Gay teens are much less likely to attempt suicide when they live in a supportive social environment — such as having gay and lesbian groups at school — compared with those who do not, a U.S. study suggests.
Several international studies have found higher attempted suicide rates among lesbian, gay and bisexual (LGB) youth compared with heterosexuals. Overall, suicide is the third leading cause of death among youth aged 15 to 24, researchers say.
The study in Monday's issue of the journal Pediatrics found LBG youth living in a social environment more supportive of gays and lesbians were 20 per cent less likely to attempt suicide than LGB youth living in environments that were less supportive.
A supportive environment was associated with a nine per cent lower rate of attempted suicide among heterosexual students.
"The results of this study are pretty compelling," said study author Mark Hatzenbuehler of Columbia University's Mailman School of Public Health in New York City.
"When communities support their gay young people, and schools adopt anti-bullying and anti-discrimination policies that specifically protect lesbian, gay, and bisexual youth, the risk of attempted suicide by all young people drops, especially for LGB youth."
The study looked at 31,852 Grade 11 students in Oregon. Of these, 1,413 or 4.4 per cent self-identified as gay, lesbian and bisexual in the anonymous survey from 2006 to 2008.
To avoid relying on the teens' own perceptions of their social environment, Hatzenbuehler developed a set of five objectives to assess the environment:
- The proportion of same-sex couples living in the county, based on the U.S. census.
- The proportion of registered Democrats living in the county, given that previous studies suggest political ideology was tied with attitudes toward sexuality.
- Whether the school had a gay-straight alliance.
- Proportion of schools with anti-bullying policies specifying protection for LGB students.
- Whether the handbook included anti-discrimination policies based on sexual orientation.
Earlier studies of LGB youth used social factors such as family and school connectedness as self-reported measures of the social environment, but those are also measures of mental health status.
In Hatzenbuehler's study, the influence of social environment on suicide attempts went beyond known risk factors such as depression, binge drinking, peer victimization like harassment, and physical abuse by an adult.
Reducing suicide attempts
"The social environment appears to confer risk for suicide attempts over and above individual-level risk factors," Hatzenbuehler concluded in the study.
"These results have important implications for the development of policies and interventions to reduce sexual orientation–related disparities in suicide attempts."
LGB health specialists and geographers have also observed that "place matters" in the mental and emotional health of LGB youth in Canada, noted Nathaniel Lewis, a PhD candidate in geography at Queen's University in Kingston, Ont. Lewis has studied gay men's migrations from the Maritimes or northern Ontario to Ottawa as they moved into adulthood.
"This study is an extremely productive intervention into the links between social environment and LGB health," Lewis said in an email.
Lewis called the findings "another step toward definitively demonstrating that it is the uneven, often difficult, social environment that gay, lesbian, and bisexual people must negotiate that is the cause of mental health disparities they experience."
The study was funded by the Center for Population Research in LGBT Health at the Fenway Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Robert Wood Johnson Foundation.