Tuesday, October 12, 2010

Suicide Risk and Prevention for Lesbian, Gay, Bisexual, and Transgender Youth - Suicide Prevention Resource Center (SPRC)

Scope of the Problem: Suicide Deaths Among LGB Youth

Suicide is the eleventh leading cause of death overall in the United States, and the third leading cause of death for youth age 15 through 24, following unintentional injuries and homicide. However, data on suicide rates—the number of suicide deaths per 100,000 of population—reveal that the rate for this age group is 10 per 100,000, below the national rate of 11.01 per 100,000 for people of all ages (Centers for Disease Control and Prevention, 2007).

Little can be said with any certainty about the extent of suicide deaths among LGB youth. Sexual orientation is not usually included in a cause of death report or on a death certificate. Even if information on sexual orientation was included in a police or a medical examiner’s report, the National Vital Statistics System that aggregates these reports at the state and national levels does not include this information. This is a significant omission: the National Vital Statistics System is a primary source of data for public health researchers studying any cause of mortality, including suicide.

Newspaper obituaries rarely make reference to the sexual orientation of the deceased or to the cause of death when suicide is involved. Families and friends may not know—or be willing to discuss—the sexual orientation of a person who died, especially by his or her own hand (Lebson, 2002).
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Overview of the Data on Suicide Attempts Among LGB Youth

Studies that compare the rate of suicide attempts among LGB youth with those among heterosexual youth show significantly higher rates for LGB youth:

• Remafedi and colleagues (Remafedi, French, Story, Resnick, & Blum, 1998) found that 28.1 percent of gay or bisexual males in grades 7 through 12 had attempted suicide at least once during their lives, while only 4.2 percent of heterosexual males in those grades had attempted suicide. The corresponding percentages for females were 20.5 percent for lesbian or bisexual females and 14.5 percent for heterosexual females.

• The Massachusetts Youth Risk Behavior Survey reported that LGB high school students in Massachusetts were more than four times as likely as the state’s non-LGB students to have attempted suicide in the last year (Massachusetts Department of Education, 2006b).

• Safren and Heimberg (1999) reported that 30 percent of LGB youth versus 13 percent of heterosexual youth (mean age of about 18) had attempted suicide at some point.

• Garofalo and colleagues (1999) found that high school students identifying as either LGB or not sure of their sexual orientation were 3.4 times as likely to have attempted suicide within the last 12 months as their heterosexual peers.

• D’Augelli and Hershberger (1995) found that LGB youth were three times as likely to have attempted suicide as heterosexual youth.

Russell and Joyner (2001) found that the risk of attempting suicide was twice as high among LGB youth as among heterosexual youth.

• Eisenberg and Resnick (2006) found that LGB students in grades 9 and 12 were significantly more likely to have attempted suicide than their heterosexual peers. 52.4 percent of LB females and 29.0 percent of GB males had attempted suicide. The percentages of non-GLB females and males who had attempted suicide were 24.8 and 12.6 percent respectively.

• A study in New Zealand found that 32.1 percent of LGB youth through age 21 had attempted suicide, whereas only 7.1 percent of same-age heterosexual youth had made such an attempt (Fergusson, Horwood, & Beautrais, 1999).

Several other studies reported dramatic suicide attempt rates among young LGB people, but these studies do not include comparison groups. In such cases, it is useful to compare the data with a range: population studies suggest that a range of 4 to 8 percent of all young people have attempted suicide by age 20 (Beautrais, 2003). In contrast, non-comparison studies of LGB youth found that the following percentages of lesbian, gay, and/or bisexual youth had attempted suicide at some point over the life course:

• 40.3 percent of LGB people up to age 21 (Proctor & Groze, 1994)

• 37 percent of LGB youth ages 14 to 21 (D’Augelli, 2002)

• 33 percent of GB males ages 15 to 25 (Remafedi, 2002)

• 30 percent of GB males ages 14 to 21 (Remafedi, Farrow, & Deisher, 1991)

The majority of literature reviews on LGB suicide attempts conclude that LGB youth have a significantly higher rate of attempting suicide than heterosexual youth. Furthermore, most suicide attempts among LGB people occur during adolescence and young adulthood (Kulkin, Chauvin, & Percle, 2000; Proctor & Groze, 1994; Remafedi et al., 1991). (The same holds true for people of all sexual orientations; national hospital data show self-harm rates are highest for youth age 15 through 19 years old (Centers for Disease Control and Prevention, 2007)).

Some researchers have compared the seriousness of suicide attempts by LGB and heterosexual youth by asking people about their intent to end their lives. Safren & Heimberg (1999) found that 58 percent of LGB people who had attempted suicide reported that they had really hoped to die. In contrast, only 33 percent of heterosexuals who had attempted suicide reported that they had really hoped to die. Another measure of seriousness is the lethality of the means used to attempt suicide. For example, people who use firearms in a suicide attempt have a higher  rate of suicide deaths than people who use other means, simply because firearms are more lethal than other means (Brent et al., 1991; Conwell et al., 2002; Brent & Bridge, 2003; Shenassa, Catlin, & Buka, 2003; Miller, Azrael, Hepburn, Hemenway, & Lippman, 2006). Remafedi and colleagues (1991) found in interviews with GB males 14 through 21 years of age that 54 percent of suicide attempts in this group could be classified as moderately to highly lethal. The study also reported that one fifth of LGB youth who attempted suicide needed hospitalization, and three-fifths were least or moderately rescuable (a measure of the seriousness of the attempt).

It is important to note that all suicide attempts should be taken seriously by those responsible for the care of young people, including parents, school staff, and health care providers.
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Prepared by the Suicide Prevention Resource Center
for the Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
Supported by Grant No. 1 U79 SM57392-02

The Suicide Prevention Resource Center (SPRC) provides prevention support, training, and resources to assist organizations and individuals to develop suicide prevention programs, interventions and policies, and to advance the National Strategy for Suicide Prevention.
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Education Development Center, Inc.
55 Chapel Street
Newton MA 02458
877-GET-SPRC (438-7772)

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