Suicide has become a major source of concern for LGBT communities over the last several years. In the new 2012 National Strategy for Suicide Prevention, the Surgeon General and the National Action Alliance for Suicide Prevention highlight the disproportionately heavy impact of suicide on the LGBT population:
The prevalence of suicide attempts among gay and bisexual men is 4 times greater than among straight men. The prevalence of suicide attempts among lesbian and bisexual women is almost twice that of straight women. LGB teens and adults are almost twice as likely as heterosexuals to report a suicide attempt in the last year. 41 percent of transgender people report making a suicide attempt — a rate 25 times higher than the general population. 12 to 19 percent of LGB adults report suicide attempts, compared with less than 5 percent of all U.S. adults. 1 in 3 LGBT adolescents report suicide attempts, compared to 1 in 10 straight adolescents. Especially high rates of suicide attempts have been reported among LGBT African Americans, Latinos, Native Americans, and Asian Americans.
This version of the strategy marks a major departure from the 2001 version, which mentioned only LGB youth. Thanks to the work of the LGBT Task Force that forms part of the National Action Alliance, the new strategy notes that adolescence isn’t the only time that suicide can affect LGBT people. In fact, LGBT people may struggle with suicidal despair and suicide attempts at different points in their lives.
The reasons that suicide is a lifelong concern for many LGBT people are complex. In particular, the strategy reflects growing understandings of how “minority stress” arising from discrimination and prejudice against minority sexual orientation and gender identity contributes to concerns about LGBT suicide. Drivers of LGBT minority stress include:
Family rejection and social isolation. Bullying, violence, and harassment. Providers refusing to offer respectful mental and behavioral health care services to LGBT people. Laws and public policies denying LGBT people benefits and protections provided to others. Media messages encouraging suicide contagion by portraying suicide as a normal response to anti-LGBT bullying or other experiences of discrimination.
These social dynamics frequently give rise to mental health concerns such as low self-esteem, depression, and anxiety, all of which are well-known red flags for heightened suicide risk. Recent research shows that gay men and lesbians living in the 16 states that passed anti-gay marriage laws between 2001 and 2005 experienced a 42 percent increase in anxiety disorders, a 37 percent increase in mood disorders, including depression, and a 248 percent increase in alcoholism. And the Trevor Project’s youth LGBT suicide hotline reports that over 70 percent of calls come from states that tend to be more socially conservative.
The strategy recognizes several protective factors and interventions that can mitigate the risk of suicide for LGBT people, including:
Promoting family acceptance and understanding among diverse families of how their views on LGBT identities can affect their children’s well-being. Fostering supportive LGBT community networks and a sense of safety. Disseminating positive messages regarding minority sexual orientation and gender identity. Expanding access to LGBT-affirming and culturally competent mental and behavioral health services. Enacting laws and policies that extend legal protections and promote acceptance of LGBT people at work, at school, and in society at large. Deepening collaboration between suicide prevention and LGBT organizations. Reducing suicide contagion by promoting responsible media coverage of suicide deaths.
Another major factor in saving LGBT lives is building a more robust evidence base about LGBT suicide. Right now, it is impossible to say how many of the 33,000 people who die of suicide every year in the U.S. are LGBT, because the U.S. death certificate, the National Violent Death Reporting System (NVDRS), and most nationwide health surveys do not collect information on sexual orientation or gender identity.
As a result, little attention has been paid to suicide risk among the LGBT population, and it is impossible to assess whether LGBT suicide prevention interventions are truly effective. This lack of data also hinders efforts to better understand the experiences of specific groups of LGBT people, including LGBT youth and elders, transgender people, and LGBT people of color, who may be at increased risk because of the multiple burdens of discrimination they bear.
The new National Strategy for Suicide Prevention is a great step forward in recognition of the toll suicide takes on LGBT communities. And it emphasizes the most important step that remains to be taken. Fundamentally, showing LGBT people that they count in the struggle against suicide will require substantial increases in data collection and research on mental health, discrimination, suicide, and resilience among LGBT communities.