The social determinants of lesbian, gay, bisexual and transgender youth suicidality in England: a mixed methods study

Abstract

BackgroundLesbian, gay, bisexual and transgender (LGBT) youth have a higher risk of suicidality and self-harm than heterosexual youth populations but little is known about the underlying mechanisms. We aimed to investigate the social determinants of this mental health inequality.MethodsA two-stage sequential mixed method study was conducted. Firstly, 29 semi-structured interviews with LGBT youth (aged 13–25 years old) were completed. Data was analysed thematically. Stage 2 involved a self-completed questionnaire employing an online community-based sampling strategy (n = 789). Logistic regression analysis was performed to predict suicidality.ResultsFive social determinants explained suicidal risk: (i) homophobia, biphobia or transphobia; (ii) sexual and gender norms; (iii) managing sexual and gender identities across multiple life domains; (iv) being unable to talk; (v) other life crises. Youth who were transgender (OR = 1.50, P < 0.022), disabled (OR = 2.23, P < 0.000), had self-harmed (OR = 7.45, P < 0.000), were affected by abuse (OR = 2.14, P < 0.000), and affected by not talking about their emotions (OR = 2.43, P < 0.044) were most likely to have planned or attempted suicide.ConclusionsPublic health universal interventions that tackle bullying and discrimination in schools, and selected interventions that provide specific LGBT youth mental health support could reduce LGBT mental health inequalities in youth suicidality.

Psychological Correlates of Self-Harm within Gay, Lesbian and Bisexual UK University Students

“…LGB young people and students appear particularly at risk (Batejan et al, 2015;Haas et al, 2011;McDermott, Hughes, & Rawlings, 2017). This research has predominantly taken place in the US but a smaller number of studies conducted in the UK population do also suggest greater risk of self-harm for LGB young people or students (Warner et al, 2004;Young, Riordan, & Stark, 2011).…”

Safeguarding LGBT+ adolescents

“…Self harm and suicide. International research shows consistently higher rates of depression, anxiety, eating disorders, substance use, self harm, and suicide in the LGBT+ population 123456. In 2017, a UK based survey of 3713 LGBT+ young people5 found that 61% reported self harm and 22% a previous suicide attempt in the LGB cohort.…”

“…Of the transgender cohort, 84% reported self harm and 45% a previous suicide attempt. The disproportionately high rates have been linked to factors including homophobia, biphobia, or transphobia and being unable to talk openly about being LGBT+ 45. There is no evidence for a causative relationship between an LGBT+ identity and mental health problems.…”

“…Recent years have seen political and social progress for people who identify as LGBT+ (lesbian, gay, bisexual, and transgender; the “+” indicating inclusion of other minority sexual and gender identities). Yet international evidence shows ongoing health and social inequalities in this group, many of which emerge during adolescence and represent unique safeguarding risks 1234567. This article offers an overview of these risks, which include increased rates of self harm, suicide, and family rejection or abuse.…”

Sexuelle Identität, der Konsum von Alkohol und anderen Drogen, gesundheitliche Probleme und Behandlungsansätze: Ein unsystematischer Forschungsüberblick

“…Zu den bislang genannten gesundheitlichen Risiken der LSB-Menschen kann das Risiko für Suizidversuche und Suizide dazukommen. Gut belegt ist ein erhöhtes Suizidrisiko bei Jugendlichen mit von der heterosexuellen Mehrheit abweichender sexueller Orientierung sowie von jungen und älteren trans* Personen [34][35][36][37][38][39][40][41][42] Suizidversuche erhöht ist [43][44][45][46], wobei der Nachweis von Suiziden im Zusammenhang mit der Zugehörigkeit zu den sexuellen Minoritäten sehr schwierig ist [47]. Diese Befunde werden im systematischen Review von Hottes und Mitarbeiter*innen [48], vgl.…”