Across many countries, a strong association between nonfatal suicide behavior and sexual orientation has been observed, supporting the hypothesis that LGBT suicide occurs at high rates. Studies conducted over the last forty years indicate that Lesbian, Gay, Bisexual, and Transgender (LGBT) people may be at a higher risk for suicide attempts and ideation. There has been minimal attention regarding this disparity because U.S. death certificates do not identify the sexual orientation or gender identity of decedents, nor is it noted on the National Violent Death Reporting system (NVDRS). Therefore it is not definitively known if LGBT suicide rates are higher than the rates for heterosexual individuals.

An analysis of 25 studies consisting of subjects of many different nationalities revealed that lifetime prevalence of attempted suicides among bisexual and gay male teens and adults was four times higher than that of heterosexual makes in the same age groups. The rates of lifetime attempted suicides among bisexual and lesbian females were nearly twice that of heterosexual females. LGB teens and adults were found to be nearly twice as apt as heterosexuals were to report an attempted suicide in the past year. A subsequent analysis of 38 studies showed that LGB youth of both genders were three times more apt to report a lifetime attempted suicide than were heterosexual youth, plus they were four times as apt to make a suicide attempt that was medically serious.

Across many studies, 12% to 19% of LGB adults say they have attempted suicide, compared to fewer than 5% of all adults in the U.S.; and at least 30% of LGB teens say they’ve attempted suicide, compared to 8% to 10% of all teens. Until now, population-based research studies have not identified transgender subjects, but many nonrandom questionnaires reveal high rates of suicidal behaviors in the transgender population, with 41% of adult participants of the National Transgender Discrimination Survey of 2009 reporting lifetime attempts to commit suicide. Most studies show a higher rate of suicide attempts in bisexual or gay males than in bisexual or lesbian females, which is the opposite of the results seen among males and females in the general population.

LGBT suicide seems to be associated with “minority stress,” stemming from the social and cultural prejudices linked to minority gender identity and sexual orientation. This is the type of stress that comes from individuals experiencing discrimination or prejudice in the form of harassment, family rejection, violence, bullying and victimization. Increasingly being recognized as a part of minority stress is something called “institutional discrimination,” which results from public policies and laws that form inequities or leave LGBT people behind in receiving the protections and benefits afforded to others. These negative policies, not minority gender identity or sexual orientation per se, seem to be the main risk factors affecting LGBT suicide, suicidal behaviors and ideation.

Factors that foster resilience in LGBT individuals would include family support and acceptance, close connections to people who care for them, a sense of safety and security, positive feelings about sexual orientation/gender identity, and access to culturally appropriate and top quality mental health treatment. In order to prevent suicidal behaviors in the LGBT population there must be strategies in place that include: better identification of symptoms of depression, substance abuse, anxiety, and other mental problems, a reduction in prejudice; increased availability of LGBT-affirming mental health services and treatments; reducing forms of victimization and bullying; improving factors that foster resilience, including school safety and family support and acceptance; changing public policies and discriminatory laws; and taking steps to reduce suicide contagion.

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