Suici and Vlence Preventn Among Gay and Bisexual Men | CDC

Contents:

• GAY SUICIS ARE ON THE RISE. THIS EPIMLOGIST EXPLAS WHY.
• DEPRSN IS KILLG GAY MEN
• STUDY HIGHLIGHTS DIFFERENC BETWEEN GAY, STRAIGHT SUICIS
• I WAS A GAY BOY WHO TRIED TO KILL MYSELF. NOW I KNOW IT WASN'T MY FLT.
• REARCHERS FD DISPARI SUICI RISK AMONG LBIAN, GAY, AND BISEXUAL ADULTS
• PEOPLE WHO ARE GAY, LBIAN OR BI HAVE MORE MENTAL HEALTH AND SUBSTANCE E PROBLEMS, SURVEY FDS
• SUICI ATTEMPTS AMONG GAY AND BISEXUAL MEN: LIFETIME PREVALENCE AND ANTECENTS
• SUICI AND SUICI RISK LBIAN, GAY, BISEXUAL, AND TRANSGENR POPULATNS: REVIEW AND REMENDATNS
• NEARLY A THIRD OF YOUNG GAY PEOPLE HAVE ATTEMPTED SUICI, STUDY FDS

GAY SUICIS ARE ON THE RISE. THIS EPIMLOGIST EXPLAS WHY.

Suici is the send leadg e of ath among young people aged 10 to 24 (Hegaard, Curt, & Warner, 2018) — and lbian, gay, bisexual, transgenr, queer, and qutng (LGBTQ) youth are at signifintly creased youth are more than four tim as likely to attempt suici than their peers (Johns et al., 2019; Johns et al., 2020) Trevor Project timat that more than 1. Acrdg to data om the Youth Risk Behavr Survey (YRBS) nducted durg 2001-2009 seven stat and six large urban school districts, 14% to 31% of gay and lbian stunts across the s and 17% of 32% of bisexual stunts across the s had been forced to have sexual terurse at some pot their liv. The 2013 fifth edn of the Amerin Psychiatric Associatn's Diagnostic and Statistil Manual (DSM) f prsn clilly as a prsive mood or loss of tert or pleasure nearly all activi over a two-week perd, along wh four of the symptoms: “chang appete or weight, sleep, and psychomotor activy; creased energy; feelgs of worthlsns or guilt; difficulty thkg, ncentratg, or makg cisns; or recurrent thoughts of ath or suicidal iatn or suici plans or attempts.

Subgroups at an creased risk of suicidal behavr, a new study sh a spotlight on the ways which suici among sexual mori differs om that of their heterosexual study, published late last month the Amerin Journal of Preventive Medice, is thought to be the first to e a large body of ernment data to exame suicis of gay mal and lbians. Like gay men, lbians were also likelier than heterosexuals to have had a diagnosed mental health ndn prr to suici and were likelier to have tried to signal their sire to attempt suici before dog study also pared the "most monly ed mechanism of jury” for straight and gay people who took their own liv. For gay men, the likelit method of suici was “hangg/strangulatn/suffotn" (38 percent); for lbians was “hangg/strangulatn/suffotn” (36 percent) and firearms (35 percent) that when pared to straight youth, lbian, gay and bisexual youth are five tim more likely to attempt suici, the study suggts “a need to nduct suici preventn activi across age groups, cludg youth.

The team also found that creased gray matter volume this regn, which is rponsible for procsg external stimuli, was associated wh creased may believe that the reason LGBTQ+ people are more likely to die by suici or have mental health problems is bee homosexualy is “unnatural” or is a psychiatric ndn. Suici risk among lbian, gay, and bisexual adults vari nsirably pendg on the tersectn between sexual inty and other aspects of inty, such as genr, age, and race/ethnicy, acrdg to a study led by rearchers at the Natnal Instute of Mental Health (NIMH), part of the Natnal Instut of Health. The study, which examed data om a natnally reprentative survey of adults the Uned Stat, also showed that lbian, gay, and bisexual adults are overall more likely to report suici-related thoughts, plans, and attempts wh the past 12 months pared wh heterosexual adults.

DEPRSN IS KILLG GAY MEN

“This study monstrat the importance of askg about sexual inty natnal data llectn efforts, and highlights the prsg need for suici preventn servic that addrs the specific experienc and needs of lbian, gay, and bisexual adults of different genrs, ag, and race and ethnic groups, ” said Rajeev Ramchand, Ph. Dpe creasg acceptance of the LGBTQ+ muny, at least some circl, adults who intify as gay, lbian or bisexual are more likely than those who intify as straight to have ser thoughts of suici and mental health ndns cludg major prsive episos, and they are more likely to mise substanc like alhol or dgs, acrdg to a new US ernment report.

However, gay, bi and straight men seemed to have siar substance e patterns: There was no difference smokg between straight and gay mal, for example, and the rate of bge and heavy drkg the month before they took the survey was the same among gay, bi and straight men. “LGBT dividuals experience addnal strs as a rult of discrimatn and stigma, stigma both at the societal level but also the way that livg a society that privileg heterosexualy that has homophobic laws and polici to sort of teach LGB people even to view themselv as ferr, ” Kidd said.

“For stance, you n image beg environments that might be validatg of people who have gay and lbian inti but might eher not regnize bisexual inty – so they are sort of visible that space – or might be really validatg of dividuals wh bisexual inty, even while the environment is affirmg or at least a ltle more ntral to folks who are gay or lbian, ” Kidd said.

STUDY HIGHLIGHTS DIFFERENC BETWEEN GAY, STRAIGHT SUICIS

4–12 The available evince13 suggts that the relative risk for ser suici attempts among gay and bisexual mal is substantially greater than that among their heterosexual unterparts, but basic epimlogil rearch on suicidal behavr this populatn is both sparse quanty and ficient qualy, plagued by methodologil fics, particularly wh rpect to samplg. Rsell and Joyner, 16 g data om the Natnal Longudal Study of Adolcent Health, found higher rat of reported suicidal thoughts and attempts among adolcents reportg same-sex romantic attractns and romantic relatnships than among adolcents not reportg such relatnships, wh this operatnalizatn of sexual orientatn havg a signifint effect above and beyond other adolcent suici risk factors (such as prsn, hopelsns, and prr victimizatn) studi examg termants of suicidaly specific to gay and bisexual men have foced on both velopmental life transns (e.

I WAS A GAY BOY WHO TRIED TO KILL MYSELF. NOW I KNOW IT WASN'T MY FLT.

METHODSSampleThe data reported here were rived om the Urban Men’s Health Study, a hoehold probabily-based sample of MSM (operatnalized as eher havg had sex wh a male sce age 14 or self-intifyg as gay or bisexual) 4 US ci (Chigo, Ill; Los Angel, Calif; New York, NY; and San Francis, Calif).

54 Therefore, analys, rponnts were placed one of the tegori, based on the difference between age at first sexual experience and age at first suici attempt (more than 5 years prr, 0–5 years prr, and after the attempt or never) the anticipatn that those whose suici attempt was wh 5 years of their first same-sex sexual experience were most likely to be that vulnerable posn of beg aware of one’s stigmatized inty but lackg social disclosure as gay. Rponnts were asked about antigay harassment (“cludg beg lled nam”) before age 17; the ial tegori were dichotomized so that “repeatedly harassed” meant 4 or more AnalysChi-square tts were ed to exame univariate rrelat of (1) ever havg planned suici and (2) ever havg attempted suici for tegoril pennt variabl. 46, 57 Increas also were found reported rat of repeated antigay harassment before age 17 (om 28% among those aged 25 or olr by 1970 to 52% among those turng 25 after 1980) exame antecents of suici attempts, we ran a logistic regrsn wh the followg variabl: birth hort, race/ethnicy, parental tn, childhood sexual ercn, repeated terparental vlence, repeated childhood physil abe, parental substance abe, and repeated antigay harassment before age 17.

The rrelat ially clud this regrsn were parental substance abe, repeated terparental vlence, repeated childhood physil abe, childhood sexual ercn, repeated harassment before age 17 about beg gay, age at first disclosure of gay or bisexual inty to others pared wh age at first or only suici attempt, age at first sexual experience wh another male pared wh age at first or only suici attempt, birth hort, parental tnal level, and race/ethnicy. In the fal mol (Table 3 ▶), suici attempts before age 25 were associated wh birth hort (g of age after 1970), parental dg or alhol abe, repeated early antigay harassment, childhood sexual ercn, eher recent disclosure or nondisclosure of beg gay or bisexual to someone else, and eher recent onset of same-sex sexual relatns or not yet havg had sex wh another male.

REARCHERS FD DISPARI SUICI RISK AMONG LBIAN, GAY, AND BISEXUAL ADULTS

18Bee fdgs the lerature suggt that antigay harassment and other experienc lked to the “g out” procs may mediate the relatn between birth hort and age at ial (or only) suici attempt, we re-ran this send logistil analysis as a hierarchil logistic regrsn mol which birth hort was entered first. Dpe the need for utn parg data om different sourc, the rat suggt that US gay and bisexual mal have more than a 3-fold creased risk of ever attemptg suici parison wh their heterosexual male ntug high levels of suici across birth horts suggt that this problem has not dimished the past few s. 11, 23, 70 Furthermore, the fdg that more recent birth horts showed an creased risk of earlier (before age 25) suici attempts suggts that prevalence of parasuici durg gay and bisexual mal’ younger years may be creasg rather than logistic regrsn mol Table 3 ▶ is suggtive rather than five, bee clus only those who have ever attempted suici and is limed by the analytic nstrats of the available measur.

” This evince seems to n unter to expectatns regardg the effect of an emergent gay culture and the prospect of earlier self-intifitn as gay or bisexual, cludg those expectatns raised by Humphri78 2 s emergence of a visible, val gay, lbian, and bisexual muny78, 79 has apparently provid a broar array of possibili for rol and life reers among those who self-fe as “gay.

PEOPLE WHO ARE GAY, LBIAN OR BI HAVE MORE MENTAL HEALTH AND SUBSTANCE E PROBLEMS, SURVEY FDS

Surgeon General, 2001) and the Instute of Medice's Rcg Suici: A Natnal Imperative (Goldsmh, Pellmar, Kleman, & Bunney, 2002) fed gay and bisexual youth as a risk populatn but provid ltle rmatn about ntributg factors and did not addrs whether targeted terventns, preventn strategi or public health polici are need to rce suici risk this November 2007, the Amerin Foundatn for Suici Preventn partnership wh the Suici Preventn Rource Center and the Gay and Lbian Medil Associatn nvened a nference to addrs the need for better unrstandg of suicidal behavr and suici risk LGBT populatns. More recent studi of adults have generally nfirmed the figur and have nsistently shown that more rponnts dite same-sex sexual behavr, and pecially same-sex attractn, than intify themselv as gay or lbian (Black, Gat, Sanrs, & Taylor, 2000; Persen & Kristiansen, 2008; Sell, 1997; Wells, McGee, & Betrais, 2010). Adults that clud multiple qutns related to sexual orientatn (Bostwick, Boyd, Hugh, & McCabe, 2010) showed that rat of mood and anxiety disorrs, key risk factors for suicidal behavr, were more strongly lked to gay, lbian or bisexual inty than to sexual behavr or attractn, particularly ntrast to sexual orientatn, genr inty refers to a person's ternal sense of beg mascule, feme, or androgyno.

Although precise numbers are lackg, one survey of 515 self-intified transgenr persons found that 31% of male-to-female rponnts and 65% of female-to-male rponnts intified as gay, lbian, or bisexual (Clements-Nolle, Marx, Guzman, & Katz, 2001) this article, we foc first on summarizg the accumulated rearch lerature on suicidal behavr and suici risk lbian, gay, and bisexual people. In any se, nclns based on the small numbers reported mt be regard as San Diego study lacked a livg ntrol group and has been cricized based on the rearchers’ assumptn that the 11% of young male suici cents who were intified as gay approximated the expected prevalence rate for young gay men the populatn unr study (McDaniel, Purcell, & D'Augelli, 2001). Usg a more likely prevalence rate of 3–4% would have suggted that young gay men were overreprented among suici cents by a factor of at least studi have ed Denmark's extensive registri of val statistics and other socmographic data to exame whether people same-sex registered domtic partnerships (a proxy ditor of sexual orientatn) were overreprented among suici cents.

SUICI ATTEMPTS AMONG GAY AND BISEXUAL MEN: LIFETIME PREVALENCE AND ANTECENTS

A recent meta-analysis of 25 ternatnal populatn-based studi that measured suicidal behavr LGB adolcents and/or adults (varly fed) nclud that the lifetime prevalence of suici attempt gay/bisexual mal was about four tim that of parable heterosexual mal (Kg et al., 2008).

In a natnal probabily study of Lato and Asian-Amerin adults (Cochran, Mays, Alegria, Ortega, & Takchi, 2007), gay and bisexual men were more likely than heterosexual men to report a recent suici DisorrsIn the populatn as a whole, mental disorrs nstute the sgle largt risk factor for suicidal behavr, and studi have also reported a generally strong associatn between mental disorrs and suici attempts LGB adolcents and adults. The fdgs of higher rat of prsn and panic disorr gay/bisexual men, and higher rat of substance e disorrs lbian/bisexual women pot to different genr patterns among LGB people, pared to the populatn as a Natnal Epimlogic Survey on Alhol and Related Condns (NESARC), a populatn-based survey of U. The likelihood of gay-related victimizatn has been found to be pecially high youth wh cross-genr appearance, tras or behavrs (D'Augelli, Grossman, & Starks, 2006; Fzpatrick, Euton, Jon, & Schmidt, 2005; Friedman et al., 2006; Plorl & Fartacek, 2007; Remafedi et al., 1991), or who exprs mory sexual orientatn at an early age (Friedman, Marshal, Stall, Cheong, & Wright, 2008).

SUICI AND SUICI RISK LBIAN, GAY, BISEXUAL, AND TRANSGENR POPULATNS: REVIEW AND REMENDATNS

Data om the Natnal Epimlogic Survey of Alhol and Related Condns (2004–2005) further documented the associatn between personal experienc of discrimatn and terpersonal vlence on elevated rat of substance e disorrs (McCabe, Bostwick, et al., 2010) and posttrmatic strs disorr (Roberts, At, Corliss, Vanrmorris, & Koenen, 2010) LGB adults over the age of is some evince that the terrelatnship among gay-related strsors, mental disorrs and suicidal behavr may vary between different racial and ethnic groups. Notg that the nstutnal amendments largely unrsred preexistg state laws, the rearchers hypothized that the negative mental health impact on LGB cizens stemmed primarily om the hostile polil mpaigns and public disurse that preced their passage, which further promulgated stigma and rerced the margalized social and legal stat of LGB LGB rponnts livg the 34 stat where nstutnal amendments agast same-sex marriage were not enacted durg the perd examed, creas generalized anxiety disorr and substance e disorrs were also found between the two wav of the survey, possibly related to extensive natnal media verage of the amendment mpaigns and the associated anti-gay rhetoric. Usg data om the California Health Interview Survey 2001, 2003, and 2005, the study found that partnered gay men were ls than half (42%) as likely to have pennt health surance verage as married heterosexual men, and partnered lbians were only 28% as likely to have verage as married heterosexual women.

PROTECTIVE FACTORSIn spe of an creased risk of suici attempts among LGB pared to heterosexual rponnts, those reportg suicidal behavr are a clear mory of the LGB dividuals who have been studied, timated at 12– 19% of gay/bisexual mal, and a smaller percentage of lbian/bisexual women (Kg et al., 2008). A nonrandom study of self-intified young and middle-aged LGB adults New York Cy found nnectedns to a gay/lbian muny and posive sexual inty were associated wh greater social and psychologil well-beg (Kertzner, Meyer, Frost, & Stiratt, 2009) fdg that exclive same-sex sexual behavr and attractn are associated wh posive mental health out women, but not men (Bostwick et al., 2010), suggts that women may be protected by greater latu and tolerance regard to female sexualy.

NEARLY A THIRD OF YOUNG GAY PEOPLE HAVE ATTEMPTED SUICI, STUDY FDS

Natnal Transgenr Discrimatn Survey (Natnal Center for Transgenr Equaly & the Natnal Gay and Lbian Task Force, 2009), which clud almost 6, 500 transgenr and genr-variant people intified through a work of 800 trans-related service and advocy anizatns, support groups, list-servs and onle social works, showed that 47% reported an adverse job actn bee of transgenr stat. This group's rpons related to suicidal behavr were pared to those reported by six other groups: heterosexual mal and femal, homosexual mal and femal, and mal and femal who matched the transgenr dividuals on natnaly, age, sexual orientatn, relatnship stat, and populatn size of the area which they rid.

Where there appears to be a logil basis for assumg monali across sexual mory persons, we clu transgenr along wh lbian, gay, and bisexual groups our remendatns, aga urgg that reful evaluatns be nducted to intify possible differenc out among transgenr pared to LGB people, and among transgenr people havg different sexual orientatns as well as different genr inti, behavrs and Health InterventnsLGBT anizatns have been at the foreont of brgg natnal attentn to health problems that disproportnately affect LGBT people, notably HIV/AIDS, seekg remedi to associated dispari rearch fundg, and workg to improve accs to high qualy, culturally appropriate health re servic. Commensurate efforts have not been directed toward elevated rat of mental disorrs LGBT people and the risk the disorrs pose for suicidal behavr, even though Healthy People 2010: Compann Document for Lbian, Gay, Bisexual and Transgenr Health (Gay and Lbian Medil Associatn and LGBT Health Experts, 2001) provid well-documented remendatns to support a foc on LGBT mental until 1973, when LGBT psychiatrists, other mental health profsnals, and their alli spearhead efforts at the annual meetg of the Amerin Psychiatric Associatn to remove homosexualy per se as a psychiatric diagnosis, variant sexual orientatn was routely equated wh mental disorr and sexual viance, leadg to a theraptic foc on “curg” people of same-sex sexual attractn and behavr. Today, more than three s after homosexualy was removed om the Amerin Psychiatric Associatn's Diagnostic and Statistil Manual of Mental Disorrs (DSM), a small but vol mory among mental health profsnals ntu to promulgate “curative” therapi for gay men and lbians, spe evince that such methods are effective and harmful (Amerin Psychiatric Associatn, 2000).