Sexual Orientation and Gender Identity in Youth Suicide Victims: An Exploratory Study

Article excerpt

Objective: Our study was designed to explore additional outcome variables of a suicide case-control study to determine the association between sexual orientation and gender identity in suicide completion in children and adolescents.

Method: Fifty-five child and adolescent suicide victims and 55 community control subjects were assessed using semi-structured, proxy-based interviews and questionnaires regarding sexual orientation and gender issues, psychopathological diagnoses, and service use.

Results: In our sample, no significant differences between suicide victims and control subjects were found regarding same-sex sexual orientation nor intimidation related to same-sex sexual orientation. Suicide victims with same-sex sexual orientation were more likely than suicide victims without same-sex sexual orientation, to meet criteria for anxiety disorders. Within the month preceding their deaths, these youth were more likely to have consulted a health professional, a psychiatrist, as well as having been hospitalized, and were more likely to have consulted a psychiatrist in the last year.

Conclusions: In our sample, same-sex sexual orientation and gender identity issues do not appear to be more prevalent among youth who die by suicide, compared with youth recruited from the general population, nor for same-sex sexual-related intimidation. While exhibiting comparable levels of general psychopathological diagnoses associated with suicide, suicide victims with same-sex sexual orientation were more likely to meet criteria for anxiety disorders and to have consulted mental health professionals before their deaths.

Can J Psychiatry. 2010;55(1):29-34.

Clinical Implications

* Our study suggests that suicide victims with same-sex sexual orientation present with higher rates of anxiety disorders, compared with suicide victims without same-sex sexual orientation.

* Our study also suggests that most suicide victims with same-sex sexual orientation had consulted in the month and year prior to suicide, and that these time intervals might be considered important for suicide prevention in this high-risk group.

Limitations

* Our study is exploratory and based on a small sample size.

* Our study has a cross-sectional design.

Key Words: children, adolescents, suicide, same-sex sexual orientation, gender identity

Suicide is one of the leading causes of death in children and adolescents. The annual rates of suicide per 100 000 inhabitants were 0.5 for females and 0.9 for males aged 5 to 14 years, and 12.0 for females and 14.2 for males aged 15 to 24 years, respectively.1 Quebec has one of the highest rates of suicide among children and adolescents in the country and compared with other industrialized nations. This rate increased markedly from the 1980s through the 1990s (that is, from 11.1 per 100 000 in 1980 to 20.5per 100 000 in 1996).2

While a substantial body of literature supports increased risk for suicide associated with the presence of Axis I disorders, it is important to identify additional risk factors to better understand the etiology of suicide and, consequently, more effectively prevent its occurrence.3

As in many other areas involving suicide research, there is a disparity between attention paid by researchers to at-risk populations in adults and children, and very little research has been done addressing suicide in youths with same-sex sexual orientation. Most studies have focused on identifying suicidality and the risk factors associated with it. Russell and Joyner4 reported that homosexual youth are at least 2 times more likely than heterosexuals to attempt suicide. Further, a comparative study between homosexual or bisexual and heterosexual youth reported a greater than 7-fold increase in odds of a suicide attempt associated with bisexuality or homosexuality.5 Recently, it has been suggested that it is the experience of harassment rather than the sexuality status per se that is predictive of suicidal behaviour. …

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