Study links social environment to high attempted suicide rates among gay youth

The study appears in the April 18 issue of Pediatrics. It was conducted by by Robert Wood Johnson Foundation Health & Society Scholar Mark L. Hatzenbuehler at Columbia University's Mailman School of Public Health.

The study of nearly 32,000 11th-grade students in Oregon found that LGB youth were more than five times as likely to have attempted suicide in the previous 12 months, as their heterosexual peers (21.5 percent vs. 4.2 percent). Using a new tool designed to measure social environment, Hatzenbuehler found that LGB youth living in a social environment that was more supportive of gays and lesbians were 25 percent less likely to attempt suicide than LGB youth living in environments that were less supportive.

Overall, suicide is the third leading cause of death among youth ages 15 to 24, and LGB youth attempt suicide at significantly higher rates than heterosexuals. Few studies, however, have examined whether a young person's social environment contributes to the likelihood that he or she will attempt suicide.

Data was drawn from the 2006 and 2008 Oregon Healthy Teens survey, an annual survey of public school students in 8th and 11th grade in Oregon. Sexual orientation is assessed only in 11th grade; participants remain anonymous.

"The results of this study are pretty compelling," said Hatzenbuehler. "When communities support their gay young people, and schools adopt anti-bullying and anti-discrimination policies that specifically protect lesbian, gay, and bisexual youth, the risk of attempted suicide by all young people drops, especially for LGB youth."

Hatzenbuehler developed five measures of the social environment surrounding LGB youth on a county-wide level that included: 1) proportion of schools with anti-bullying policies specifically protecting LGB students; 2) proportion of schools with Gay-Straight Alliances (GSAs); 3) proportion of schools with anti-discrimination policies that included sexual orientation; 4) proportion of same-sex couples; and 5) proportion of Democrats in the county.

The study found that a more supportive social environment was associated with 20 percent fewer suicide attempts than an unsupportive environment. A supportive environment was also associated with a 9% lower rate of attempted suicide among heterosexual students.

Previous studies have documented risk factors for suicide attempts among LGB youth including depression, binge drinking, peer victimization, and physical abuse by an adult. Hatzenbuehler controlled for these individual risk factors in order to assess the influence of the social environment on suicide attempts above and beyond known risk factors for suicide attempts.

"The good news is that this study suggests a road map for how we can reduce suicide attempts among lesbian, gay and bisexual youth," Hatzenbuehler said. Unfortunately, he notes, some communities are heading in the wrong direction. He points to Utah, where school-based Gay-Straight Alliances -- student groups that work toward increasing tolerance between homosexual and heterosexual youth -- have come under attack.

"This study shows that the creation of school climates that are good for gay youth can lead to better health outcomes for all young people," said Hatzenbuehler.