Olr Gay Men and the Risk of Suici - The Doctor Weighs In

Contents:

• PEOPLE WHO ARE GAY, LBIAN OR BI HAVE MORE MENTAL HEALTH AND SUBSTANCE E PROBLEMS, SURVEY FDS
• STUDY HIGHLIGHTS DIFFERENC BETWEEN GAY, STRAIGHT SUICIS
• SUICI ATTEMPTS AMONG GAY AND BISEXUAL MEN: LIFETIME PREVALENCE AND ANTECENTS
• DEPRSN IS KILLG GAY MEN
• DEPRSN AND SUICIDALY GAY MEN: IMPLITNS FOR HEALTH CARE PROVIRS
• REARCHERS FD DISPARI SUICI RISK AMONG LBIAN, GAY, AND BISEXUAL ADULTS
• GAY SUICIS ARE ON THE RISE. THIS EPIMLOGIST EXPLAS WHY.

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

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. As a postdoctoral rearch fellow nursg at the Universy of Brish Columbia, I work on the Still Here project to engage gay and bisexual men who have prevly stggled wh suici (or who have lost another gay or bisexual man to suici) to tell their stori through photographs. 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.

STUDY HIGHLIGHTS DIFFERENC BETWEEN GAY, STRAIGHT SUICIS

“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. 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. "Compared to heterosexuals, the report found gay men who killed themselv were likelier to have had a diagnosed mental health ndn, a history of suicidal thoughts or plans, an argument before ath and a crisis around the time of ath.

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.

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

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. 19–26 Societal strs of beg gay are not, however, buffered by support om ual sourc (such as fay), bee many young adults have not disclosed their sexual orientatn to fay members or have enuntered negative reactns to such disclosure.

G., experienc of antigay victimizatn, the sense of viance and stigmatizatn prompted by an awarens of one’s nonheterosexual orientatn) and the pcy of psychologil rourc (characteristic of relative youth) are associated wh greater vulnerabily to suicidal behavr. Are velopmental experienc relevant to sexual inty formatn (early experienc of antigay harassment, and beg earlier stag of the procs of “g out” or of disclosg one’s sexual orientatn) more likely to be associated wh earlier vs later suici attempts? 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).

DEPRSN IS KILLG GAY MEN

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. 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.

DEPRSN AND SUICIDALY GAY MEN: IMPLITNS FOR HEALTH CARE PROVIRS

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. Dpe the accumulated evince that “g out” and associatn wh affirmative gay/lbian/bisexual social works have posive effects terms of psychologil adjtment (particularly wh rpect to selfteem), 57, 59–61 this procs n also be associated wh some negative experienc.

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. Although no evince is available to explore this qutn, is possible that historil ntext had an effect, given that the 1969 Stonewall Inn rts New York Cy are wily viewed as a marker of the birth of the morn “gay liberatn” movement. ” 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.

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

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. 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.

While many gay, bisexual, and other men who have sex wh men may not seek re om a mental health provir bee of a fear of discrimatn or homophobia, is important to keep this as an optn and to fd a provir that is tstworthy and patible. Related to this, gay men’s health has often been fed by sexual practic, and poorly unrstood are the tersectns of gay men’s physil and mental health wh social termants of health cludg ethnicy, lole, tn level, and socenomic stat. Keywords: gay men’s health, prsn, suicidaly, men’s health, men’s help seekgIntroductnDeprsn is prevalent among gay men, where gay men are three tim more likely to experience prsn pared wh the general adult populatn (Cox, 2006; Kg et al., 2008).

In terms of potential of prsn and suicidaly gay men, relatnship problems, acceptg one’s homosexualy, experiencg homophobia, stutnal discrimatn, and alienatn om gay muni have been reported as unrpng issu (Cox, 2006; Haas et al., 2011; Wang, Plörl, Hӓermann, & Weiss, 2015) rearch exists about gay men’s health beyond sexual health issu, most often HIV (Hott, Ferlatte, & Gk, 2014). Though gay men self-report that they rank mental health as one of their top health ncerns (Grov, Ventuneac, Renda, Jimenez, & Parsons, 2013) prsn and suicidaly the liv of gay men are poorly unrstood (Haas et al., 2011; Kg et al., 2008). DeprsnDeprsn is fed clilly as the experience of a prsive mood or loss of tert or pleasure nearly all activi over a 2-week perd, along wh four of the followg 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” (Amerin Psychiatric Associatn, 2013).

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

(2008) noted that general practners ed anxiety-related symptoms to intify addnal signs of prsn gay terms of e–effect and triggers for prsn, a range of factors have been tailed, many of which are tertwed wh the strs that n acpany beg part of socially margalized gay muni (Mays & Cochran, 2001; Meyer, 1995, 2003). Young gay men n experience prejudice their fay the form of rejectn, often after disclosg their sexual orientatn durg adolcence, which turn n heighten young men’s risk for prsn (Ryan, Huebner, Diaz, & Sanchez, 2009) expectatns of discrimatn and homophobic rejectn n also negatively affect gay men’s mental health (Hatzenbuehler, 2009; Meyer, 2003).

Self-acceptance is therefore a cril element for gay men’s well-beg, as is beg accepted by others (Ash & Mackereth, 2013) addn to the four factors tailed Meyer’s (1995, 2003) mory strs mol, a lack of acceptance and rejectn om the gay muny n also crease the risk for gay men’s prsn. Particularly at risk of rejectn om other gay men are men livg wh HIV (Courtenay-Quirk, Wolski, Parsons, Gómez, & Seroposive Urban Men’s Study Team, 2006) as well as men om racial/ethnic mory groups (Bowleg, 2012; Haile, Rowell-Cunsolo, Parker, Padilla, & Hansen, 2014; Riggs, 2012).

Gay men livg wh HIV are also at creased risk for prsn across the entire illns trajectory cludg diagnosis of HIV, iatn of HIV treatment, treatment failure, diagnosis of AIDS, and/or havg a iend diagnosed wh AIDS (Körner et al., 2008). Health re provirs workg wh HIV posive gay men have nfirmed that the isolatn and loss of social relatnships and fay support experienced as a rult of this health stat are signifint triggers for prsn (Körner et al., 2008) men who belong to an ethnic mory are at higher risk for prsn.

Prsure to nform to such rigid genr norms creat unique discrimatory environments (Guareno, 2007), and gay Hispanic men report higher rat of fay rejectn and negative mental health out pared wh their Csian male unterparts (Ryan et al., 2009).

An Amerin study of gay Hispanic men reported homophobic experienc durg childhood, cludg beg told that gays are not normal people (91%), amid harborg beliefs that their sexual orientatn would hurt and embarrass their fay (70%; Diaz et al., 2001). A study by De Santis, Col, Vasquez, and McCa (2008) wh predomantly gay Hispanic (75%) men reported siar issu notg that gay Hispanic men who had prsive symptoms were likely to engage sexual practic wh high risks for exposure to HIV. Rearch regardg HIV posive gay men and/or ethnic mory gay men is emergent (De Santis et al., 2008) and future work might efully foc on intifyg and addrsg the unique prsn risk factors among the vulnerable subgroups as a means to improvg their mental and physil health.