Appendix B

Summary of the Risk for Suicide on the Basis of Sexual Orientation Noted in Books on Youth Suicide

Books about the adolescent suicide problem have a history of being silent about the probability that GLB (gay, lesbian, and bisexual) youth would be at risk for attempted suicide and possibly suicide. Suicide Among Youth: Perspectives on Risk and Prevention(1989) was silent on the subject(96). Suicide Among the Young(1984) only has a few references as isolated case histories(98). By 1991, however, Adolescent Suicide Assessment and Intervention contained the following information. "Harry(1989)[38] notes for example that homosexuals are 2 to 6 times more likely to attempt suicide than are heterosexuals and that risk for an attempt is greatest during the period of coming to terms with 'coming out' typically about the age of 18-19." (91:98) [This is outdated information related to the Bell & Weinberg(1978) study. According to Remafedi(1991) (and others), the high risk age would now be 14-16.]

The 1994 book, Suicide and Homicide Among Adolescents, also noted that homosexuality was a factor in the youth suicide problem. "Sixth, gender identity issues, including homosexuality, also appear to represent a risk factor for youth suicide (Remafedi et al. 1991; Judson, 1993)."(95:16) The factor is also noted in the table Risk Factor for Suicide(95:115), but explanations are not given concerning why homosexuality, or even gender identity issues, are implicated in the youth suicide problems. Of the two references given to enlighten the reader about this problem, the "Judson" reference is listed as Research proposal. Unpublished manuscript, 1993."

Some exceptions to the rule occurring before 1991 nonetheless exist. Growing Up Dead: A Hard Look at Why Adolescents Commit Suicide(1978) contained a chapter titled "Colour Me Gay." The author, however, was a journalist, not a suicidologist. Herbert Hendin, a suicidologist, did have a chapter Suicide and Homosexuality in Suicide in America(1982). Clinical data was given to support the idea that homosexuals would be at greater risk for suicide, but little else; not even citing the Bell & Weinberg(1978) study which suggested that GLB people, and especially GLB youth, were at risk for suicide attempts(92:107-124).

In Hendin's 1995 version of the same book, the chapter on homosexuality had changed somewhat, especially at the beginning. Additional information was presented suggesting that GLB people, and possibly GLB youth, may be a higher risk for suicide. Little effort was made, however, to present a convincing argument in this respect. This was expected, however, because Hendin's 1987 and 1991 papers on youth suicide(1,93) did not mention GLB youth and their probable high risk for having suicide-related problems.

Hendin (1995) cites the Rich et al.(1986) study as concluding that "the rate of suicide among homosexuals is not greater than that for heterosexuals"(94:129), but he recognized that the researchers probably did not identify all homosexuals in their sample of suicide victims. (See information related to this study and related conclusions made in this paper.) He nonetheless goes on to note, as was done in 1982, that his "own work has provided some evidence that homosexuals are overly represented in suicide attempts." (94:131)

Canada's official publication on suicide, Suicide in Canada(1987), did not mention anything related to homosexuality, and the same occurred in the unpublished updated version of the same book which became available in 1993(99,100). I was troubled by the omission, contacted Dick Ramsay (Associate Professor, Faculty of Social Work, University of Calgary) early in 1994, and expressed my concerns. As a result of this, given the information presented in the first edition of The Gay, Lesbian and Bisexual Factor in the Youth Suicide problem, and in the greatly expanded second edition(107), an addition was made to the text. The 1995 edition of Suicide in Canada now contains a subsection titled "Gay men and lesbian" in the section High-Risk Groups. (101:24-25)

In October, 1995, a Supplement of Suicide and Life-Threatening Behavior, Research Issues in Suicide and Sexual Orientation, was published. It was the result of a workshop which had been held Atlanta in June, 1994(102:1). "The workshop was convened," not because Suicidologists really wanted to address this issue, so it seems, but because it was a "response to public and Congressional inquiries regarding rates of suicide among gay and lesbian people, and to repeated media reports of a purportedly elevated risk of suicidal behavior in this population."(102:1) Although interesting papers were published and needed research recommendations were made, the ultimate conclusion was that "numerous limitations currently prevent drawing accurate conclusions about the potential relationship between suicide and sexual orientation(102:2,103). Recommendations were not made with respect to having suicide prevention/intervention programs begin addressing GLB youth suicide issues. At best, professionals in these fields were left with the "out" most have used to avoid helping these youth. They were told that nothing is conclusive about the relationship of youth suicide problems and sexual orientation.

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25 Nov 1995