Gay Youth as All You Need Support and Acceptance: A Revealing Study

Young gay men's suicide rate higher, study says

by Peter Freiberg
for The New YorkBlade

Also on Gay.com:
Coping with depression
Coming out
Youth Zone


Nearly one in five men who report having sex with men have attempted suicide at least once, a rate more than five times as frequent as men who report they are exclusively heterosexual, according to a recently released study. But of those homosexually active men who reported at least one suicide attempt, the overwhelming majority were under 30. This striking age correlation, the researchers said, suggests that the higher risk for homosexually active men compared to heterosexually active men "might not continue through later adulthood." In fact, the researchers predicted, the "great majority" of homosexually active men will not report any suicide attempts during their lifetime. Co-author Vickie Mays, also a psychologist, said the findings reinforced evidence that the vast majority of homosexually active people "do not suffer from psychopathology"and when they do, it is not "because they are gay." The study, published in the April issue of the American Journal of Public Health, also found that the great majority of homosexually active men did not report having experienced any of the three major emotional disorders assessed in the survey. The study found that 19 percent of men who report having sex with other men have attempted suicide at least once, a rate more than five times as frequent as men who say they are exclusively heterosexual.

The results, said the study's other co-author, psychologist and epidemiologist Susan Cochran, in an interview, "suggest to me that whatever increased risk there is for suicide attempts (among gay men) is clustered in the younger ages, around adolescence and younger adulthood, the teens and early twenties."

"What the study underscores," Cochran said, "is that there's a greater risk of suicide attempts in people's coming out years." Cochran and Mays, members of the faculty at the University of California at Los Angeles, examined the results of the third National Health and Nutrition Examination Survey, given between 1988 and 1994 to a sampling of Americans from 17 to 39
years old. The survey, which is conducted by the National Center for Health Statistics of the federal Centers for Disease Control and Prevention, does not ask men their sexual orientation, but does ask them the gender of their sexual partners. (Women were not questioned about the gender of their sex partners.)

While Cochran and Mays caution that the survey's focus on sexual behavior alone may lead to overestimating the number of homosexual/bisexual men, it is also likely that an unknown number of men failed to report same-sex partners to interviewers. The 3,503 men in the overall sampling were divided into three groups; those reporting same-sex partners, those reporting
only female sexual partners, and those reporting no sexual partners. The groups were compared for histories of suicide symptoms and emotional disorders. Of the 3,503 men, 78 (or 2.2 percent) reported having had at least one male sexual partner, and most of these also had had female partners. Of these men, 19 percent reported at least one previous suicide attempt. In
contrast, only 3.6 percent of heterosexually experienced men reported having attempted suicide. But while men younger than 30 were about 61 percent of the homosexually experienced men, they represented 98 percent of that population's group reporting a previous suicide attempt. This was very different from the exclusively heterosexually experienced men, whose reporting of suicide attempts did not vary significantly between younger and older men. The authors note the that rate of reported suicide attempts for the homosexually experienced men was somewhat lower than the rates revealed in two recent surveys of high school students in Minnesota and Massachusetts.

One possible reason for the rate differences, the authors say, is that the CDC sample includes older men, who have passed the age when the risk for suicide attempts is greatest. There may be "reporting bias," the authors say: Older men may not recall as suicide attempts their youthful self-destructive behaviors, especially less severe ones, or they may interpret them differently from an older vantage point. According to Gary Remafedi, associate professor of pediatrics at the University of Minnesota, the greater risk of suicide attempts among gay youth compared to heterosexual youth is due to specific factors such as gender "non-conformity" among males, coming out very early, and conflicts with family and friends over being gay. There are also, Remafedi noted, risk factors common to all young people, such as substance abuse and mental health problems. The CDC study also examined the existence of three types of emotional disorders among the men surveyed, major depression (single episode and recurrent), mania and dysthymia (low-level chronic depression). No significant differences were observed between the two groups with regard to experiences of mania or dysthymia. The researchers also found no differences in overall reports of depression between the homosexually and exclusively heterosexually experienced men. But there was more reporting of recurrent depression among homosexually experienced men with as many as one out of five having dealt with this problem, and
usually at a younger age than exclusively heterosexual men.

"This finding provides further evidence that adolescence may be a particularly difficult time for young gay men," assert Mays and Cochran. In another study by Cochran and Mays, published last month in the American Journal of Epidemiology, the researchers found that nearly three-quarters of homosexually active men and women had not had any of six psychiatric disorders in the previous year.

However, they found a "small increased risk" among homosexually active individuals compared to heterosexually active people for experiencing at least one of these syndromes. Homosexually active men were more likely than other men to experience major depression and panic attacks (possibly), the authors say, due to the psychological effects of coping with the HIV
epidemic, while homosexually active women were more likely than other women to be classified with alcohol or drug dependence syndromes. Both groups were more likely than heterosexually active individuals to have used mental health/substance abuse services in the year prior to the interview, which could indicate a greater willingness to use such services as opposed to a greater need. "There could be a variety of reasons why the utilization is higher," Mays said. "There may actually be healthy reasons for it." In an interview, Mays said that while the vast majority of homosexually active people do not have psychiatric disorders, "We should be vigilant about making sure that we provide adequate and appropriate treatment" for those who do.

The two studies reflect what Cochran called a "new phase" of examining mental health issues relating to gay men and lesbians. Fifty or sixty years ago, Cochran noted, the presumption was that gay people were all psychologically disturbed. Then, Dr. Evelyn Hooker demonstrated, and other researchers confirmed, that there is no difference between the rate of mental illness
among gays and the rest of the population. More recently, Cochran said, researchers are re-examining these issues and finding that there may be "some excess risk (among gays) for some disorders," such as alcohol abuse or suicide attempts. "One of the concerns for those of us who are doing this work," Cochran said, "is that we don't want to go back to where life was before Evelyn Hooker. So I want to make the point that even though there's increased risk, most (homosexually active) people don't report suicide attempts or (emotional) disorders. That's very, very important to remember."