The amount of support that a community has for its homosexual members is an independent risk factor for suicide attempts among lesbian, gay, and bisexual (LGB) teens, according to a recent study of nearly 32 000 11th graders in 34 Oregon counties.
Mark Hatzenbuehler, PhD, of the Mailman School of Public Health at Columbia University, in New York City, analyzed student data from 297 schools and reported that LGB teens living in unsupportive surroundings had a 20% higher risk of attempting suicide than those in more supportive areas.
Even when Hatzenbuehler controlled for known risk factors for suicide attempts among LGB teens—depression, binge drinking, physical abuse by an adult, and being bullied by peers—social climate still was linked with a significant increase in attempted suicide.
“Characteristics of the social environment increase the risk for suicide attempts among LGB youth, over and above individual-level risk factors,” Hatzenbuehler wrote (Hatzenbuehler ML. Pediatrics. doi:10.1542/peds.2010-3020. [published online April 18, 2011]).
He noted that one of the strengths of the study is an index he developed to evaluate LGB students' social surroundings. Some studies have evaluated social support based only on participants' comments, which can blur the line between legally discriminatory practices and perceived discrimination.
The index consists of 5 objective indicators, based in part on previous research with LGB adults, that correlated strongly with social support. Those indicators are the proportions of same-sex couples, Democratic party voters, schools with gay-straight alliances, schools with antibullying policies that specifically protect LGB students, and schools with antidiscrimination policies that include sexual orientation.
The study is based on student responses in the 2006-2008 Oregon Healthy Teens survey as well as data from the US Census Bureau, Oregon Secretary of State Election Division, and the Oregon Department of Education.
Of the students surveyed, 1% identified themselves as gay or lesbian and 3% as bisexual. Overall, 20% of lesbian and gay students and 22% of bisexual students said they had attempted suicide at least once during the previous 12 months. In contrast, 4% of heterosexual students reported a suicide attempt in the previous year.
While LGB teens' risk of attempting suicide was 20% higher in areas with little or no support, the increased risk among heterosexual students in unsupportive surroundings was 9%.
The findings suggest that schools should adopt policies to create more supportive and inclusive surroundings. By encouraging more positive environments, such policies could help reduce the risk of suicide attempts not only among LGB students, but also among heterosexual students.
Hatzenbuehler said future research should try to determine more specifics about unsupportive surroundings that increase the risk of attempted suicide. As an example, he mentioned studies in which LGB adults living in states that deny them legal protections report that negative media portrayals, antigay graffiti, derogatory comments and jokes, and a lost sense of security are substantial sources of stress.
“Stress contributes to the development of psychopathology, which in turn increases the risk of suicide attempts,” he wrote.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
and access these and other features:
Register Now
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.