By Dave Reynolds, M.P.H. (Advocacy and Education Manager, The Trevor Project) and Phoenix Schneider, M.S.W. (Program Director, The Trevor Project)
Q: Are lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth more likely to attempt suicide than other youth, and if so, why?
Numerous research studies have shown that LGBTQ youth are more likely to think about and attempt suicide than their heterosexual peers. According to the Massachusetts Youth Risk Behavior Survey, LGBTQ youth are up to four times more likely to attempt suicide than their heterosexual peers (2007). These findings are confirmed by numerous non-government research studies, many of which actually find the risk among sexual minority youth to be higher (selected research: Bradford JB – J Consult and Clin Psych 1994;62(2):228-242; D’Augelli AR – Suicide and Life Threatening Behav 2001;31:250-264; Paul JP – AJPH 2002;92(8):1338-1345; Silenzio VMB – AJPH 2007;97:2017-2019).
Nearly half of young transgender people have seriously thought about taking their lives and one-quarter have reported attempting suicide (Grossman AH, D’Augelli AR – Suicide and Life Threatening Behav 2007;37(5):527-537). Questioning youth, or those who are less certain of their sexual orientations, report experiencing thoughts of depression or suicide at even higher levels than their heterosexual or openly LGBT-identified peers (Poteat VP – J Consult and Clin Psych 2009;77(1):196-201).
This research can be shocking to those who are not acquainted with the disproportionate burden of mental illness that falls on LGBTQ young people, but it is also important to stress that these negative mental health outcomes are not a product of identifying as LGBT. Rather, the increased risk for suicide is a reaction to the negative and non-affirming languages and behaviors that so many sexual minority youth experience in their homes, schools, communities and religious institutions.
Q: Are shy or isolated LGBTQ youth more likely to have suicidal thoughts than LGBTQ youth growing up in metropolitan areas like New York City?
Our colleagues at the Gay, Lesbian and Straight Education Network (GLSEN) recently released a report in the Journal of Youth and Adolescence that found more bullying and harassment of young people related to sexual orientation or gender identity/expression in rural areas than in suburban or urban locations. These higher levels of harassment were also experienced by LGBTQ youth in communities where poverty is high and education levels are low (Kosciw JG – J Youth Adole 2009;38(7)L:976-988).
Numerous research studies have also shown a strong link between experiencing bullying related to one’s perceived sexual orientation or gender identity and the increased risk for suicide among young people. To speak to these points, two-thirds of callers to The Trevor Helpline reach out to us from non-urban areas, and in states like New York and California, more than 80% and 90% (respectively) call us from outside major metropolitan areas.
Major cities like New York City or Los Angeles have many more resources available to LGBTQ young people than rural areas, so that can help to alleviate isolation for some. There are likely to be more mental health services, community centers and youth organizations as well. However, we know that young LGBTQ people are struggling in locations all across the country. Therefore, it’s not accurate to definitively state that it’s “easier” to identify as LGBTQ in a larger city.
Q: Are parents from some ethnic groups more likely to reject their LGBTQ children than others?
There are some research studies looking at the sexual identity development of LGBTQ young persons of color, but there is still a pressing need for more. Recent research has shown that LGBTQ youth who reporthigher levels of family rejection related to their sexuality are up to nine times more likely to report having attempted suicide, six timesmore likely to report high levels of depression and more than three times morelikely to use illegal drugs. They are also three times more likely to reporthaving engaged in unprotected sexual intercourse, when compared withpeers that reported no or low levels of familyrejection. Latino men reported the highest number of negativefamily reactions to their sexual orientation in adolescence (Ryan C – Peds 2009;123(1):346-352).
Q: Are LGBTQ youth who attempt suicide usually under the influence of alcohol or other drugs during the attempt?
Far too many LGBTQ youth struggle with isolation and rejection from their families, friends, schools, communities and religious institutions. A large percentage of these young people will then turn to drugs and alcohol – a huge risk factor for attempting suicide.
Additionally, youth today, LGBTQ and otherwise, are increasingly misusing prescription medicines – both to cope and also as a means for a suicide attempt. Surveillance data from the Centers for Disease Control and Prevention (CDC) find that one-third of all suicide victims have alcohol in their systems at the time of death, and another one-fifth have opiates in their systems (2006). No data exists that can provide the sexual orientation or gender identity of suicide victims, but there is research regarding the use of drugs and alcohol among LGBTQ youth.
A recent study found that when compared with their heterosexual peers, youthidentifying as sexual minorities report having initiatedalcohol use at younger ages. Initiating alcohol use at younger ages among sexual minority youth significantlycontributes to elevated risks of binge drinking, and the findings suggest that disparities in alcoholuse among youth with a minority sexual orientation emerge inearly adolescence and persist into young adulthood (Corliss, HL – Arch Ped & Adole Med 2008;162(11):1071-1078). Further, questioning youth who are less certain of their sexual orientations, report even higher levels of substance abuse than their heterosexual or openly LGBT-identified peers (Poteat VP – J Consult and Clin Psych 2009;77(1):196-201). Recalling that substance abuse is a major risk factor in attempting suicide, and the increased risk for substance abuse among LGBTQ youth is a huge consideration in suicide prevention efforts among that group.
Q: What services are available to help these young people?
Aside from The Trevor Project’s programs, there are some other resources for LGBTQ youth that social workers and service providers should know about it. For middle and high schools across the nation, the Gay, Lesbian, Straight Education Network, GLSEN, (www.GLSEN.org) provides resources for students and educators alike to make their schools safer and healthier places for sexual minority youth. GSA Network (www.GSANetwork.org) also works to make schools safer in the state of California. Campus Pride (www.CampusPride.org) is a similar advocacy and education organization that focuses its efforts on college campuses nationwide. Given the link between being the victim of sexual orientation and gender violence with the increased risk for making a suicide attempt, these organizations do critical work.
For young transgender people or those that might be struggling with issues around gender identity, there is Trans Youth Family Allies, TYFA, (www.ImaTYFA.org). With a mission of promoting education and eliminating harassment, TYFA works nationwide to ensure that more services and support are available to young people who have specific needs related to gender identity and expression. Parents, Family and Friends of Lesbians and Gays (PFLAG) also has support and information available to help young transgender people; it is available through their PFLAG Transgender Network at http://community.pflag.org/Page.aspx?pid=380.
For young people who may be unsure of their sexuality and/or gender identity or who have questions on how to “come out,” www.OutProud.org has online information on all of these topics to help navigate these tough waters. There is also a GLBT National Youth Talkline for non-crisis issues, and it is staffed by trained volunteers at 1.800.246.7743 in the evenings every night. There are also valuable resource databases for the local level available both at www.TheTrevorProject.org under “Suicide Resources” as well as the GLBT National Help Center who in addition to the Youth Talkline also offers online peer-support chat. Their services are accessible at www.GLBTNationalHelpCenter.org.