Article

Sexual Orientation and Risk of Suicide Attempts Among a Representative Sample of Youth

Division of General Pediatrics, Children's Hospital/Harvard Medical School, Cambridge, Mass., USA.
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 4.25). 05/1999; 153(5):487-93. DOI: 10.1001/archpedi.153.5.487
Source: PubMed

ABSTRACT To examine whether sexual orientation is an independent risk factor for reported suicide attempts.
Data were from the Massachusetts 1995 Centers for Disease Control and Prevention Youth Risk Behavior Survey, which included a question on sexual orientation. Ten drug use, 5 sexual behavior, and 5 violence/ victimization variables chosen a priori were assessed as possible mediating variables. Hierarchical logistic regression models determined independent predictors of suicide attempts.
Public high schools in Massachusetts.
Representative, population-based sample of high school students. Three thousand three hundred sixty-five (81%) of 4167 responded to both the suicide attempt and sexual orientation questions.
Self-reported suicide attempt in the past year.
One hundred twenty-nine students (3.8%) self-identified as gay, lesbian, bisexual, or not sure of their sexual orientation (GLBN). Gender, age, race/ethnicity, sexual orientation, and all 20 health-risk behaviors were associated with suicide attempt (P<.001). Gay, lesbian, bisexual, or not sure youth were 3.41 times more likely to report a suicide attempt. Based on hierarchical logistic regression, female gender (odds ratio [OR], 4.43; 95% confidence interval [CI], 3.30-5.93), GLBN orientation (OR, 2.28; 95% CI, 1.39-3.37), Hispanic ethnicity (OR, 2.21; 95% CI, 1.44-3.99), higher levels of violence/ victimization (OR, 2.06; 95% CI, 1.80-2.36), and more drug use (OR, 1.31; 95% CI, 1.22-1.41) were independent predictors of suicide attempt (P<.001). Gender-specific analyses for predicting suicide attempts revealed that among males the OR for GLBN orientation increased (OR, 3.74; 95% CI, 1.92-7.28), while among females GLBN orientation was not a significant predictor of suicide.
Gay, lesbian, bisexual, or not sure youth report a significantly increased frequency of suicide attempts. Sexual orientation has an independent association with suicide attempts for males, while for females the association of sexual orientation with suicidality may be mediated by drug use and violence/victimization behaviors.

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    • "Reports indicate high rates of depression and suicidal ideation among lesbian, gay, bisexual, and transgender (LGBT) youth as compared to heterosexual youth (Garofalo et al., 1999; Gibson, 1989; Noell & Ochs, 2001; Remafedi, 1999; Safren & Heimberg, 1999). Additional research has shown that YMSM in particular have high rates of depression (Botnick et al., 2002; Kipke et al., 2007; Perdue et al., 2003; Salomon et al., 2009). "
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    • "With the exclusively heterosexual group as the referent for both genders, adjusted odds ratios (ORs) for all weight-related outcomes were calculated for each sexual orientation subgroup using multivariate logistic regression, adjusting for age (as a continuous variable) and race/ethnicity, based on findings of prior studies [11] [21]. In addition, ORs for having engaged in any unhealthy weight loss behavior were calculated for nonexclusively heterosexual youth as a combined groupdthat is, sexual minority youth, including those classified as heterosexual with same-sex partners, gay/lesbian, and bisexualdbecause this group as a whole may be at elevated risk for a number of adverse health outcomes [22] [23]. Those who responded " not sure " to the question on sexual orientation were not included in this combined group because previous research suggests that many unsure youth ultimately self-identify as exclusively heterosexual [16]. "
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    • "In contrast to previous studies (Fergusson et al., 1999; van Heeringen & Vincke, 2000), these findings showed suicide-risk LGBQ participants did not significantly differ from heterosexual counterparts on various measures of suicidal ideation or depressive symptoms. Instead, in support of other earlier findings, LGBQ reported more previous suicide attempts (e.g., Eisenberg & Resnick, 2006; Garofalo et al., 1999), greater likelihood disclose their suicidal intent (Ciro et al., 2005), and were more likely to predict future suicide attempts. These results show some support for unique suicidal characteristics by sexual orientation. "
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