China's 2017 Censorship Policy and Attitudes Towards Same-Sex Behavior: An Interrupted Time Series Analysis.

Public attitudes toward sexual and gender minority (SGM) populations have important implications for health outcomes and human rights. This study examined how China's 2017 censorship policy restricting media portrayals of SGM populations was associated with attitudes towards same-sex behavior using data from the Chinese General Social Survey (2010-2021, N = 66,057). Using interrupted time series analysis, we found that the policy was associated with a significant shorter-term decrease in positive attitudes (OR = 0.73, 95% CI: 0.62 to 0.85, p < 0.001), with males (38% lower odds, OR = 0.62, 95% CI: 0.44 to 0.88, p = 0.007) showing larger decreases than females (17% lower odds, OR = 0.83, 95% CI: 0.68 to 1.01, p = 0.065; interaction OR = 0.75, 95% CI: 0.56 to 0.99, p = 0.048). In the longer term, trajectories diverged by internet usage: frequent internet users' annual increase in positive attitudes slowed from 14% (OR = 1.14, 95% CI: 1.11 to 1.17, p < 0.001) before the policy to 7% after (OR = 1.07, 95% CI: 0.90 to 1.28, p = 0.453), while infrequent users' increase accelerated from 14% (OR = 1.14, 95% CI: 1.11 to 1.17, p < 0.001) to 23% (OR = 1.23, 95% CI: 1.09 to 1.38, p < 0.001; interaction OR = 0.87, 95% CI: 0.77 to 0.99, p = 0.037). These findings highlight complex relationships between media censorship and attitude formation, with relevance for understanding how information control policies may shape societal acceptance of SGM populations.