Suicide Risk Rife in Sexual Minority Teens

Megan Brooks

December 20, 2017

According to an analysis of data from the 2015 National Youth Risk Behaviors Survey, adolescents who identify as lesbian, gay, bisexual, or as being unsure of their sexual orientation ― individuals whom the investigators identify as "questioning" ― are at increased risk for suicidal thoughts and actions.

Athough sexual minority adolescents are thought to be at elevated risk for suicide, studies supporting this claim have rarely used nationally representative samples, which is a major limitation, the authors note. In addition, most studies have "ignored" the diversity among sexual minorities, assuming all share the same risks.

John Ayers, PhD, from the Graduate School of Public Health, San Diego State University, California, and colleagues estimated suicide risk behaviors in sexual minority adolescents using nationally representative data from 2015.

A total of 15,624 high school students reported their sexual orientation as heterosexual (89% overall), gay or lesbian (2% overall), bisexual (6% overall), or questioning (3% overall). They were asked whether, in the past year, they had seriously considered, planned, or attempted suicide.

The study was published online December 19 in JAMA.

40% Think About Suicide

In the past year, 40% of sexual minority adolescents said they had seriously considered suicide, 35% said they had planned suicide, and 25% said they had attempted suicide. These numbers are far greater than those of their heterosexual peers, of whom 15% said they had seriously considered suicide, 12% said they had planned suicide, and 6% said they had attempted suicide in the prior year.

After adjusting for potential confounders, compared to their heterosexual peers, sexual minority adolescents were significantly more likely to consider suicide (risk ratio [RR], 2.45; 95% confidence interval [CI], 2.12 - 2.81), plan suicide (RR, 2.59; 95% CI, 2.18 - 3.04), or attempt to take their own life (RR, 3.37; 95% CI, 2.73 - 4.09).

By subgroup, lesbian, gay, bisexual, and questioning adolescents were all at elevated risk for suicide relative to heterosexuals. The greatest risk was in bisexuals, who, compared to their heterosexual peers, were 46%, 41%, and 32% more likely to consider, plan, or attempt suicide, respectively.

"The substantial suicide risks among sexual minorities merits a comprehensive reaction," the investigators write.

"Policy makers should invest in research to understand and prevent suicide among sexual minorities. Clinicians should discuss sexual orientation with patients, and allocate appropriate mental health resources. Caretakers should watch for signs of suicide risk behaviors among sexual minority adolescents, and seek supportive help when warranted," they advise.

In an interview with Medscape Medical News, Caitlin Ryan, PhD, director and cofounder of the Family Acceptance Project at San Francisco State University in California, said suicide is a "serious problem not only among LGBT [lesbian, gay, bisexual, transgender] youth and adults, but it's an increasing problem among adolescents in general. This has been a concern for many, many years."

Dr Ryan noted that the latest National Strategy for Suicide Prevention, released in 2012, designates LGBT populations as being at higher risk for suicidal behaviors than the general population.

Dr Ryan, who has worked in LGBT healthcare and mental health care for nearly 40 years, said everyone has a role to play in preventing suicide.

"There is a myth that seems to be pervasive that if you ask a young person about suicide, you are giving them that idea for the first time, and that's not the case at all. It's really kind of horrifying to think that providers wouldn't ask an adolescent if they feel like hurting themselves or if they ever tried to hurt themselves or if they ever thought of taking their life," said Dr Ryan.

Increasing connectedness within the family is also important for suicide prevention. "I think the chaos in society, the lack of connectedness, the speeded-up pace of our lives, using social media and smartphones, all of that is contributing to a lack of those critical relationships that are so important to reduce risk," said Dr Ryan.

"During the holidays, it is particularly important to talk about suicide prevention, because the holidays add so much stress to families," she added.

The study had no commercial funding. The authors have disclosed no relevant financial relationships.

JAMA. Published online December 19, 2017. Abstract

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