Sexual Orientation Associated With Suicide Risk

6 March 2001
Sexual Orientation Associated With Suicide Risk

More than one-third of all gay, lesbian or bisexual teenagers reported in an anonymous in-school survey that they had attempted suicide within the previous 12 months, according to a recent report in the journal Pediatrics.

Among straight teenagers, 9.9 percent said they had attempted suicide.

The responses came in a voluntary, anonymous Youth Risk Behavior Survey prepared by the U.S. Centers for Disease Control and Prevention with an added question on sexual orientation, according to Robert H. DuRant, Ph.D., professor of pediatrics at the Wake Forest University Baptist Medical Center, and senior author of the Pediatrics paper.

The study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents.

Youth who identify themselves as gay, lesbian or bisexual during high school are more likely to report engaging in multiple risky behaviors and to start them at an earlier age than other teens. In fact, the study showed that about 50 percent of these teens reported engaging in more than five risky behaviors, compared to fewer than 25 percent of their straight counterparts . . But these teens also feel threatened. More than one-fourth of the gay, lesbian or bisexual teenagers in the survey reported missing school because of fear in the previous 30 days, strikingly different from just 5.1 percent among straight teens. Among the gay teens, 32.7 percent said they had been threatened with a weapon in the previous 30 days, compared to 7.1 percent among straight teens.

More than half of the gay teens reported property damage at school during the past 12 months, and more than 68 percent reported they had been involved in a fight during the previous year. For 14 percent, the results of the fighting were serious enough to require medical treatment.

The survey also found that one-third of the gay, lesbian or bisexual teens reported sexual contact against their will, compared with 9 percent of the straight teens.

The teens, and especially the gay, lesbian or bisexual teens, described participating in a host of risky behaviors -- include alcohol, drug and cigarette use, and multiple sexual partners.

The survey was conducted in Massachusetts high schools in 1995 -- while DuRant was still a part of the Division of Adolescent and Young Adult Medicine of Children's Hospital in Boston. The sexual orientation question was added in Massachusetts only.

DuRant and the study's lead author, Robert Garofalo, M.D., now of the Sidney Borum Jr. Health Center in Boston, said, "These findings suggest that educational efforts, prevention programs and health services must be designed to address the unique needs of gay/lesbian/bisexual youth."

The degree of animosity to gay, lesbian and bisexual teenagers in Massachusetts was somewhat of a surprise, because at the time, two of the state's 10 congressmen were openly gay, along with a number of other office holders and public figures, and attitudes in Massachusetts on homosexuality are generally more liberal than in other parts of the country.

The contrast between gay and straight teens in risky behaviors that were volunteered on the anonymous questionnaire produced other surprises. For instance, use of smokeless tobacco in the previous 30 days was four times as common among gay teens than straight ones. Anabolic steroids were used six times more often by the gay teens than the straight ones.

Fifty-nine percent of gay teens smoked cigarettes, compared to 35 percent of straight teens.

The study found that gay teens engaged in a range of risky behaviors, even while they were very young. For instance, 59 percent reported alcohol use before age 13, 48 percent smoked cigarettes before age 13, 37 percent had tried marijuana, 17 percent had tried cocaine, and 27 percent engaged in sexual intercourse. All are strikingly more common than among straight teens.

The researchers asked questions about lifetime exposure to risky behaviors as well as in the preceding 30 days. In almost any variant -- use of alcohol, binge drinking, sharing needles, three or more sexual partners within the past 12 months -- the percentages were far higher among the gay teens.

"Gay, lesbian and bisexual adolescents face tremendous challenges growing up physically and mentally healthy in a culture that is often unaccepting," the researchers said.

In the survey of 4,159 teens in 59 high schools, 0.6 percent identified themselves as gay or lesbians, 1.9 percent identified themselves as bisexual, a total of 2.5 percent. Another 1.5 percent responded "not sure," and 3.7 percent responded "none of the above." And 9.3 percent skipped the sexual orientation question.