Report on GLBT Youth Suicide Seeks Answers, Action

A new report on suicides among GLBT youth suggests that the phenomenon--which has taken on the appearance of a national crisis in recent months--be given corresponding resources in order to gain an understanding of exactly why teens who self-identify as sexual minorities are more likely to kill themselves.

The report was published on Jan. 5, a day before New Jersey Gov. Chris Christie signed a bill to implement what activists called "America's toughest anti-bullying law."

The report is the work of an "expert panel of 26 leading researchers, clinicians, educators and policy experts," according to an American Foundation for Suicide Prevention press release. The report was published in "a special edition of the Journal of Homosexuality" online, the release noted.

Suicide and Suicide Risk in Lesbian, Gay, Bisexual and Transgender Populations: Review and Recommendations notes that according to multiple surveys, about 3% of students in America's school system are GLBT. The report cites earlier research that demonstrates that GLBT youth are at increased risk of suicide compared with heterosexual youth, and also notes the discovery that lower suicide rates prevail even among youths who engage in same-gender sexual contact, but nonetheless describe themselves as straight.

"Despite four decades of research pointing to elevated rates of suicide attempts among LGBT people, national suicide prevention initiatives, including the 2001 U.S. National Strategy for Suicide Prevention, have given scant attention to suicide risk in sexual minority persons," the release says.

"With this report and recommendations, we hope to move LGBT suicide prevention squarely onto the national agenda and provide a framework for actions aimed at reducing suicidal behavior in these populations," lead author Dr. Ann Haas said. Haas is the Director of Prevention Projects for the American Foundation for Suicide Prevention, the release noted.

"It's time for the federal government, suicide prevention agencies, mental health professionals, policy makers and LGBT organizations to join together to bring this problem out of the closet and work toward effective solutions," added Haas.

Other research has shown that GLBTs are more prone to substance abuse, depression, and anxiety. Those trends are especially acute in places and at times when populations of sexual minorities find themselves under legal or social attack, such as when gays are demonized and made the subject of ballot initiatives or other political actions. Other forms of stigma, along with social, religious, and familial rejection are thought to contribute to higher rates of depression and anxiety among gays; that, in turn, is suspected of accounting for higher rates of substance abuse, which can then translate into behavior that elevates risk for contracting STIs, including HIV.

While acknowledging the higher rates of depression, anxiety, and substance abuse among LGBTs, "the panel found that these problems, by themselves, do not account for the higher rates of suicide attempts that have been reported by LGBT people," the press release noted. "Thus, the consensus report identified stigma and discrimination as playing a key role especially acts such as rejection or abuse by family members or peers, bullying and harassment, denunciation from religious communities and individual discrimination.

"The report also highlighted evidence that discriminatory laws and public policies have a profound negative impact on the mental health of gay adults." The report called for efforts at suicide prevention to take those factors into account.

In addition to data relating to sexual orientation, the report also included information on gender identity. Transgendered individuals are separate and distinct from gays, lesbians, and bisexuals, though there can be overlap between the groups.

Although homosexuality has not been regarded as a mental health disorder in America since 1973, the same is not true of transgendered individuals, with the result that transgendered people might still be stigmatized with the label of being mentally disordered. "The consensus panel called for revision of diagnoses pertaining to transgender people in the 5th edition of the Diagnostic and Statistical Manual (due out in 2013) to affirm that gender identity, expression and behavior that differ from birth sex is not indicative of a mental disorder," the release noted.

The report observes a disparity between LGBT suicide attempts and actual suicides, a gap that exists in part because records kept on individuals who die by suicide do not indicate what their sexual orientation or gender identity might have been.

"Suicidal Behavior" More Prevalent Among LGBT Youth

However, the report noted, a strong correlation has been demonstrated between sexual orientation and "suicidal behavior." The report says, "Since the early 1990s, population-based surveys of U.S. adolescents that have included questions about sexual orientation have consistently found rates of reported suicide attempts to be two to seven times higher in high school students who identify as LGB, compared to those who describe themselves as heterosexual."

The risk of suicide among young gays, lesbians, and bisexuals seems to taper off with age. The study cited a report that "found that the risk for suicide attempts in young men who reported same-sex romantic attractions was largely confined to the adolescent years. Another study cited by the report found "that elevated suicidal behavior among LGB members was associated with depression, anxiety disorders and substance use disorders, and that the associations were more marked in males than females."

However, LGB adults were still more prone to mental health problems and related behavior, the report noted, referencing a study that "confirmed a higher prevalence of lifetime mood and anxiety disorders among participants who identified as LGB, compared to those who identified as heterosexual." Once again, there appeared to be correlations between the mental health of sexual minorities and the legal and social attacks they suffer.

"There is ample evidence that across the lifespan, LGB people commonly experience discrimination in the form of personal rejection, hostility, harassment, bullying, and physical violence," the report said. "One especially powerful stressor for LGB youth is rejection by parents and other family members. Several nonrandom studies have found an association between parental rejection because of sexual orientation and higher risk of suicide attempts among LGB youth

--Other recommendations focus on improving information about LGBT people by measuring sexual orientation and gender identity in all national health surveys in which respondents' privacy can be adequately protected, and encouraging researchers to include such measures in general population studies related to suicide and mental health."

Moreover, "institutional discrimination" also takes a heavy toll, the report noted. "Institutional discrimination results from laws and public policies that create inequities or fail to provide protections against sexual orientation-based discrimination," the report explained, going on to cite a study that "found that LGB adults who lived in one of 19 states that lacked specific protections against sexual orientation-based hate crimes or employment discrimination had significantly higher prevalence of mood, anxiety, and substance use disorders, compared to heterosexual adults living in those states and LGB adults living in states that extended protection in at least one of these areas.

"LGB respondents in states without protective policies were almost five times more likely than those in other states to have two or more mental disorders," the report added.

Another study cited by the report focused on "the effects of state constitutional bans on same-sex marriage on the mental health of LGB adults." The report noted that in "16 states that enacted constitutional amendments against same-sex marriage during 2004 and 2005, the researchers found significant increases in mental disorders among self-identified LGB respondents in these states between wave 1 (2001-2002) and wave 2 (2004-2005) of the survey. Specifically, mood disorders increased by more than one-third, from 23 to 31% of LGB respondents. Increases were also found in generalized anxiety disorder, from 3 to 9%, and alcohol use disorder, from 22 to 31%.

"By contrast, no comparable increases in mental disorders between the two waves of the survey were observed in heterosexual respondents living in these 16 states," the report said. "Among LGB respondents living in the 34 states where constitutional amendments against same-sex marriage were not enacted during the period examined, increases in generalized anxiety disorder and substance use disorders were also found between the two waves of the survey, possibly related to extensive national media coverage of the amendment campaigns and the associated anti-gay rhetoric. Again, comparable increases in mental disorders were not found in heterosexual respondents living in the same states."

The report also cited a study that indicated that, "Among some urban men who have sex with men, elevated risk of HIV/AIDS has been found to be associated with depression, substance abuse, and elevated risk of suicidal behavior."

Suicide attempts among transgendered individuals were even higher than among LGBs--up to 25%, according to one study. As with younger LGBs, suicidal behavior seemed to taper off with time: "Suicide attempts appear to occur more frequently among transgender adolescents and young adults than among older age groups," the report noted.

The report noted that little in the way of resources has historically been committed to studying suicide and suicidal behavior among sexual minorities, leading to significant knowledge gaps. Moreover, "what is already known has not yet been applied to practices aimed at reducing suicidal behavior and suicide risk in LGBT people," the report noted. The report called for increased practical applications for what is known now about the elevated risk of suicide among sexual minorities, as well as efforts to close those gaps in understanding.

One major resource for improved public health in the LGBT sector, the report suggested, would be efforts to reduce or eliminate social, political, and religious stigma and rejection aimed at sexual minorities. "Among the most salient findings to emerge from recent research are those linking public policies that discriminate against sexual minorities to elevated rates of mental disorders in LGB people," the report noted. "The well-established association between mental disorders and suicide attempts in at least some LGBT subgroups points to the need to include advocacy for policy change as a component of a comprehensive plan for LGBT suicide prevention."

To combat the injurious effects of anti-gay laws and gaps in legal parity for sexual minorities, the report recommended an end to legal inequities affecting gay and lesbian families, stronger laws to combat anti-gay bullying in public schools, and efforts to include LGBTs in public surveys designed to measure the need or, and find solutions to address, public health concerns.

"Although many questions are as yet unanswered, there appears to be little doubt that a broad national effort will be needed to encourage and fund the needed research, raise awareness of the problem among LGBT and suicide prevention leaders, and develop the interventions, prevention strategies, and policy changes through which suicidal behavior and suicide risk in LGBT populations can be reduced," the report concluded.

A newly signed bill in New Jersey stands to address at least one point for improvement set out in the report. Gov. Chris Christie signed a bill on Jan. 6 to mandate "specific anti-bullying procedures for schools across the state," a press release sent that same day by GLBT advocacy group Garden State Equality said.

"Garden State Equality spearheaded the campaign for the new law," the release noted. " Since the organization's founding in 2004, New Jersey has enacted 212 laws at the state, county and local levels advancing LGBT civil rights. That is a national record.

"Garden State Equality now initiates its new Anti-Bullying Partnership--comprised of legal experts, educational experts, corporate leaders, bullied students and parents--to partner with schools, student organizations and parent-teacher organizations to make sure the new law is enforced," the release added.

"The overwhelmingly bipartisan support for this landmark legislation will give impetus to other states across America, whether they are blue or red, to adopt anti-bullying laws just like ours," said Garden State Equality chair Steven Goldstein. The bill's specific, mandatory requirements mean "The era of vagueness and loopholes in anti-bullying laws is over, and hope for our children has begun," Goldstein added.

"Under the new law, teachers and other school personnel must report incidents of bullying to principals on the same day as a bullying incident," the release said. "An investigation of the bullying must begin within one school day. A school must complete its investigation of bullying within 10 school days, after which there must be a resolution of the situation."

The release went on to note that the new law "provide[s] training to teachers in suicide prevention specifically with regard to students from communities at high risk for suicide." The law also extends to bullying that takes place on school buses, and covers incidents of cyber-bullying. Moreover, the law applies to public universities.

"The law applies to all bullied students," the release says. "In addition to protecting students based on the categories of actual or perceived race, color, religion, ancestry, national origin, disability, gender, sexual orientation, and gender identity or expression, the law has clear language protecting students bullied for any other reason."