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Wednesday, October 25, 2006

 

Are gays more suicidal than straights?

A reader wrote and asked if I would review another new study from the Archives of Sexual Behavior regarding suicidality and sexual orientation. The reference is:

de Graaf, R., Sandfort, T.G.M., & ten Have, M. (2006). Suicidality and sexual orientation: Differences between men and women in a general population-based sample from the Netherlands. Archives of Sexual Behavior, 35, 253-262.

I don't have time for a full review but in looking over the study, it is noteworthy and important the authors controlled for prior psychiatric conditions and they asked participants about their feelings of discrimination.

There were significant differences between straight and gay men, after controlling for psychiatric status on death ideation, death wishes, suicidal contemplation and deliberate self-harm. Controlling for psychiatric status left only one statistical difference between straight women and lesbians: suicide contemplation.

Some points to consider:
1. Although the majority of gay men were free of suicidality, there is a risk for one or more measure of suicidality based on sexual orientation.
2. The effect sizes of the risk are small to modest. In other words, there is much overlap between gay and straight groups. The differences require much else besides sexual orientation to account for the variation.
Death ideation - .7% (trivial)
Death wish - 2%
Suicide contemplation - 4%
Deliberate self-harm - 2%
3. Discrimination moderated the first two factors but even with this variable considered, suicide contemplation and self-harm were association with sexual orientation.

These data are neutral with regard to ideology. Caution is warranted and one cannot say that homosexual orientation leads to suicidality but for reasons that are unclear, there is a small to modest risk. There are other factors that should have been controlled as well but apparently were not: child abuse, current sexual behavior, substance abuse, etc. The remainder of the variation might be accounted for by factors not assessed.

Comments:
Did the study ask about experience of discrimination or more specifically about "feelings" of discrimination?
 
They asked if the participants had experienced discrimination. 24.4% of men said they had and 18.6% of the women did.
 
"Caution is warranted and one cannot say that homosexual orientation leads to suicidality."

Correct. Because that would be our old friend "post hoc, ergo propter hoc". Correlation does not equal cause.

It is not at all surprising to me that gay people might be more prone to suicidal thinking, impulses or actions. Did they factor in the damage it does to one's psyche to be told that you are going to burn in Hell for all eternity if you don't stop being gay?
 
Along the same lines, did the researchers consider HIV status? Multilple Loss Syndrome ("Gay Grief")? Did they take into account the subjects' level of family and community support?

Did they ask whether those who were closeted were more likely to be suicidal? Whether or not those from more fundamental religious backgrounds showed more suicidal tendencies?

Too often, folks who are opposed to homosexuality look at studies like these and condlude that the gayness (not the social and religious pressure) is the source of the subjects' unhappiness. Discrimination is ubiquitous and subtle. It is not just the overt acts of persecution, it's the constant implied and spoken message that you are sick or sinful -- and that you would try to change if you were a "good" person.
 
I do not easily dismiss the idea that sexual orientation might have some direct relationship to a small amount of the variation between straight and gay groups. At least one cannot do this due to the data that we have. A study would need to hold constant all known risk factors for suicide and leave only sexual orientation as the factor of interest. At the same time, those who want to find same-sex attraction as the culprit have a hard empirical case to make. Since many factors have not been controlled and sampling is so critical, one cannot be dogmatic about the nature of the differences observed. The other inconvenient observation for those who find sexual orientation as the causal factor is that most gays do not show the risk factors. These studies are comparisons of group central tendencies with much overlap between groups.
 
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