intrinsic Orientation (IO)
Orthodoxy (Odx)
Interaction (IO x Odx)
Social-Extrinsic Orientation Model
Social-Extrinsic Orientation (EsO)
Orthodoxy (Odx)
Interaction (EsO x Odx)
Personal-Extrinsic Orientation Model
Personal-Extrinsic Orientation (EpO)
Orthodoxy (Odx)
Interaction (EpO x Odx)
Quest Orientation Model
Quest Orientation (QO)
Orthodoxy (Odx)
Interaction (EpO x Odx)
*p < .05; **p < .01; ***p < .001

B

SE B

-1.20
-0.87
0.03

0.75
0.45
0.02

-1.85
-0.54
0.06

1.52
0.30
0.03

-3.47*
-0.74*
0.07*

1.71
0.36
0.04

0.42
0.33
-0.01

0.29
0.35
0.01

F
1.583

df1
6

df2
224

R2
0.04

1.536

6

224

0.04

1.705

6

224

0.04

1.292

6

224

0.03

OLS Regression of Spiritual Trauma on PTSD
The second step in PROCESS computations is an OLS regression of the mediator
(spiritual trauma) on the consequent variable (PTSD) with all other model variables included as
covariates. Since each preceding model included all four antecedent variables (one as x-var and
the other three as covariates) this part of the PROCESS computations consistently used all four
antecedent variables as covariates. Thus, the inferential statistics describing the relationships
between spiritual trauma and PTSD are computationally exact for all the models above, and only
need to be presented once. OLS regression indicated spiritual trauma had a significant effect on
PTSD (B = .30, t(225) = 6.83, p < .000) when controlling for intrinsic, social-extrinsic, personalextrinsic, and quest orientations. The overall model was also significant (F(5, 225) = 10.197, p <
.000), with spiritual trauma explaining approximately 18% of the variance in PTSD scores (R2 =
.18).

 82
Table 13
Model Summary and Regression Coefficients for Spiritual Trauma on PTSD
Model Fit
Spiritual Trauma
*p < .05; **p < .01; ***p < .001

B

SE B

0.30***

0.04

F
10.197***

df1
5

R2
0.18

df2
225

Testing for Direct and Conditional Process Effects
The final step in PROCESS computations are inferential statistics for both direct and
indirect effects of the antecedent variable on the consequent variable. Direct effects are a
measure of the hypothetical path from the antecedent to the consequent variable rather than the
proposed path through the mediator and moderator. For the antecedent variables in the current
study, none had a significant direct effect on PTSD (see Table 14).
Table 14
Direct Effects of Religious Orientation on PTSD
Predictor
Intrinsic Orientation
Social-Extrinsic Orientation
Personal-Extrinsic Orientation
Quest Orientation

B
-0.15
-0.13
-0.34
-0.01

SE B
0.17
0.26
0.36
0.05

95% CI
[-0.48, 0.18]
[-0.64, 0.38]
[-1.04, 0.37]
[-0.11, 0.08]

p
0.360
0.623
0.346
0.752

Conditional process effects are calculated through bootstrap confidence intervals. For the
current study, 10,000 bootstrap samples were used to produce bias-corrected confidence
intervals. These bootstrap confidence intervals provide an estimation of the effect of a moderated
mediation in the model. Bootstrap confidence intervals that do not contain zero indicate the
moderated mediation has an effect that is statistically different from zero. For the current study,
none of the religious orientations showed evidence of a moderated mediation based on bootstrap
confidence intervals (Table 15).

 83
Table 15
Index of Moderated Mediation of Religious Orientation on PTSD through Spiritual trauma
and Orthodoxy
Predictor
Intrinsic Orientation
Social-Extrinsic Orientation
Personal-Extrinsic Orientation
Quest Orientation

Bootstrap 95% CI
[0.00, 0.02]
[0.00, 0.04]
[0.00, 0.04]
[-0.01, 0.00]

Summary
This chapter presented the findings of the current study. Two-hundred and seventy-eight
participants completed all relevant study measures. These participants were between 18 to 71
years old, with an average age of 33.2 years old. Respondents were also predominantly White
88.5%, n=246) and lived in the United States (94.2%, n=262). Over half of respondents
identified as lesbian or gay (53.2%, n=148), approximately one-quarter (23.7%, n=66) identified
as bisexual, 9.7% (n=27) identified as same-sex attracted, and 10.4% (n=29) identified as
another sexuality. Half of respondents (51.8%, n=144) indicated they still attend LDS Church
services at least monthly, and most respondents (65.5%, n=182) were currently a member of the
LDS Church in good standing (not under current church discipline). Perceiving LDS teachings or
experiences as “damaging” or “very damaging” was quite common, with nearly all respondents
(94.6%, n=263) experiencing at least one damaging event. On average, respondents reported
13.8 ecclesiastical interactions or religious beliefs/teachings as being “damaging” or “extremely
damaging.” Three-quarters (73.4%, n=204) of respondents would have likely met criteria for
PTSD diagnosis related to their religious experiences.
OLS regression analyses did not show any statistically significant interaction between
intrinsic, social-, personal-extrinsic, or quest orientation and spiritual trauma, either directly or
when moderated by orthodoxy. Spiritual trauma did have a statistically significant effect on

 84
PTSD (B = .30, t(225) = 6.83, p < .000), with the overall model explaining approximately 18%
of the variance in PTSD scores (R2 = .18, F(5, 225) = 10.197, p < .000). However, neither
intrinsic, social-, personal-extrinsic, nor quest orientation had any substantial effects on PTSD,
either directly or through a moderated mediation with orthodoxy and spiritual trauma.

 85

CHAPTER 5
DISCUSSION
LGBTQQA persons continue to experience acts of oppression in society, including hate
crimes, sexual orientation violence, anti-gay harassment, gay slurs, and familial and social
rejection (see Bourassa & Shipton, 1991; Burn, 2000; D’Augelli & Rose, 1990; DiPlacido, 1998;
Herek, 1989, 2000; Herek et al., 2002; Plummer, 2001; Thurlow, 2001). LGBTQQA persons
also often face bias from religious cultures that prohibit homosexuality, and view nonheteronormative sexualities as sinful and immoral (Lease et al., 2005; see also Clark et al., 1990;
LeVay & Nonas, 1995; Melton, 1991; Sherkat, 2002). This population may experience cognitive
dissonance between their sexual or gender identity and religious teachings, which can lead to the
loss of their religious beliefs or community (Dahl & Galliher, 2009; Lease et al., 2005; Ryan &
Rees, 2012; Schuck & Liddle, 2001; Sherkat, 2002), and decreased mental health outcomes
(Gage Davidson, 2000; Mahaffy, 1996; Rodriguez & Ouelette, 2000; Schuck & Liddle, 2001).
This study is one of a growing number of studies assessing the relationship between
religious-based anti-gay prejudice, LGBTQQA identity, and mental health outcomes. In a recent
nationwide U.S. study of 1600 individuals, Sowe et al. (2017) found that religious anti-gay
prejudice predicted increased anxiety, stress, and shame; however, the authors stated “the
specific measurement of religious-based homonegativity has been largely absent in empirical
studies” (p. 2). Through an empirical examination of spiritual trauma via mistreatment by
religious leaders (Johnson & VanVoderen, 1991; Ward, 2011) as well as potentially punitive
messages, beliefs, and experiences (Purcell, 1998a, 1998b; Stone, 2013), this study provides

 86
additional insight to the mechanisms of anti-gay religious bias on PTSD. Given the LDS
Church’s centralized, hierarchy structure with correlated doctrinal messages and policies that
oppose homosexuality and transgenderism, LBGTQQA Mormons and ex-Mormons serve as a
useful study group. This study examined the relationship between religious orientation,
orthodoxy, spiritual trauma, and PTSD in adult LGBTQQA Mormons and ex-Mormons. As
such, this study’s research questions and hypotheses were:
1. Does orthodoxy moderate the relationship, if any, between religious orientation and
spiritual trauma?
a. It is hypothesized that intrinsic orientation will be negatively correlated with
spiritual trauma.
b. It is hypothesized that social- and personal-extrinsic orientations will be
positively correlated with spiritual trauma.
c. It is hypothesized that quest orientation will be negatively correlated with
spiritual trauma.
d. It is hypothesized that orthodoxy will be positively correlated with spiritual
trauma.
2. Does spiritual trauma correlate positively with PTSD?
3. Does religious orientation have an indirect impact on PTSD through a moderated
mediation with orthodoxy and spiritual trauma?
a. It is hypothesized that no religious orientations will have a direct effect on
PTSD.

 87
In the following sections, the study findings for the key hypotheses will be discussed,
study limitations will be addressed, and implications for practice and further research will be
considered.
Religious Orientation and Spiritual Trauma
For the current study, religious orientation was operationalized using Allport and Ross’s
(1967) intrinsic/extrinsic taxonomy, with the addition of Batson’s (1976) quest orientation.
Allport and Ross’ taxonomy of religious orientations is “among the most frequently used
measures in the psychology of religion” (Hill & Hood, 1999, p. 120), and attempts to explain
religion’s paradoxical position as both a “therapeutic community” (Allport, 1963, p. 188), and its
use of pathogenic appeals that “[instill] an abnormal degree of terror” (Allport, 1963, p. 189).
Thus, this taxonomy was deemed an appropriate mechanism to identify how religious messages
and experiences could act as a source of both potential benefit and potential harm to LGBTQQA
Mormons and ex-Mormons. Drawing on McFarland’s (1989) research on religious orientation
and homophobia, orthodoxy was included as a potential moderating variable.
Intrinsic Orientation
As intrinsic orientation was originally viewed as a deeply internalized creed wherein the
person fully “lives his religion” (Allport & Ross, 1967, p. 434), initial hypotheses predicted this
would be negatively correlated with spiritual trauma. Thus, those whose religious commitment
was “subordinate to no other motives” (Allport, 1963, p. 193) would view religious teachings
and experiences in a favorable light. While OLS regression analysis showed a slight negative
association between intrinsic orientation and PTSD when controlling for social-extrinsic,
personal-extrinsic, and quest orientations (B = -1.20), this relationship was not statistically
significant (t(224) = -1.60, p = .111). Thus, there is insufficient support to indicate intrinsic

 88
orientation has any true interaction on spiritual trauma. Additionally, orthodoxy was not found to
have a significant interaction on intrinsic orientation (B = .03, t(224) = 1.89, p = .060). These
findings would indicate that the degree to which the respondent “lives his religion” (Allport &
Ross, 1967, p. 434) has no practical bearing on their perceived harm from their religious
experiences. Rather, perceptions of spiritual trauma demonstrate independence from
respondents’ degree of intrinsic orientation or orthodoxy.
Social- and Personal-Extrinsic Orientations
Allport (1963) initially conceptualized extrinsic orientation as the opposite to intrinsic
orientation; extrinsic orientation views religion as “something to use, but not to live” (p. 193,
emphasis in original). Extrinsic orientation was an “immature formation” (Allport, 1963, p. 194)
that used religion to serve other, more ultimate interests of the person. Kirkpatrick (1989)
separated extrinsic orientation into two distinct subtypes: 1) social-extrinsic and 2) personalextrinsic. These two subtypes differed on the interests the person sought to gain from religion.
The social-extrinsic orientation was focused on social rewards, like avoiding isolation or other
social prestige. The personal-extrinsic was more oriented toward finding personal comfort, relief,
and protection through religion.
Being conceptualized as an opposite to intrinsic orientation, the current study
hypothesized both social- and personal-extrinsic orientations would be positively correlated with
spiritual trauma. In the case of social-extrinsic orientation, messages of rejection would
hypothetically run counter to the internal goals of social acceptance and prestige. For personalextrinsic orientations, punitive messages and leadership experiences would by hypothetically
unfavorable to personal comfort in religious engagement. Contrary to the hypothesis, OLS
regression analysis found social-extrinsic orientation to have a slight negative regression on

 89
spiritual trauma (B = -1.85); however, this test lacked statistical significance (t(224) = -1.22, p =
.225). Orthodoxy did not have a significant interaction on social-extrinsic orientation (B = .06,
t(224) = 1.82, p = .071). Personal-extrinsic orientation also had a negative relationship to
spiritual trauma, which was statistically significant (B = -3.47, t(224) = -2.03, p = .044).
Personal-extrinsic orientation was also significantly moderated by orthodoxy (B = .07, t(224) =
2.07, p = .040). The direction of this relationship was counter to the hypothesized relationship; it
is plausible that personal-extrinsic orientation’s relationship to frequency of prayer (Kirkpatrick,
1989) acts as a protective factor against institutional activity. However, overall model inferential
statistics showed personal-extrinsic orientation explained only 4% of overall variability in
spiritual trauma when controlling for intrinsic, social-extrinsic, and quest orientation (R2 = .04,
F(6, 224) = 1.705, p = .121). Thus, there is insufficient support to indicate either social- or
personal-extrinsic orientations have a significant impact on spiritual trauma. Similar to intrinsic
orientation, participants’ responses to social- or personal-extrinsic orientation do not drive the
participants’ perceptions of spiritual trauma.
Quest Orientation
One key aspect of quest orientation is the emphasis toward questions rather than the
ability to discover an ultimate truth (Batson & Schoenrade, 1991b). Those with a quest
orientation use religion as the process of “probing and questioning generated by the tensions,
contradictions, and tragedies in their own lives and in society” (Batson, 1976, p. 32). Thus, it was
hypothesized quest orientation would be negatively correlated with spiritual trauma as it eschews
rigid dogma and provides a framework to examine contradictions. Results from the current study
showed quest orientation had the weakest direct relationship to spiritual trauma (B = .42, t(224) =
1.46, p = .345), and was similarly not moderated by orthodoxy (B = -.01, t(224) = -1.37, p =

 90
.173). Therefore, there is insufficient evidence to support quest orientation has a predictive
relationship to spiritual trauma. The results of this study indicate participants’ ability to use
religion to probe and question their own lives and society does not impact their perceived trauma
from their LDS religious experiences; those who might be considered high questioners
experience spiritual trauma similarly to those who would be considered low questioners.
Orthodoxy
Consistent with McFarland (1989) and Herek (1987), orthodoxy was conceptualized as
having a literal belief in Mormon teachings and doctrines. This was measured through assessing
participants’ agreements with statements regarding the veracity of LDS scripture, relevance of
modern LDS prophets, and the importance of the LDS Church in their lives. Given the
conceptual similarities between orthodoxy and spiritual literalism (Purcell, 1998b), it was
hypothesized that orthodoxy would be positively correlated with spiritual trauma. However,
when included as a moderating variable for each religious orientation, orthodoxy was not
significantly related to spiritual trauma in three of the four tests (intrinsic orientation, socialextrinsic orientation, and quest orientation). In the case of personal-extrinsic orientation,
orthodoxy did produce a significant regression coefficient (B = -.74, t(244) = -2.07, p = .040);
however, the overall model proved to have almost no predictive value (R2 = .04, F(6, 224) =
1.705, p = .121). Overall, there is insufficient evidence to support any significant relationship
between orthodoxy and spiritual trauma when controlling for intrinsic, social-extrinsic, personalextrinsic, and quest orientations. The degree to which a respondent holds an orthodox belief of
the LDS Church does not appear to impact their perceived spiritual trauma from their religious
experiences; individuals with an orthodox belief in the LDS Church show no greater disposition
toward spiritual trauma than unorthodox believers. This finding is perhaps one of the most

 91
intriguing since orthodoxy had been conceptualized similarly to spiritual literalism, indicating
orthodoxy and spiritual trauma may be more distinct than originally hypothesized.
Relationship between Religious Orientation and Spiritual Trauma
For the current study, religious orientation was viewed as a multi-dimensional construct
as recommended by Batson and Ventis (1982), rather than mutually-exclusive types based on
mean cutoff scores (see Donahue, 1985; Hood, 1970). In the current study, if respondents had
been categorized according to mean cutoff scores, most respondents (77.7%, n=216) would have
been categorized into two, three, or four orientation types. Only 17.6% (n=49) of study
respondents would have been categorized into one orientation type, and 4.7% (n=13) would not
have been categorized into any religious orientation type. Thus, in the current study there was a
high degree of overlap in religious orientations among the participants.
By using religious orientation as a dimension score, and simultaneously using all
orientations (as either the antecedent variable or covariates), OLS regression analysis was able to
identify the amount of variation in spiritual trauma specific to the identified religious orientation.
Overall, each religious orientation accounted for only 3% to 4% of the variability in spiritual
trauma specific to that religious orientation when moderated by orthodoxy. Any variance shared
by the different religious orientations was cancelled out through the use of other religious
orientations as covariates. Therefore, results from this study do not find intrinsic orientation,
social-extrinsic, personal-extrinsic, or quest orientation to have any substantive impact on
respondents’ perceptions of spiritual trauma. Additionally, orthodoxy was not found to have any
substantive impact on spiritual trauma either directly or as a moderating variable. As such,
hypotheses 1a, 1b, 1c, and 1d are not supported; religious orientation and orthodoxy do not

 92
provide valid correlation to the perception of spiritual trauma among LGBTQQA Mormons and
ex-Mormons in the current study.
Spiritual Trauma and PTSD
Scholarly attention to spiritual trauma grew out of research on the cult phenomenon
(Ward, 2011); however, this has been covered more in popular literature than in peer reviewed
research (see Plante, 2004; Purcell, 2008; Winell, 1993; Wright, 2001). Building off the work by
Stone (2013) and Purcell (1998a, 1998b), spiritual trauma in this study was operationalized as
perceived damage caused by punitive religious teachings, beliefs, and experiences. Respondents
were presented with 32 items representing possible teachings or ecclesiastical counsel regarding
sexual and gender identity. While 11 items were removed from analysis due to item nonresponse,
the remaining 21 items allowed for the current study to assess the relationship between
LGBTQQA Mormons’ and ex-Mormons’ perceived spiritual trauma and reported PTSD
symptoms.
Spiritual Trauma
Overall, study participants reported fairly high perceived trauma from leadership
interactions, and LDS teachings and beliefs. Scores on this measure ranged from 15 to 105, with
an average of 77.5 (SD = 18.96, n=236). Overall, nearly all of the study respondents (94.6%,
n=263) perceived at least one event or teaching as “damaging” or “extremely” damaging.”
Experiencing multiple “damaging” or “extremely damaging” spiritual events was common;
17.3% (n=48) reported two to nine events, 20.5% (n=57) reported 10 to 14 events, 47.5%
(n=132) reported 15 to 20 events, and 9.0% (n=25) reported all 21 events. On average,
respondents perceived 13.8 ecclesiastical interactions or religious beliefs/teachings as being
“damaging” or “extremely damaging.”

 93
Table 16 presents the ten most common LDS teachings, beliefs, or ecclesiastical
experiences from study participants. The prevalence of these experiences, teachings, and beliefs
include those who perceived either harm or benefit from the item, thus mean scores are also
presented to provide contextual information as to how the study group perceived the item. Full
response distributions for all items can be found in Table 9 in Chapter 4.
Table 16
Ten Most Commonly Experienced LDS Beliefs, Teachings, or Ecclesiastical Counsel
Regarding Sexual or Gender Identity
Item
Homosexuality was a sin.
I would not be exalted without heterosexual marriage.
God would punish me for my same-sex sexual behaviors.
A stronger belief in God would change my homosexuality
or gender identity.
Counsel you to not focus on your sexual or gender identity.
Associate your gender or sexual identity with an addiction
or other temptation.
I would be excommunicated for my same-sex sexual
behaviors.
My sexual or gender identity would be changed after death.
Life-long celibacy was required for me to return to God.
I needed to change my sexual or gender identity to be
acceptable before God.

Experienced
260
253
241

%
93.5%
91.0%
86.7%

Mean
4.49
4.38
4.37

SD
0.82
0.90
0.89

229

82.4%

4.45

0.76

228

82.0%

3.88

0.97

226

81.3%

4.38

0.75

224

80.6%

4.33

0.90

222
221

79.9%
79.5%

4.15
4.46

1.01
0.81

212

76.3%

4.52

0.71

The most common experience was being taught that homosexuality was a sin. On
average, respondents scored this belief as 4.49, putting it between “damaging” or “extremely
damaging.” Being taught that heterosexual marriage is required for salvation was also extremely
common, reported by 91.0% (n=253) participants, and believing that God would punish samesex sexual behaviors (86.7%, n=241). Being taught or believing that God would change
homosexuality or gender identity through increased faith was also a common experience
(82.4%). While the current study did not ask participants if they had attempted to change their
sexuality through increased faith, the frequency of this belief in the current study supports
findings by Dehlin et al. (2014) wherein personal righteousness was the most common sexual

 94
orientation change effort among same-sex attracted current and former LDS members. This
belief was seen as unfavorable, with an average rating of 4.45 (between “damaging” and “very
damaging”), which is also consistent with prior research indicating attempts to change sexual
orientation through personal righteousness were seen as more harmful than helpful (Dehlin et al.,
2014).
Other items experienced by at least three-quarters of respondents include being counseled
to not focus on one’s gender or sexual identity (82.0%, n=228), having one’s gender or sexual
identity associated with an addiction or temptation (81.3%, n=226), believing one would be
excommunicated from the church for same-sex behaviors (80.6%, n=224), believing one’s
sexual or gender identity would be changed after death (79.9%, n=222), believing life-long
celibacy would be required for salvation (79.5%, n=221), and believing that one needed to
change their sexual or gender identity to be acceptable before God (76.3%, n=212). On average,
nearly all these common events were perceived within “damaging” to “extremely damaging,”
with the exception of being counseled to not focus on one’s gender or sexual identity, which had
an overall rating just below “damaging.”
It should be noted that while 11 items were removed from scale scoring and inferential
analysis due to being uncommon experiences or specific to the non-cisgender experience, on
average these events were also perceived as being primarily “damaging” or “very damaging”
when experienced. For example, only 44.6% (n=124) had a leader associate their sexual or
gender identity with pedophilia, but this item had the highest mean score (4.46, SD=.81) among
all 32 items. Thus, even uncommon religious experiences can carry substantial weight for those
who experience them. When observed as a group, the study participants perceived the identified
religious experiences, teachings, and messages to be primarily damaging. As noted in the prior

 95
section, this perception of damage cannot be ascribed to the respondents’ religious orientations
or orthodoxy. These findings demonstrate that study participants overwhelmingly perceived LDS
teachings, messages, and experiences associated with their gender or sexual identity to be
harmful.
PTSD
PTSD has been recognized as a mental health diagnosis since the third edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM-III) (APA, 1980); however,
research on trauma has been traced back to veterans of the Franco-Prussian War (1870-1871)
(Jones & Wessley, 2007). Since the diagnostic inception of PTSD, “traumatic” events have
included (but were not limited to) direct experience of combat, rape, life-threatening accidents,
natural disasters, deliberately caused disasters (APA, 1987), robbery, kidnaping, life-threatening
disease diagnosis, and contact with dead bodies/body parts (APA, 1994). At the time of this
study, the generally accepted conceptualization of trauma encompasses actual or threatened
injury, other threat to one’s safety, or learning about such experiences of one’s close friends and
relatives.
The STSS (Bride et al., 2004) was used to measure potential PTSD symptoms in the
current study. This measure assesses 17 symptoms of arousal, intrusion, and avoidance,
consistent with DSM-IV-TR (APA, 2000) diagnostic criteria. Items were adapted to reflect
respondent’s reaction to their religious experiences. Total scores for the current sample ranged
from 17 to 85 (mean=53.9, SD=14.42, n=276), with higher scores indicating greater PTSD
symptomology. A large majority of respondents (89.2%, n=248) endorsed at least one intrusion
symptom, with similar percentages endorsing at least three avoidance symptoms (86.3%, n=240)
or endorsing at least two arousal symptoms (85.6%, n=238). Overall, nearly three-quarters

 96
(73.4%, n=204) of respondents would have likely met criteria for PTSD diagnosis based on the
presence of a “damaging” or “extremely damaging” religious belief or experience and
combination of intrusion, avoidance, and arousal symptoms. This estimation of PTSD prevalence
in the current study respondents is ten times greater than the approximately 8% for the general
U.S. adult population (APA, 2000). This substantial difference in likely PTSD prevalence
between the study respondents and general U.S. adult population presents a significant concern
for the psychosocial functioning of the overall study population. Since participants were asked to
consider PTSD symptoms in relationship to their religious experiences, these findings further
highlight religious engagement as a potential source of decreased mental health outcomes for
LGBTQQA adults (see Gage Davidson, 2000; Mahaffy, 1996; Rodriguez & Ouelette, 2000;
Schuck & Liddle, 2001; Sowe et al., 2017).
Relationship between Spiritual Trauma and PTSD
At the time of this study, there was no available peer reviewed research examining the
relationship between spiritual trauma and PTSD. Recent work by Sowe et al. (2017) found
exposure to religious anti-gay prejudice predicted higher levels of anxiety, stress, and shame, but
noted an absence of studies exploring the relationship between forms of religious homonegativity
and psychosocial harm. Thus, this study is perhaps the first quantitative study to attempt to link
specific religious teachings or events with perceived spiritual trauma
OLS regression analyses showed total spiritual trauma had a statistically significant effect
on total trauma scores (B = .30, t(225) = 6.83, p <.000) when controlling for intrinsic, socialextrinsic, personal-extrinsic, and quest orientations. This relationship was positive, indicating
that when total spiritual trauma scores raised by one point, total PTSD scores raised by .30
points. The regression analysis produced statistically significant predictive qualities (F(5, 225) =

 97
10.197, p < .000), with spiritual trauma accounting for 18% of the variance in total PTSD scores
(R2 = .18). Thus, the findings support the second research question; spiritual trauma is positively
correlated with PTSD. Participants’ who perceived LDS teachings, beliefs, and experiences
regarding sexuality and transgenderism to be more damaging also reported increased PTSD
symptomology. As both participants’ perception of spiritual harm and PTSD symptomology
were expressively connected to their LDS religious experiences, these findings demonstrate a
substantive connection between one’s LDS religious experiences and spiritual trauma and PTSD.
These results lend further support to viewing punitive religious teaching and experiences as a
being a valid source of PTSD symptomology and clinical impairment in LGBTQQA Mormons
and ex-Mormons.
Direct and indirect effects of religious orientation on PTSD. The final set of study
hypotheses address the relationship between religious orientation and PTSD. The original model
theorized religious orientation would indirectly impact PTSD through a mediated moderation
with orthodoxy and spiritual trauma. As noted above, the results of the current study did not
show any substantive relationship between the four religious orientations and spiritual trauma,
either directly or through moderation by orthodoxy. Therefore, presence of a conditional process
interaction between religious orientation on PTSD through spiritual trauma and orthodoxy would
not be expected. An examination of the bootstrap 95% confidence intervals did not support the
presence of a moderated mediation for any of the religious orientations (see Table 15). Thus, the
second research question is not supported; it appears that religious orientation does not have an
indirect impact on PTSD. Similarly, there was no significant indication of direct effects of the
four religious orientations on PTSD (see Table 14), which supports hypothesis 3a. Respondent’s
PTSD symptomology is not dependent on their spiritual orientation. Holding an intrinsic, social-,

 98
personal-extrinsic, or quest orientation (or any combination of these religious orientations) has
no impact on the participants’ reported PTSD symptomology, regardless of the presence of
orthodox beliefs or perceived spiritual trauma. Similar to findings regarding religious orientation
and spiritual trauma, this study does not show that any particular religious orientation has an
effect on the participants’ report of PTSD symptoms related to their LDS religious experiences.
Across all religious orientations and levels of orthodoxy, PTSD symptomology remained fairly
consistent.
Overall Findings
Overall, this study does not support the conceptual framework outlined in Figure 1.
Primarily, the results of this study failed to identify substantive effects of the four religious
orientations on spiritual trauma, whether independently or when moderated by orthodoxy. As
such, there is insufficient evidence to indicate religious orientation impacts respondents’
perceptions of spiritual trauma or PTSD symptoms that they experience related to their religious
beliefs, teachings, or experiences.
Despite the lack of support for the conceptual framework, this study does provide
substantive information regarding spiritual trauma and PTSD among LGBTQQA Mormons and
ex-Mormons. When presented with 32 potentially harmful religious teachings, beliefs, and
ecclesiastic experiences, respondents overwhelmingly indicated these experiences were either
“damaging” or “very damaging.” Among the spiritual trauma items, the lowest average score
was 3.56, being between “Neither damaging or beneficial” and “damaging.” The majority of
items (84.4%, n=27) had an average score corresponding to “damaging” or “very damaging”.
Regarding the 11 spiritual trauma items retained for scale scoring and inferential analysis, nearly
all study respondents (94.6%, n=263) indicated experiencing at least one damaging event. On

 99
average, respondents reported 13.8 ecclesiastical interactions or religious beliefs/teachings as
being “damaging” or “extremely damaging.” Therefore, data from this study would indicate that
LDS teachings and beliefs are often experienced as spiritually damaging to LGBTQQA members
and former members.
Similarly, the study respondents presented as having substantial PTSD symptomology
related to their experiences within Mormonism, with approximately three-quarters (73.4%,
n=204) likely meeting criteria for associated PTSD diagnosis during their lifetime. This
prevalence is far above the 8% estimated for the U.S. population (APA, 2000). Further, results of
the study show a statistically significant link between respondent’s perceptions of spiritual
trauma and PTSD symptoms. While the current study was unable to support any link between
religious orientation and PTSD, it has demonstrated a strong link between spiritual trauma and
PTSD among LGBTQQA Mormons and ex-Mormons. These findings would indicate that
receiving potentially punitive or biased religious messages can have a direct impact on PTSD
symptomology and associated clinical impairment.
Study Limitations
Given this study’s use of convenience sampling, it is plausible that recruitment resulted in
selection bias. Recruitment relied heavily on LDS-affiliated LGBTQQA Facebook support and
discussion groups. While efforts were made to recruit outside these Facebook groups (including
through other social media channels and via email to non-religiously affiliated LGBTQQA
organizations in areas of substantial Mormon populations), it is possible these results are
reflective of LGBTQQA Mormons and ex-Mormons who engage in online discussion and
support groups rather than the overall population of LGBTQQA Mormons and ex-Mormons.
Individuals who engage in such online support and discussion groups might experience spiritual

 100
trauma differently than those who do not, or prior negative experiences might have disposed
them to seek online support and discussion groups. Similarly, those who have had negative
experiences within Mormonism might have had additional personal incentive to participate than
those with net positive experiences. However, efforts were made to recruit through LDS
affirming groups, and approximately half of respondents (51.8%, n=144) indicated they still
attend LDS Church services at least monthly. Nevertheless, the lack of randomized,
representative sampling does not allow results from this study to be widely generalized to the
larger population.
Secondly, the research method relied on a cross-sectional design to study historic
experiences. While questions were presented to encourage participants to respond regarding
earlier and later life periods, this approach lacks the kind of rigor necessary to make causal
assumptions. For the current study, spiritual trauma was conceptually positioned as an antecedent
to PTSD, but it is impossible to verify this time sequence from the resulting data. Additionally, it
is plausible participant’s reactions to early potentially spiritual traumatic experiences impacted
their perception of later spiritual traumatic experiences. Issues of memory recall and
retrospective memory changes can also be problematic for cross-sectional research.
Thirdly, as highlighted by Sowe et al. (2013), studies on religious anti-gay prejudice
often lack inclusion of a heterosexual comparison group. The lack of a comparison group in the
current study makes it impossible to ascertain what variance is a result of the specified study
variables, and what variance is a result of differences between heterosexual cisgender persons
and LGBTAAQ persons. Additionally, the lack of a comparison group restricts the study’s
ability to speak to the experiences of other groups, such as cisgendered heterosexuals or
LGBTQQA persons of other faiths. It is possible homonegative religious teachings or beliefs

 101
also cause distress for non-LGBTQQA persons. For example, approximately 1500 Mormons
resigned from the LDS Church following a policy change that designated same-sex marriage as
apostasy and barred children of same-sex parents from baptism and other rites (Moyer, 2015).
Finally, academic study of spiritual trauma is a relatively new area and suffers from a
lack of accepted conceptual clarity. While spiritual trauma presents a “fertile area” for research
(Purcell, 1998b, p. 229), the lack of concise conceptual agreement makes comparing studies
difficult. The current study relied on researcher-developed items to measure spiritual trauma that
were conceptually bound to Mormonism. While these Mormonism-specific questions allowed
this study to bridge identified research gaps connecting specific forms of religious
homonegativity to psychosocial harm (see Sowe et al., 2017), the use of these items would likely
be of little use in studies of other religious groups leading to difficulty replicating this research in
other contexts. Although recent research has developed a 17-item Spiritual Abuse Questionnaire
(Keller, 2016), that measure primarily focuses on participants’ global opinions of the power and
authority of church leaders, and not on the events that might lead a person to hold such opinions.
Implications for Social Work Practice
As discussed in Chapter 1, addressing the needs of and empowering people who are
vulnerable or oppressed is one of the core ethics driving social work as a profession (NASW,
2008). LGBTQQA clients are likely to experience varied types of oppression and bias, including
hate crimes, sexual orientation violence, anti-gay harassment, gay slurs, and familial and social
rejection (see Bourassa & Shipton, 1991; Burn, 2000; D’Augelli & Rose, 1990; DiPlacido, 1998;
Herek, 1989, 2000; Herek et al., 2002; Plummer, 2001; Thurlow, 2001). Unfortunately, religious
communities do not always act as a safe haven for LGBTQQA persons, with many Protestant,
Catholic, Islamic, and Judaic traditions viewing non-heteronormative sexualities as sinful and

 102
immoral (Lease et al., 2005; see also Clark et al., 1990; LeVay & Nonas, 1995; Melton, 1991;
Sherkat, 2002). In turn, LGBTQQA individuals who participate in organized religion can
experience decreased mental health (Gage Davidson, 2000; Mahaffy, 1996; Rodriguez &
Ouelette, 2000), including increased shame, depression, suicidal ideation, and difficulty
accepting their sexual identity (Schuck & Liddle, 2001).
This study aligns with others connecting religion to decreased mental health outcomes in
LGBTQQA persons (Gage Davidson, 2000; Mahaffy, 1996; Rodriguez & Ouelette, 2000;
Schuck & Liddle, 2001; Sowe et al., 2017), indicating spiritual trauma might be a linking factor
between LGBTQQA persons’ religious experiences and mental health concerns. However,
clients may not identify spiritual trauma as a presenting concern (Stone, 2013); thus clinicians
working with LGBTQQA persons would be wise to include questions about religious
involvement, and the client’s perceptions of religion during the assessment phase. Through a
review of the literature regarding social workers’ use of spirituality, Sheridan (2009) found that
the majority of social workers did not receive appropriate training on religious and spiritual
issues from professional education programs, putting social workers at risk of doing more harm
than benefit. Additionally, clinicians who included spirituality in assessments generally focus on
the helpful rather than the harmful impacts of spirituality and religion (Sheridan, 2009). Thus,
this researcher supports Sheridan’s (2009) recommendations for social work education and
research to address training in religious and spiritual assessment as well as to contribute to
additional research on both positive and negative impacts of religion and spirituality.
The findings from this study can also assist social workers involved in advocacy
activities. Whereas religious organizations are generally not controlled by democratic processes,
advocacy efforts are more likely to be focused on case advocacy than cause advocacy (Epstein,

 103
1981; Ezell, 1991, 2001). Part of this can include connecting LGBTQQA clients to supportive
systems, and providing those in their personal network with accurate information (Morrow,
1993). Social workers can also help clients to become empowered and more visible in their
religious communities, and to share their experiences (Griffin et al., 2004; Penney, 2013;
Woodford et al., 2013). However, a crucial part of facilitating empowerment among their clients
will first start with addressing any PTSD symptomology to help protect clients from being
retriggered when sharing their story.
Suggestions for Future Research
As research on spiritual trauma is still in its infancy, this area remains a fertile space for
future researchers. This study is the first known attempt to quantify LGBTQQA persons’
reactions to specific religious beliefs, teachings, and experiences with ecclesiastical leaders.
Thus, additional studies are recommended to replicate and confirm the findings presented in this
dissertation. While several items measuring spiritual trauma in this study are specific to LDS
Church doctrine and policy, many items could likely be used with other religious populations
with minor alteration. Additional testing is required to fully assess the psychometric properties of
this study’s spiritual trauma measure to identify any underlying factor structure, particularly as
this might align or deviate from existing conceptualization of spiritual trauma (see Purcell,
1998a, 1998b; Stone, 2013; Ward, 2011). Similarly additional research could examine the
validity of these items against other measures focused on spiritual trauma (Keller, 2016) or
homonegative prejudice (Sowe et al., 2017).
As noted by Sowe et al. (2017), future research would benefit from the inclusion of a
non-LGBTQQA comparison group. While research has continued to find connections between
religious engagement and decreased mental health outcomes in LGBTQQA populations, little is

 104
known about how anti-gay messages are perceived by the larger heterosexual and cisgender
populations, particularly among LGBTQQA straight allies or family members. It is plausible that
straight allies and family members also experience undue strain from messages punitive to the
LGBTQQA population.
Finally, while findings from this study provided support for the relationship between
spiritual trauma and PTSD, it did not provide any insight into the mechanisms that determine
why these messages and experiences are seen as harmful or beneficial. As noted previously,
Purcell (1998b) conceptualized spiritual trauma as a continuum “from terroristic to zero abuse”
(p. 227), with spiritual terrorism comprised of obvious abuses, as opposed to unintentional
abuses. Thus, it would be beneficial for future researchers to more deeply examine spiritually
traumatic events if perceived intent impacts spiritual trauma. Such research would not only
provide deeper understanding of the perceived trauma, but also further develop spiritual trauma
as a theoretical concept. Similarly, future research on specific types and sources of spiritual
trauma should further explore potential protective factors that could prevent religious messages
from triggering damage and PTSD in LGBTQQA populations. Prior research has shown family
acceptance as a protective factor against risky behaviors and mental health (Ryan & Rees, 2012);
additional research examining a potential relationship between family acceptance and
perceptions of spiritual trauma would be warranted.
Summary
This chapter provided discussion of the study findings with recommendations for social
work practice and research. Overall, participants in this study perceived LDS Church teachings,
messages, and experiences to be primarily damaging. When given the opportunity to identify
their religious experiences as helpful or damaging, on average participants identified 13.8 of

 105
possible experiences as “damaging” or “extremely damaging.” Participants’ perception of harm
due to their LDS experiences was directly correlated with PTSD symptomology. Nearly threequarters (73.4%, n=204) of respondents would have likely met criteria for PTSD diagnosis
related to their religious experiences. The prevalence of PTSD among study participants was ten
times greater than that for the general U.S. adult population (APA, 2000). While this study found
significant connections between spiritual trauma and PTSD, results did not show intrinsic, social, personal-extrinsic, or quest orientation to have any impact in participant’s perception of
spiritual trauma or reported PTSD symptomology. To better serve LGBTQQA clients, social
workers should address spirituality and religion as both protective and harmful factors during
assessment. Finally, future research should continue to examine spiritual trauma in an effort
further develop valid instruments that can advance the conceptual understanding of this
phenomenon and its impact on client functioning.

 106

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Szymanski, D. M., & Balsam, K. F. (2011). Insidious trauma: Examining the relationship
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http://nymag.com/daily/intelligencer/2015/01/mormons-to-excommunicate-gaymarriage-backer.html

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APPENDIX A
SAMPLE SOCIAL MEDIA MESSAGES
Facebook
October 6, 2016. Are you Mormon and LGBTQ? Have you felt conflicted between the
church and your same-gender attraction or gender identity? Please participate in this survey!
www.tinyurl.com/spiritualtrauma
Reconciling one’s LDS and sexual/gender identities can be challenging – potentially
resulting in the loss of family and friends, loss of church membership, and uncertainty about
salvation or life’s purpose. This research study will examine how religious orientation relates to
spiritual abuse among LGBTQQA Mormons by assessing protective spiritual and environmental
factors and potentially harmful religious messages. Participation in this study includes
completing a 30-45 minute online survey. Study participation is voluntary and confidential.
If you have questions about this study, please contact Brian Simmons at
brian.simmons@uga.edu. This dissertation research is being conducted under the direction of Dr.
Shari E. Miller in the School of Social Work at The University of Georgia.
November 22, 2016. The last few weeks have been tumultuous, with many people
seeking for a way to make their voice heard. Democracy is not dead; there are many ways to
share your voice. One often overlooked democratic tool is participating in research and surveys.
By sharing your voice with researchers, you help to build knowledge. No two experiences are
unique; share yours!
www.tinyurl.com/spiritualtrauma

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Please add your voice to my current study on the impact of religious orientation on
spiritual trauma among LGBTQ+ Mormons and former Mormons. If you've felt pain in being
LGBTQ+ and Mormon, I want to know. If you've found Mormonism strengthens your wellbeing, I want to know. Lend your voice to help us understand why some LGBTQ+ members
thrive spiritually, while others experience pain. Hopefully this research can help educate
professionals, spiritual leaders, and others on what spiritual messages LGBTQ+ members need.
This survey will take 30-45 minutes. PLEASE SHARE the survey link with your friends.
Please help to bring more voices to the discussion. Together, our voices can be strong.
January 3, 2017. The new year is a great time to review where you’ve been and where
you’re going. For many LGBTQ+ Mormons, this includes whether their path includes continued
LDS activity. For some, this question hinges on the difference between spiritual nourishment and
spiritual trauma. However, given the uniformity of LDS teaching and doctrine, why are some
LGBTQ+ Mormons spiritually fed while others are spiritually famished? To better understand
this question, I am currently researching the relationship between one’s religious orientation and
perceived benefit or trauma from LDS teachings and experiences.
http://tinyurl.com/SpiritualTrauma
If you are LGBTQ+ and Mormon (including former Mormons), I encourage you to add
your voice to this study. Over 175 people have already responded, but there are many more
experiences to be added. The survey is strictly confidential and takes approximately 30-45
minutes.
Please participate by January 31, 2017 to be included in this project. If willing, please
share the survey link (copy and paste from above) on your own Facebook wall.
January 20, 2017. Looking for a distraction from politics? Then take a survey!

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www.tinyurl.com/spiritualtrauma
This study is looking at how religious orientation impacts perceived benefit or harm from
religious messages and beliefs. The study is open to all LGBGQ+ Mormons and former
Mormons age 18 and over. The survey will take approximately 35 to 45 minutes and is
completely confidential.
Please participate by January 31st to be included in this study. Feel free to share the
survey link with your friends and networks.
January 25, 2017. LGBTQ+ Mormons and former Mormons --- there is just ONE
WEEK left to participate in this important study. Join your voice with the over 200 other people
who have already responded.
www.tinyurl.com/spiritualtrauma
This study is looking at how religious orientation impacts perceived benefit or harm from
religious messages and beliefs. The study is open to all LGBGQ+ Mormons and former
Mormons age 18 and over. The survey will take approximately 35 to 45 minutes and is
completely confidential.
Please participate by January 31st to be included in this study. Feel free to share the
survey link on your wall or other groups (please copy-paste this post rather than clicking “share”
to ensure more people can see it).
January 31, 2017. LAST CHANCE!!
TODAY IS THE LAST DAY to provide your voice to this important study for LGBTQ+
Mormons and former Mormons. Please lend your voice to help us better understand how
religious orientation impacts perceived benefit or harm from religious messages and beliefs.
www.tinyurl.com/spiritualtrauma

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Each experience is important – do not let your voice be silenced. The survey will take
approximately 35 to 45 minutes and is completely confidential. Please participate TODAY
(January 31st) to be included in this study. Feel free to share the survey link (copy-paste this post
rather than clicking “share” to ensure more people can see it).
Twitter
October 6, 2016. #Gay and #Mormon? Take this #survey on religious orientation &
#spiritual #trauma! tinyrul.com/SpiritualTrauma #lgbt #glbt #LDS #spiritualtrauma

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APPENDIX B
RECRUITMENT EMAIL
Hi,
I am a doctoral candidate under the direction of Dr. Shari E. Miller in the School of
Social Work at The University of Georgia. I am currently conducting my dissertation study
examining the relationship between religious orientation and spiritual trauma among lesbian,
gay, bisexual, transgender, queer, questioning, and asexual (LGBTQQA) Mormons or former
Mormons. I obtained your email address from your organization’s public website.
Your position as a director of a LGBT support/advocacy group in Utah, likely puts you in
contact with many LGBTQQA Mormons and former Mormons. Please help me in sharing this
survey information with your agency participants and network. This study is open to any
LGBTQQA Mormon or former Mormons over the age of 18.
http://tinyurl.com/SpiritualTrauma
You are likely quite aware of the challenges LGBTQQA Mormons might face in
reconciling their religious and sexual/gender identities. Sexual minorities and transgender people
who participate in organized religion can experience increased shame, depression, difficulty
accepting their identity, and even thoughts of suicide. This research study will examine how
religious orientation relates to spiritual abuse among LGBTQQA Mormons by assessing
protective spiritual and environmental factors and potentially harmful religious messages.

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Participation in this study includes completing a 30-45 minute online survey. Study participation
is voluntary and confidential. This research study has been approved by The University of
Georgia Institutional Review Board; telephone (706) 542-3199; email address irb@uga.edu.
Please share this email, survey link, and attached flyer with your agency staff and
participants. Feel free to post the survey link and a short message to your agency and personal
social media accounts.
Thank you,
Brian W. Simmons, MSW

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APPENDIX C
SURVEY INSTRUMENT
Q1 Informed Consent
Spiritual Trauma among LGBTQQA Mormons
I am a doctoral candidate under the direction of Dr. Shari E. Miller in the School of
Social Work at The University of Georgia. I invite you to participate in a research study,
“Spiritual Trauma among LGBTQQA Mormons.” The purpose of this study is to examine the
relationship between religious orientation and spiritual trauma among lesbian, gay, bisexual,
transgender, queer, questioning, and asexual (LGBTQQA) Mormons or former Mormons. This
study will focus on how LDS people have experienced same-sex attraction and transgenderism
over time, their religious orientation, their feelings about LDS teachings regarding sexuality and
gender, family and peer response, and ways they might have used religion to understand their
identity.
To participate in this study, you must be 1) a current or former member of The Church of
Jesus Christ of Latter-day Saints, 2) at least 18 years old, and 3) identify as lesbian, gay,
bisexual, transgender, queer, questioning, asexual, or same-sex (same-gender) attracted.
Your participation will involve completing a web-based survey and should take about 3045 minutes. Your involvement in the study is voluntary, and you may choose not to participate or
to stop at any time without penalty. If you decide to stop or withdraw from the study, the
information/data collected from or about you up to the point of your withdrawal will be kept as
part of the study and may continue to be analyzed. Upon completion of the online survey, you

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will be given the option to submit your email address to participate in additional research
regarding your experience as a LGBTQQA Mormon or former Mormon. Opting to provide your
email address does not constitute consent for any future study; additional research participation
will require a separate consent.
All survey responses will be kept confidential. Internet communications are insecure and
there is a limit to the confidentiality that can be guaranteed due to the technology itself.
However, once the materials are received by the researcher, standard confidentiality procedures
will be employed. Only the investigators will have access to the data, which will be downloaded
and stored on a password-protected computer. If you elect to provide your email address upon
completion of the online survey, this will be kept separate from your survey responses. The
results of the research study may be published, but your name or any identifying information will
not be used. In fact, the published results will be presented in summary form only.
There may not be any direct benefits to you from participating in this study; however,
you may benefit from the opportunity to reflect on your experiences. The findings from this
project may provide information on the experiences of same-sex attracted and transgender
Mormons, increasing the competence and sensitivity of the consumers of this research. There are
minimal risks associated with this research. To minimize the risk of a confidentiality breach,
response data will be secured via password protection known only to the researcher. If you feel
uncomfortable answering any question, you may skip the question(s) and proceed with the
questionnaire.
This study has been reviewed by the University of Georgia Institutional Review Board
under STUDY00003429. If you have any questions about this research project, please feel free to
call me at (706) 542-0586 or send an e-mail to brian.simmons@uga.edu. Questions or concerns

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about your rights as a research participant should be directed to The Chairperson, University of
Georgia Institutional Review Board; telephone (706) 542-3199; email address irb@uga.edu.
By taking this web-based survey, you are agreeing to participate in the above described
research project. Thank you for your time and consideration!

Sincerely,
Brian W. Simmons, MSW
Doctoral Candidate
School of Social Work
The University of Georgia

Q2 To affirm you are at least 18 years old and would like to participate in the study, please enter
the year you were born below.

Q3 If you prefer not to participate in the study, please indicate that in the box provided below.
I prefer not to participate in the study (1)

Q4 Instructions for Web Survey
You may take this survey on a standard computer, laptop, tablet, or cell phone. If you're
using a mobile device, some questions may display better in landscape orientation. Please note
that certain questions on this survey will appear or disappear depending on your previous
answers. Please do not use your browser's back or forward buttons to navigate through the
survey. Instead, please use the back and forward arrows found at the bottom of each page.
Completing this survey will take about 30-45 minutes. It is recommended you complete the

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survey in one sitting as to not lose previously entered responses. If you must return to a response
in progress, you must do so from the same Internet browser on the same computer (with cookies
enabled). In order to save your answers on a page, you must hit the forward button at the bottom
of the page. Your response is completed until you click "Submit" on the final page. If you have
questions, please contact Brian Simmons at brian.simmons@uga.edu.

Q5 First, please tell us a little bit about your previous and current involvement in the LDS
Church.
Q6 Were you . . . ?
Born in the church (1)
Converted after age 8 (2)
Prefer not to say (3)

Display This Question:
If Were you . . . ? Born in the church Is Not Selected

Q7 How old were you at baptism?

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Q8 Identify your past activity and leadership role(s) in the LDS Church (select all that apply)
Ordained to the Aaronic Priesthood (1)
YM quorum or YW group presidency (2)
Ordained to the Melchizedek Priesthood (3)
Temple endowed (4)
Served a mission (5)
Sealed to spouse in the temple (6)
Ward auxiliary presidency (such as Primary, Sunday School, Young Men/Women) (7)
Melchizedek Priesthood quorum presidency or Relief Society presidency (8)
Bishopric counselor (9)
Bishop (10)
Stake auxiliary presidency (such as Primary, Sunday School, Young Men/Women) (11)
Stake presidency counselor (12)
Stake president (13)
Mission presidency counselor (14)
Mission president or president's wife (15)
Temple presidency counselor (16)
Temple president or matron (17)
General authority (specify position, e.g. Area Presidency) (18) ____________________
If not described above, please specify (19) ____________________
Q9 Identify your current activity and leadership role(s) in the LDS Church (select all that apply)
Member without calling (1)
Temple recommend holder (2)
Home or visiting teacher (3)
Quorum or auxiliary teacher (4)
Ward auxiliary presidency (such as Primary, Sunday School, Young Men/Women) (5)
Melchizedek Priesthood quorum presidency or Relief Society presidency (6)
Bishopric counselor (7)
Bishop (8)
Stake auxiliary presidency (such as Primary, Sunday School, Young Men/Women) (9)
Stake presidency counselor (10)
Stake president (11)
Mission presidency counselor (12)
Mission president or president's wife (13)
Temple presidency counselor (14)
Temple president or matron (15)
General authority (specify position, e.g. Area Presidency) (16) ____________________
If not described above, please specify (17) ____________________

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Q10 Are you currently active in the LDS Church (attend at least once a month)?
Yes (1)
No (2)
Prefer not to say (3)

Q11 What is your current standing with the LDS Church?
Member in good standing (not currently under church discipline) (1)
Formal or informal probation (2)
Disfellowshipped (3)
Excommunicated (4)
Resigned (5)
Other (please specify) (6) ____________________
Prefer not to say (7)

Q12 Which (if any) best describes your current religious affiliation?
LDS (1)
Community of Christ (RLDS) (2)
Other Latter-day Saint faith (e.g. FLDS, Church of Christ, AUB) (3)
Agnostic (4)
Atheist (5)
Baptist (6)
Buddhist (7)
Catholic (8)
Episcopalian (9)
Hindu (10)
Jewish (11)
Lutheran (12)
Methodist (13)
Metropolitan Community Church (14)
Muslim (15)
Unitarian Universalism (16)
United Church of Christ (17)
If not described above, please specify: (18) ____________________
None (19)
Prefer not to say (20)

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Q13 The next sections will ask you about your gender and sexual identity.
Q14 What is your current gender identity?
Male (1)
Female (2)
Female-to-male/Transgender Male/Trans Male (3)
Male-to-female/Transgender Female/Trans Woman (4)
Genderqueer, neither exclusively male or female (5)
Other (please specify) (6) ____________________
Prefer not to say (7)

Q15 What was your assigned gender at birth?
Male (1)
Female (2)
Intersex (3)
Prefer not to say (4)

Q16 Is the gender on your LDS Church records consistent with your gender at birth?
Yes (1)
No (2)
Don't know (3)

Q17 Do you think of yourself as . . . ?
Lesbian or gay (1)
Same-sex (same-gender) attracted (2)
Straight, that is, not gay (3)
Bisexual (4)
Something else (5)
Don't know (6)
Prefer not to say (7)

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Display This Question:
If Do you think of yourself as . . . ? Something else Is Selected

Q18 By something else, do you mean that . . . ?
You are not straight, but identify with another label such as queer, trisexual, omnisexual, or
pansexual? (1)
You have not or are in the process of figuring out your sexuality (2)
You do not think of yourself as having a sexuality (3)
You personally reject all labels of yourself (4)
You made a mistake and did not mean to pick this answer (5)
You mean something else. What do you mean by something else? (6)
____________________
Prefer not to say (7)

Display This Question:
If Do you think of yourself as . . . ? Don't know Is Selected

Q19 By don't know, do you mean that . . . ?
You don’t understand the words (1)
You understand the words, but you have not or are in the process of figuring out your
sexuality (2)
You mean something else. What do you mean by something else? (3)
____________________
Prefer not to say (4)

Q20 Regarding your lifetime feelings of sexual attraction, please indicate where you position
yourself from exclusively opposite-sex oriented to exclusively same-sex oriented.
Exclusively opposite sex (1)
Mostly opposite sex, only minimally same sex (2)
Mostly opposite sex, but more than minimally same sex (3)
Equally opposite and same sex (4)
Mostly same sex, but more than minimally opposite sex (5)
Mostly same sex, only minimally opposite sex (6)
Exclusively same sex (7)
Asexual or nonsexual (8)
Don't Know (9)
Prefer not to say (10)

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Q21 Regarding your lifetime sexual behaviors/experiences, please indicate where you position
yourself from exclusively opposite-sex oriented to exclusively same-sex oriented.
Exclusively opposite sex (1)
Mostly opposite sex, only minimally same sex (2)
Mostly opposite sex, but more than minimally same sex (3)
Equally opposite and same sex (4)
Mostly same sex, but more than minimally opposite sex (5)
Mostly same sex, only minimally opposite sex (6)
Exclusively same sex (7)
Asexual or never engaged in sexual behaviors (8)
Don't Know (9)
Prefer not to say (10)

Q22 What was the earliest age (in years) that you began to sense a difference (in feeling,
attitudes, or behaviors) between yourself and others of your same age and biological sex that you
now attribute to your sexual orientation?

Q23 At what age did you first realize you were attracted romantically or sexually to persons of
the same sex?

Q24 How old were you when you experienced your first same-sex romantic or sexual
experience? If you have never had a same-sex romantic or sexual experience, please enter "0."

Q25 How old were you when you first labeled yourself gay, lesbian, bisexual, questioning,
queer, same-sex attracted, or another personal label you have chosen for yourself?

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Q26 How old were you when you first told someone of your sexual identity or attraction? If you
have never told anyone of your sexual identity or attraction, please enter "0."
Q27 Overall, to what degree are you currently "out" regarding your sexual orientation?
I have not told anyone about my sexual orientation (1)
I have told only a few of the people I trust the most. (2)
I have told less than half of the people about my sexual orientation (3)
I have told more than half of the people about my sexual orientation (4)
I have told most people in most settings (e.g., work, school, friends, family) (5)
I am totally open about my sexual orientation (6)
Prefer not to say (7)

Display This Question:
If Overall, to what degree are you "out" regarding your sexual orientation? I have not told anyone
about my sexual orientation Is Not Selected

Q28 Please rank which persons you are most comfortable disclosing your sexual orientation: (1
being most comfortable and 5 being least comfortable).Please click and hold to drag into the
correct order.
______ Immediate family (1)
______ Friends (2)
______ Coworkers or Classmates (3)
______ People in your church congregation (4)
______ Others (please specify) (5)
Q29 What was the earliest age (in years) that you began to sense a difference (in feeling,
attitudes, or behaviors) between yourself and others of your same age and biological sex that you
now attribute to your gender identity?

Q30 How old were you when you first labeled yourself transgender, transsexual, genderqueer,
agender, gender variant, or another personal label you have chosen for yourself?

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Q31 How old were you when you first told someone of your gender identity? If you have never
told someone of your gender identity, please enter "0."
Q32 Overall, to what degree are you "out" regarding your gender identity?
I have not told anyone about my gender identity (1)
I have told only a few of the people I trust the most. (2)
I have told less than half of the people about my gender identity (3)
I have told more than half of the people about my gender identity (4)
I have told most people in most settings (e.g., work, school, friends, family) (5)
I am totally open about my gender identity (6)
Prefer not to say (7)

Display This Question:
If Overall, to what degree are you "out" regarding your gender identity? I have not told anyone about
my gender identity Is Not Selected

Q33 Please rank which persons you are most comfortable disclosing your gender identity: (1
being most comfortable and 5 being least comfortable).Please click and hold to drag into the
correct order.
______ Immediate family (1)
______ Friends (2)
______ Coworkers or Classmates (3)
______ People in your church congregation (4)
______ Others (please specify) (5)
Q34 To better understand your experiences as a LGBTQQA Mormon in the church, please think
of a period when you felt the most concern about being LGBTQQA and Mormon. This could
include concern regarding your "fit" with church doctrines, acceptance from other church
members, standing with God, or future as a LDS church member.
Approximately how old were you (in years) when you felt the most concern about these
issues?

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Q35 During this time of most concern, were you "out" to any of the following persons? (Select
all that apply)
Siblings (1)
Parents (2)
Friends (3)
Coworkers or Classmates (4)
LDS Church Leaders (5)
LDS Ward Members (6)
Other (7) ____________________
None (I was not out to anyone at that time) (8)

Q36 When you were approximately (Q34 Response), in which country did you reside?
United States (1)
Mexico (2)
Canada (3)
Other (please specify) (4) ____________________
Prefer not to say (5)

Q37 How would you describe the community you lived in when you were approximately (Q34
Response)?
Rural (1)
Suburban (2)
Urban (3)
Other: (please describe) (4) ____________________

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Display This Question:
If When you were approximately (Q34 Response), in which country did you reside? United States Is
Selected

Q38 When you were approximately (Q34 Response), in which state did you reside?
Utah (1)
California (2)
Idaho (3)
Arizona (4)
Alabama (5)
Alaska (6)
Arkansas (7)
Colorado (8)
Connecticut (9)
Delaware (10)
District of Columbia (DC) (11)
Florida (12)
Georgia (13)
Hawaii (14)
Illinois (15)
Indiana (16)
Iowa (17)
Kansas (18)
Kentucky (19)
Louisiana (20)
Maine (21)
Maryland (22)
Massachusetts (23)
Michigan (24)
Minnesota (25)
Mississippi (26)
Missouri (27)
Montana (28)
Nebraska (29)
Nevada (30)
New Hampshire (31)
New Jersey (32)
New Mexico (33)
New York (34)
North Carolina (35)
North Dakota (36)

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Ohio (37)
Oklahoma (38)
Oregon (39)
Pennsylvania (40)
Rhode Island (41)
South Carolina (42)
South Dakota (43)
Tennessee (44)
Texas (45)
Vermont (46)
Virginia (47)
Washington (48)
West Virginia (49)
Wisconsin (50)
Wyoming (51)
Prefer not to say (52)

Q39 We would now like to ask you some questions regarding your religious beliefs and activity
during the period when you felt the most concerned about being LGBTQQA and Mormon. In the
following sections, please respond according to how you thought and felt when you were
approximately (Q34 Response).

Q40 I enjoyed reading about my religion.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

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Q41 I went to church because it helped me to make friends.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q42 It didn't much matter what I believed so long as I was good.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q43 It was important to me to spend time in private thought and prayer.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q44 Please respond according to how you thought and felt when you were approximately (Q34
Response).

Q45 I often had a strong sense of God's presence.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

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Q46 I prayed mainly to gain relief and protection.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q47 I tried hard to live all my life according to my religious beliefs.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q48 What religion offered me most was comfort in times of trouble and sorrow.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q49 Please respond according to how you thought and felt when you were approximately (Q34
Response).

Q50 Prayer was for peace and happiness.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

 152
Q51 Although I was religious, I didn't let it affect my daily life.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q52 I went to church mostly to spend time with my friends.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q53 My whole approach to life was based on my religion.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q54 Please respond according to how you thought and felt when you were approximately (Q34
Response).

Q55 I went to church mainly because I enjoyed seeing people I know there.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

 153
Q56 Although I believed in my religion, many other things were more important in life.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q57 I believed the president of the LDS Church was a prophet of God.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q58 I believed the Book of Mormon was the word of God.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q59 Please respond according to how you thought and felt when you were approximately (Q34
Response).

Q60 I believed The Church of Jesus Christ of Latter-day Saints was the only true church on
earth.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

 154
Q61 I believed Joseph Smith actually saw God the Father and Jesus Christ.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q62 I believed the Book of Mormon contained no errors or contradictions
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q63 I believed Mormons should not let themselves be influenced by worldly ideas.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q64 Please respond according to how you thought and felt when you were approximately (Q34
Response).

Q65 I believed living prophets imparted true teachings of God.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

 155
Q66 I believed Mormons must know and follow the teachings of God’s ancient and modern
prophets.
I strongly disagree (1)
I tend to disagree (2)
I am not sure (3)
I tend to agree (4)
I strongly agree (5)

Q67 Please rate the following statements regarding your religious beliefs when you were
approximately (Q34 Response). Simply click along the line to move the slider to your desired
response from Strongly Disagree (0) to Strongly Agree (9).

Q68 I was not very interested in religion until I began to ask questions about the meaning and
purpose of my life

Q69 I was driven to ask religious questions out of a growing awareness of the tensions in my
world and in my relation to my world.

Q70 My life experiences led me to rethink my religious convictions.

Q71 God wasn't very important for me until I began to ask questions about the meaning of my
own life.

 156
Q72 Please rate the following statements regarding your religious beliefs when you were
approximately (Q34 Response). Simply click along the line to move the slider to your desired
response from Strongly Disagree (0) to Strongly Agree (9).

Q73 It might be said that I valued my religious doubts and uncertainties.

Q74 For me, doubting was an important part of what it meant to be religious.

Q75 I found religious doubts upsetting.

Q76 Questions were far more central to my religious experience than were answers.

Q77 Please rate the following statements regarding your religious beliefs when you were
approximately (Q34 Response). Simply click along the line to move the slider to your desired
response from Strongly Disagree (0) to Strongly Agree (9).

Q78 As I grew and changed, I expected my religion also to grow and change.

Q79 I was constantly questioning my religious beliefs.

Q80 I did not expect my religious convictions to change in the next few years.

Q81 There were many religious issues on which my views were still changing.

 157
Q82 Please answer the following questions regarding your relationship with Mormonism when
you were approximately (Q34 Response).

Q83 Some doctrines of the LDS Church were hard for me to accept.
Not at all (1)
Slightly (2)
Somewhat (3)
Moderately (4)
Exactly (5)

Q84 I didn't really care about the LDS Church.
Not at all (1)
Slightly (2)
Somewhat (3)
Moderately (4)
Exactly (5)

Q85 I didn't accept some of the standards of the LDS Church.
Not at all (1)
Slightly (2)
Somewhat (3)
Moderately (4)
Exactly (5)

Q86 The LDS Church put too many restrictions on its members.
Not at all (1)
Slightly (2)
Somewhat (3)
Moderately (4)
Exactly (5)

 158
Q87 Church programs and activities were an important part of my life.
Not at all (1)
Slightly (2)
Somewhat (3)
Moderately (4)
Exactly (5)

Q88 When you were approximately (Q34 Response), how often did you . . . ?

Q89 Have family religious discussions?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q90 Have family discussions about right or wrong?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

 159
Q91 Have personal scripture study?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q92 Have personal prayer?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q93 When you were approximately (Q34 Response), how often did you . . . ?

Q94 Fast?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

 160
Q95 Attend church services?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q96 Attend church social activities (i.e. WM/YW, ward activities)?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q97 Engage in church callings?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

 161
Q98 When you were approximately (Q34 Response), how often did you . . . ?

Q99 Have family prayer?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q100 Have family scripture study?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

Q101 Have Family Home Evening (FHE)?
Never (1)
A few times a year (2)
Monthly (3)
A few times a month (4)
Weekly (5)
A few times a week (6)
Daily (7)

 162
Q102 How would you describe yours and your family's commitment to LDS doctrines when you
were approximately (Q34 Response)?
Orthodox: a traditional, staunch, or conservative believer. Unorthodox: a progressive,
flexible, or questioning believer.

Q103 Yourself
Extremely orthodox (1)
Orthodox (2)
Neutral (3)
Unorthodox (4)
Extremely unorthodox (5)

Q104 Mother or stepmother
Extremely orthodox (1)
Orthodox (2)
Neutral (3)
Unorthodox (4)
Extremely unorthodox (5)
Not applicable (was not a member) (6)

Q105 Father or stepfather
Extremely orthodox (1)
Orthodox (2)
Neutral (3)
Unorthodox (4)
Extremely unorthodox (5)
Not applicable (was not a member) (6)

 163
Q106 Siblings or stepsiblings
Extremely orthodox (1)
Orthodox (2)
Neutral (3)
Unorthodox (4)
Extremely unorthodox (5)
Not applicable (was not a member) (6)

Q107 The next few questions will ask about your relationship with others during the period when
you felt the most concerned about being LGBTQQA and Mormon.
How well do these statements describe your family relationships due to your sexual or
gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how you believe the
relationship would have been.

Q108 I was included in family events and was asked to bring my close friend(s).
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q109 My family were friendly with my partner(s).
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

 164
Q110 My family told me that I should seek help to change my sexual or gender identity.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q111 My family told me that it would be a good idea for me to date members of the opposite
sex.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q112 How well do these statements describe your family relationships due to your sexual or
gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how you believe the
relationship would have been.

Q113 My family told me that I was intentionally hurting them.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

 165
Q114 My family asked me how my relationships were going.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q115 My family offered me support in my relationships.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q116 How often did your LDS (step)parents or (step)siblings do the following due to your actual
or perceived sexual or gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how you believe they
would have acted.

Q117 I was teased or ridiculed by family members saying things to me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 166
Q118 I was pushed, shoved, hit, or kicked.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q119 A family member made rude or derogatory remarks at me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q120 A family member ignored me when they were with other people.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q121 How often did your LDS (step)parents or (step)siblings do the following due to your actual
or perceived sexual or gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how you believe they
would have acted.

 167
Q122 Jokes were made up about me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q123 A family member got others to turn against me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q124 My property was damaged on purpose.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q125 Things were said about my looks I didn’t like.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 168
Q126 How often did your LDS (step)parents or (step)siblings do the following due to your actual
or perceived sexual or gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how you believe they
would have acted.

Q127 A family member started a rumor about me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q128 I was threatened to be physically hurt or harmed.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q129 I was left out of activities, games on purpose.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 169
Q130 I was called names I didn’t like.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q131 How accepting were your LDS family members of your sexual or gender identity when
you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, how accepting did you believe they
would have been?
Extremely rejecting (1)
Rejecting (2)
Neither rejecting or accepting (3)
Accepting (4)
Extremely accepting (5)

Q132 How well do these statements describe your relationships with LDS peers (friends, ward
members, etc) due to your sexual or gender identity when you were approximately (Q34
Response)?
If they were unaware of your sexual or gender identity, respond how believe the
relationship would have been.

 170
Q133 I was included in church events and was asked to bring my close friend(s).
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q134 LDS peers or ward members were friendly with my partner(s).
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q135 LDS peers or ward members told me that I should seek help to change my sexual or gender
identity.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q136 LDS peers or ward members told me that it would be a good idea for me to date members
of the opposite sex.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

 171
Q137 How well do these statements describe your relationships with LDS peers (friends, ward
members, etc) due to your sexual or gender identity when you were approximately (Q34
Response)?
If they were unaware of your sexual or gender identity, respond how believe the
relationship would have been.

Q138 LDS peers or ward members told me that I was intentionally hurting them.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q139 LDS peers or ward members asked me how my relationships were going.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

Q140 LDS peers or ward members offered me support in my relationships.
Uncertain (1)
Never true (2)
Rarely true (3)
Sometimes true (4)
Always true (5)

 172
Q141 How often did LDS peers (friends, ward members, etc) do the following due to your actual
or presumed sexual or gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how believe they would
have acted.

Q142 I was teased or ridiculed by LDS peers saying things to me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q143 I was pushed, shoved, hit, or kicked.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q144 An LDS peer wouldn’t be friends with me because other people didn’t like me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 173
Q145 An LDS peer made rude or derogatory remarks at me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q146 How often did LDS peers (friends, ward members, etc) do the following due to your actual
or presumed sexual or gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how believe they would
have acted.

Q147 Jokes were made up about me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q148 An LDS peer got their friends to turn against me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 174
Q149 My property was damaged on purpose.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q150 Things were said about my looks I didn’t like.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q151 How often did LDS peers (friends, ward members, etc) do the following due to your actual
or presumed sexual or gender identity when you were approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, respond how believe they would
have acted.

Q152 An LDS peer started a rumor about me.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 175
Q153 I was threatened to be physically hurt or harmed.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q154 I was left out of activities, games on purpose.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

Q155 I was called names I didn’t like.
Never (1)
Sometimes (2)
Once or twice a month (3)
Weekly (4)
Several times a week (5)
Daily or nearly daily (6)

 176
Q156 How accepting were your LDS peers of your sexual or gender identity when you were
approximately (Q34 Response)?
If they were unaware of your sexual or gender identity, how accepting did you believe they
would have been?
Extremely rejecting (1)
Rejecting (2)
Neither rejecting or accepting (3)
Accepting (4)
Extremely accepting (5)

Q157 The following section will ask about experiences you might have had with LDS leaders or
teachings throughout your lifetime. Please consider all interactions you have had with the LDS
church and its leaders.
The following is a list of way LDS leaders might respond to LGBTQQA church
members. Even if your LDS leaders were unaware of your sexual or gender identity, they might
have expressed these attitudes generally.
Please indicate how these responses have ever impacted you. If you never encountered
these responses from LDS leadership, please select “Not Applicable.”

Q158 Counsel you to not focus on your sexual or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 177
Q159 Counsel you to not speak to others about your sexual or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q160 Counsel you to not identify as gay, lesbian, bisexual, homosexual, or transgender.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q161 Counsel you to separate your sexual attractions from your sexual behaviors.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q162 Please indicate how these responses from LDS leaders have ever impacted you. If you
never encountered these responses from LDS leadership, please select “Not Applicable.”

 178
Q163 Associate your sexual or gender identity with pedophilia.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q164 Associate your gender or sexual identity with an addiction or other temptation.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q165 Encourage you to seek professional treatment to change your sexual or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q166 Encourage heterosexual marriage as a solution for your sexual or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 179
Q167 Please indicate how these responses from LDS leaders have ever impacted you. If you
never encountered these responses from LDS leadership, please select “Not Applicable.”

Q168 Encourage you to increase your religious participation (attendance, prayer, fasting, temple
worship, etc) to change your sexual or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q169 "Out" you to your family, friends or other church members.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q170 Threaten your church membership because of your gender or sexual identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 180
Q171 Threaten your church membership because of your same-sex relationships or gender nonconforming appearance/behavior.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q172 The following is a list of concepts you may have been taught or believed regarding your
sexual or gender identity. Please indicate how these teachings or beliefs have ever impacted you.
If you never encountered these teachings or beliefs, please select “Not Applicable.”

Q173 God would punish me for my sexual attractions.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q174 I would be excommunicated for my sexual attractions.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 181
Q175 I would be eternally separated from my family for my sexual attractions.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q176 God would punish me for my same-sex sexual behaviors.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q177 Please indicate how these teachings or beliefs have ever impacted you. If you never
encountered these teachings or beliefs, please select “Not Applicable.”

Q178 I would be excommunicated for my same-sex sexual behaviors.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 182
Q179 I would be eternally separated from my family for my same-sex sexual behaviors.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q180 God would punish me for not identifying as my assigned gender.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q181 I would be excommunicated for not identifying as my assigned gender.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q182 Please indicate how these teachings or beliefs have ever impacted you. If you never
encountered these teachings or beliefs, please select “Not Applicable.”

 183
Q183 I would be eternally separated from my family for not identifying as my assigned gender.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q184 Heterosexual marriage would change my sexual or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q185 I would not be exalted without heterosexual marriage.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q186 Homosexuality was a sin.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 184
Q187 Please indicate how these teachings or beliefs have ever impacted you. If you never
encountered these teachings or beliefs, please select “Not Applicable.”

Q188 A stronger belief in God would change my homosexuality or gender identity.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q189 I needed to change my sexual or gender identity to be acceptable before God.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q190 My sexual or gender identity would be changed after death.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 185
Q191 Life-long celibacy was required for me to return to God.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q192 Please indicate how these teachings or beliefs have ever impacted you. If you never
encountered these teachings or beliefs, please select “Not Applicable.”

Q193 Satan seeks to confuse gender and gender roles.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q194 Gender roles were ordained of God.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

 186
Q195 Gender was a fixed, eternal characteristic.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q196 God intended me to live as the gender I was assigned at birth.
Extremely beneficial (1)
Beneficial (2)
Neither damaging or beneficial (3)
Damaging (4)
Extremely damaging (5)
Not Applicable (6)

Q197 Now we would like to ask you about how you might have responded to your experiences
with LDS leadership/teachings and the conflict you felt about your sexual/gender identity. The
following is a list of statements that people sometimes have in response to concern about being
LGBTQQA and Mormon. Please read each statement carefully and then indicate how much you
have ever been bothered by that problem. Please note, religious experiences can include personal
religious activities (scripture study, prayer, etc.) or involvement with church activities (meeting
attendance, serving in callings, conversations with leadership, temple worship, etc).

Q198 I felt emotionally numb.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

 187
Q199 My heart started pounding when I thought about my religious beliefs or experiences.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q200 It seemed as if I was reliving previous religious experiences.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q201 I had trouble sleeping.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q202 I felt discouraged about the future.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q203 Please read each statement carefully and then indicate how much you have ever been
bothered by that problem in response to being LGBTQQA and Mormon. Religious experiences
can include personal religious activities or involvement with formal church activities.

 188
Q204 Reminders of my religious beliefs or experiences upset me.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q205 I had little interest in being around others, particularly those from the LDS community.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q206 I felt jumpy.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q207 I was less active than usual.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

 189
Q208 I thought about my religious beliefs or experiences when I didn't intend to.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q209 Please read each statement carefully and then indicate how much you have ever been
bothered by that problem in response to being LGBTQQA and Mormon. Religious experiences
can include personal religious activities or involvement with formal church activities.

Q210 I had trouble concentrating.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q211 I avoided people, places, or things that reminded me of my religious beliefs or experiences.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q212 I had disturbing dreams about my religious beliefs or experiences.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

 190
Q213 I wanted to avoid aspects of my religious beliefs or experiences.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q214 I was easily annoyed.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q215 Please read each statement carefully and then indicate how much you have ever been
bothered by that problem in response to being LGBTQQA and Mormon. Religious experiences
can include personal religious activities or involvement with formal church activities.

Q216 I expected something bad to happen.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

Q217 I noticed gaps in my memory about religious experiences.
Never (1)
Rarely (2)
Occasionally (3)
Often (4)
Very often (5)

 191
Q218 Now we would like to ask you about how you might have coped with conflict you felt
about your sexual/gender identity and Mormonism.
Please read the statements listed below and please indicate to what extent each of the
following was ever involved in your coping with being LGBTQQA and Mormon.

Q219 Trusted that God would not let anything terrible happen to me.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q220 Experienced God's love and care.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q221 Realized that God was trying to strengthen me.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q222 In dealing with the problem, I was guided by God.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

 192
Q223 Realized that I didn't have to suffer since Jesus suffered for me.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q224 Please read the statements listed below and please indicate to what extent each of the
following was ever involved in your coping with being LGBTQQA and Mormon.

Q225 Used Christ as an example of how I should live.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q226 Took control over what I could and gave the rest to God.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q227 My faith showed me different ways to handle the problem.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

 193
Q228 Accepted the situation was not in my hands but in the hands of God.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q229 Found the lesson from God in the event.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q230 Please read the statements listed below and please indicate to what extent each of the
following was ever involved in your coping with being LGBTQQA and Mormon.

Q231 God showed me how to deal with the situation.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q232 Used my faith to help me decide how to cope with the situation.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

 194
Q233 Tried to be less sinful.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q234 Confessed my sins.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q235 Led a more loving life.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q236 Please read the statements listed below and please indicate to what extent each of the
following was ever involved in your coping with being LGBTQQA and Mormon.

Q237 Attended religious services or participated in religious rituals.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

 195
Q238 Participated in church groups (support groups, prayer groups, religious studies).
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q239 Provided help to other church members.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q240 Felt angry with or distant from God.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q241 Felt angry with or distant from the members of the church.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q242 Please read the statements listed below and please indicate to what extent each of the
following was ever involved in your coping with being LGBTQQA and Mormon.

 196
Q243 Questioned my religious beliefs and faith.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q244 Received support from the clergy.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q245 Received support from other members of the church.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q246 Asked for a miracle.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q247 Bargained with God to make things better.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

 197
Q248 Please read the statements listed below and please indicate to what extent each of the
following was ever involved in your coping with being LGBTQQA and Mormon.

Q249 Asked God why it happened.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q250 Focused on the world-to-come rather than the problems of this world.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q251 I let God solve my problems for me.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

Q252 Prayed or read the scriptures to keep my mind off my problems.
Not at all (1)
Somewhat (2)
Quite a bit (3)
A great deal (4)

 198
Q253 Before we finish, tell us a little bit more about your background. In which country do you
currently reside?
United States (1)
Mexico (2)
Canada (3)
Other (please specify) (4) ____________________
Prefer not to say (5)

Display This Question:
If Before we finish, tell us a little bit more about your background. In which country do you presen...
United States Is Selected

Q254 In which state do you currently reside?
Utah (1)
California (2)
Idaho (3)
Arizona (4)
Alabama (5)
Alaska (6)
Arkansas (7)
Colorado (8)
Connecticut (9)
Delaware (10)
District of Columbia (DC) (11)
Florida (12)
Georgia (13)
Hawaii (14)
Illinois (15)
Indiana (16)
Iowa (17)
Kansas (18)
Kentucky (19)
Louisiana (20)
Maine (21)
Maryland (22)
Massachusetts (23)
Michigan (24)
Minnesota (25)
Mississippi (26)

 199
Missouri (27)
Montana (28)
Nebraska (29)
Nevada (30)
New Hampshire (31)
New Jersey (32)
New Mexico (33)
New York (34)
North Carolina (35)
North Dakota (36)
Ohio (37)
Oklahoma (38)
Oregon (39)
Pennsylvania (40)
Rhode Island (41)
South Carolina (42)
South Dakota (43)
Tennessee (44)
Texas (45)
Vermont (46)
Virginia (47)
Washington (48)
West Virginia (49)
Wisconsin (50)
Wyoming (51)
Prefer not to say (52)

Q255 Are you Hispanic, Latino, or Spanish origin?
Yes (1)
No (2)
Prefer not to say (3)

 200
Q256 What is your race? (Select all that apply)
White (1)
Black or African American (2)
American Indian or Alaska Native (3)
Asian (4)
Native Hawaiian or Other Pacific Islander (5)
Other (please specify) (6) ____________________
Prefer not to say (7)

Q257 What is the highest level of education you have completed?
Less than high school (1)
High school graduate or GED (2)
Some college but no degree (3)
Occupational/vocational program (4)
Associate degree (5)
Bachelor’s degree (BA/BS) (6)
Master’s degree (MS, MA, MSW, MBA) (7)
Professional degree (MD, DDS, DVM, LLV, JD) (8)
Doctorate degree (PhD, EdD) (9)
Other (please specify) (10) ____________________
Prefer not to say (11)

 201
Q258 What is your current relationship status?
Single (never married) (1)
Married heterosexual relationship (2)
Married same-sex relationship (3)
Civil union (heterosexual relationship) (4)
Civil union (same-sex relationship) (5)
Domestic partnership (heterosexual relationship) (6)
Domestic partnership (same-sex relationship) (7)
Unmarried, but committed to opposite sex partner (8)
Unmarried, but committed to same-sex partner (9)
Separated (heterosexual marriage) (10)
Separated (same-sex marriage) (11)
Divorced (heterosexual marriage) (12)
Divorced (same-sex marriage) (13)
Widowed (heterosexual marriage) (14)
Widowed (same-sex marriage) (15)
Other (please describe) (16) ____________________
Prefer not to say (17)

Q259 Have you ever been heterosexually married?
Yes (1)
No (2)
Prefer not to say (3)

Display This Question:
If Have you ever been heterosexually married? Yes Is Selected

Q260 How many years were/are you heterosexually married?

Display This Question:
If Have you ever been heterosexually married? Yes Is Selected

Q261 Is this your current relationship?
Yes (1)
No (2)
Prefer not to say (3)

 202
Q262 Do you have any additional experiences you would like to share regarding your
experiences being LGBTQQA and Mormon?

Q263 Would you like to be contacted to participate in additional studies related to your
experiences as a LGBTQQA Mormon or former Mormon? If you select yes, you will be
redirected to a separate survey to provide your email address.
Yes (1)
No (2)
Prefer not to say (3)