Lesbian, gay and bisexual teens are five times more likely to attempt suicide than their heterosexual peers - but those living in a supportive community might be a little better off, according to a new study.
The findings, published online in Paediatrics, showed that lesbian, gay and bisexual (LGB) teens living in counties with a high proportion of gay and lesbian couples, and those who went to schools with gay-straight alliances and anti-discrimination policies, were less likely to attempt suicide than LGB teens living in less accepting environments.
The finding is "a call to action in providing a roadmap for how we can begin to reduce suicide in LGB youth," Dr Mark Hatzenbuehler, the study's author from Columbia University in New York, said.
He said that while previous studies have shown that LGB teens are more likely to attempt suicide, those studies haven't been able to determine why exactly that's the case.
Dr Hatzenbuehler used data from 3 years of health surveys given to teens in Oregon. The data covered more than 30,000 high school students across the state, all surveyed during 11th grade.
Teens answered questions about depression, alcohol use, and relationships with their peers and family, as well as their sexuality.
To evaluate teens' social environments, Dr Hatzenbuehler gave each of the 34 counties where survey participants lived a score based on the proportion of same-sex couples living there, the county's percentage of registered Democrats, and the proportion of schools in the area that had gay-straight alliances and anti-discrimination and anti-bullying policies.
About 1400 - or between 4% and 5% - of teens surveyed identified themselves as being gay, lesbian, or bisexual.
Of those students, almost 22 kids out of every hundred said they had attempted suicide in the past year. That compared to about 4 of every hundred teens who identified as straight and said they had attempted suicide.
Suicide attempts were more common in LGB teens who reported being depressed and binge drinking, as well as those who had been victimized by their peers or physically abused by an adult.
But even accounting for all those factors, teens' social environment made a difference too. Those who lived in counties that scored poorly on measures of social environment were about 20% more likely to have attempted suicide than teens from high-scoring social environments.
"That challenges the myth that there's something inherent to being gay that puts (LGB teens) at risk for suicide attempts," Dr Hatzenbuehler said.
The findings show that by making a few concrete changes to their policies, schools can improve the community for their LGB students and perhaps cut down on attempted suicides as well, Dr Hatzenbuehler said.
Dr Ritch Savin-Williams, a psychologist from Cornell University in Ithaca, New York, questioned the notion that LGB youth are more likely to attempt suicide at all, and said the issue is more controversial than this study suggests.
He said that while LGB youth report suicide attempts more often than straight youth, their idea of a suicide attempt may be skewed. "We have given them the message that they are suicidal," Dr Savin-Williams, who wasn't involved in the study, said.
That's not to say that life is easy for those teens, Dr Savin-Williams said, and many of their thoughts of suicide might be attributed to LBG youth being victimized or hurt.
And it also doesn't mean schools shouldn't be doing everything they can to protect those teens with anti-discrimination policies, he added.
"Every kid has to be protected, every kid has to be safe, and it's the school's responsibility to do that," Dr Savin-Williams said. But rather than highlight suicide risks, he said, "my approach would be: look what kind of abilities you're squashing by not having protection of gay kids. I think that's a real loss."
Recently, some high schools and districts have faced legal trouble surrounding bans on gay-straight alliances, including schools in Corpus Christi, Texas, last month.
"If schools want to take seriously reducing suicide attempts among LGB youth, several things they can do are allowing gay-straight alliances, implementing anti-discrimination policies and implementing anti-bulling policies," Dr Hatzenbuehler concluded. "We can reduce suicide attempts in LGB youth by improving the social environment." (Reuters Health/ April 2011)