This is my graduate thesis from 2010, a literature review on the topic of Gay Adolescent Suicide.

Running Head: Gay Adolescent Suicide

Gay Adolescent Suicide:

A Review of the Literature

Brandon Muller

University of Puget Sound

Abstract

This literature review evaluates and connects previous research on the topic of suicide in adolescent lesbian, gay, bisexual, and transgender (LGBT) populations.  Risk factors for suicide are identified that may be specific to or particularly noteworthy for this population: negative peer attitudes, rejection, social isolation, homophobic attitudes, shame, and lack of parental acceptance.  Protective factors for suicide are also identified: familial acceptance, proud identity, access to resources, self-acceptance, and high self-esteem.  It appears that negative attitudes and beliefs about homosexuality create a perpetual negative societal climate for LGBT individuals, which may be the underlying causal factor with regard to many other risk factors and ultimately suicide attempts or completions themselves. 

Imagine for a moment that you are a parent, and you have just learned that your adolescent son or daughter has committed suicide.  What thoughts and emotions would flood you?  Shock, horror, hopelessness, helplessness, and despair would likely be experienced regardless of whether your son or daughter was lesbian, gay, bisexual, or transgender (LGBT).  Now imagine that you were aware of your son or daughter’s orientation and you weren’t accepting of or were even hostile toward your child: the wide spectrum of emotions experienced may be even more intense and the deep regret you experience may be overwhelming.

For many parents it takes the suicide of their LGBT child for them to realize how much society and religion’s negativity and hostility, as well as their own lack of acceptance of LGBT individuals, likely affected their son or daughter.  Other parents are left with questions as their seemingly happy teenager commits suicide out of the blue, and the fact that they might be LBGT didn’t even cross their mind.  The results of a study cited by Kitts (2005) indicate that 54% of LGBT adolescents may attempt suicide at least once before coming out to others.  

Being adolescent alone increases the chance of suicide.  When factors start to compound, that risk may grow exponentially.  Gould et al., as cited by Kitts (2005), relate that every year suicide is attempted by about one million adolescents, and that every 90 minutes one adolescent succeeds in suicide completion.  In an article on suicide risk factors in gay youth, Proctor and Groze (1994) indicate that among young people in the United States in the 1980’s aged 15-19, suicide was the second leading cause of death, and the suicide rates have only climbed since then.  The findings of a 1989 study by the U.S. Department of Health and Human Services (DHHS), as cited by Proctor and Groze, indicate that when compared to non-LGBT adolescents, LGBT youth are two to three times more likely to complete suicide.  Also in the same article, Bell and Weinberg (1978), as cited by Proctor and Groze (1994), assert that gay men are six times more likely to attempt suicide than heterosexual men, and lesbians are twice as likely to attempt suicide as heterosexual women.  

Only by understanding the reasons behind their increased risk can we as a society hope to prevent the additional psychological distress that LGBT youth are forced to endure and begin to reduce their risk for suicide.  In this paper I will seek to answer the following questions: What risk factors contribute to suicide in LGBT youth, and why are they at increased risk for suicide?  What protective factors exist, and what effect do they have at mitigating risk factors?

Method

I found my sources by searching on the electronic databases ERIC and PsycINFO.  I utilized the following search keywords: homosexuality + suicide (109 results), homosexuality + suicide + stigma (7 results), homosexuality + suicide + risk factors (12 results), homosexuality + suicide + risk factors + adolescents (6 results), gay + youth + suicide (47 results), gay + youth + suicide + homophobia (11 results), gay + social isolation + suicide (3 results).  In an attempt to reduce bias and increase validity, various keywords were used with effort to compile a diverse array of sources that represented different perspectives.  I populated 195 results total, and out of these I utilized seven for the purposes of this literature review.  My process in choosing articles was to read abstracts and make a determination whether the article contained pertinent information to my topic.  I was looking for specific information: articles that explored suicide risk for LGBT adolescents and discussed risk factors and/or protective factors for suicide.  I was also looking for articles that explored how protective factors interacted with risk factors in this population as well as articles that examined possible underlying causes of risk factors such as homophobia, negative peer attitudes, and lack of familial acceptance.  Each article I selected met one or more of these criteria.

Results

Risk Factors

In their article on risk factors among LGBT youth, Proctor and Groze (1994) reviewed several studies and identified several risk factors believed to contribute to suicide in LGBT youth.  The risk factors identified were low self-esteem, social isolation, depression, negative family interactions, and negative social attitudes.  One such study conducted by Remafedi et al. (1991) concluded that out of the total number of attempted suicides, the percentage of subjects who attributed the attempt to family problems was 44%.  The percentage of subjects who attributed the attempt to personal or interpersonal turmoil was 33%.  Also in this study, 30% of the subjects identified depression and 22% cited problems with peers.  Sears (1991), as cited by Proctor and Groze (1994), discovered several possible precursory factors for suicidal ideation or attempts in LGBT youth, including social isolation, anger, depression, repeated stress, feelings of inadequacy, and sexual-identity difficulties.  Common risk themes that appear out of these studies are low self-esteem, depression, social isolation, and negative interactions (familial and peer).  

Schneider, Farberow, and Kruks (1989), as cited by Proctor and Groze, attempted to determine risk factors for high school – college age LGBT individuals.  Likely risk factors were identified for those who attempted suicide.  These included paternal alcoholism, familial physical abuse, and familial suicide attempts.  They concluded that lack of family acceptance may not be the key factor in LGBT suicide, as they found no difference in how the suicide attempters and non-suicidal LGBT subjects viewed the degree of acceptance or rejection in key areas of coming out.  All of these factors are related to families and suggest that even though they concluded that family acceptance of LGBT youth may not be the deciding factor in a suicide attempt or completion, family history comprises an important set of risk factors that should not be ignored.  Therefore, the finding that lack of family acceptance may not be the key factor of suicide should be interpreted cautiously. Even if not a primary factor, it likely still plays a critical role.  Many other studies emphasize the importance of familial risk factors in LGBT youth. (Remafedi et al. (1991), Schneider, Farberow, and Kruks (1989), Sullivan and Woodarski (2002)).    

Lack of family acceptance likely contributes to and compounds with other risk factors: for example, a LGBT youth may become depressed that his or her family doesn’t accept him or her.  Another could develop low self-esteem because he or she isn’t accepted by their family and as a result may be avoided (social isolation), disrespected, made fun of, or any number of other risk factors which may stem from the lack of acceptance.  Sullivan and Woodarski (2002) suggest that LGBT adolescents face a unique risk factor that involves not having a loving parental role model who has gone through the same thing.  This lack of parental relatability may compound the adolescent’s risk factors and lack of familial acceptance.  Lack of parental relatability and lack of parental acceptance may not be the direct cause of suicide attempts or completions for LGBT adolescents, but it is possible these factors predispose LGBT adolescents to many other risk factors.

Kourany (1987), as cited by Proctor and Groze (1994), conducted a study which involved psychiatrists who were members of the American Association of Adolescent Psychiatry.  They completed questionnaires which asked about suicide risk factors and degree of risk among LGBT youth.  Kourany found that it was the psychiatrists’ opinions that the most common cause of LGBT youth suicide was related to familial problems.  Intrapsychic distress was thought to be the next and was defined as feelings of isolation, futility, rejection, rootlessness, hopelessness, low self-esteem, lack of identity, and lack of direction and goals in life.  The psychiatrists also thought psychiatric disorders such as depression, character disorders, schizophrenia, and substance abuse to be risk factors, although they weren’t thought to have as dramatic of an impact on suicide as other factors.  Again, familial factors are singled out as very significant in LGBT youth suicide.  It is useful to consider how familial problems (most likely resulting from lack of familial acceptance or lack of parental relatability) may be causal factors in intrapsychic distress, and are at the very least almost certainly correlated ones.  The psychiatrists also suggested that intrapsychic distress may have a big impact on LGBT suicide.  If an LGBT youth isn’t accepted by his or her family, (rejection), this rejection can breed hopelessness that they will never be accepted, which could have a profoundly negative impact on identity (lack of positive identity development).  It is easy to see how constant rejection, hopelessness, and lack of identity could contribute to low self-esteem, and in turn suicide risk.  

Hunter (1990), as cited by Proctor and Groze (1994), looked at violence as a risk factor for LGBT youth.  Of Hunter’s sample of 500 youth from the Hetrick-Martin Institute, 40% reported violent attacks.  Of this 40%, 46% felt the attack was related to their sexual orientation.  Sixty one percent of the attacks were within the youth’s families, and 44% of the youths who reported being attacked also experienced suicidal ideation.  Hunter did not determine whether violence caused the suicidal ideation or was merely correlated with it.  Violence is not a happy thing to have experienced, and especially when accompanied with lack of familial acceptance, it is easy to see how it could contribute to suicidal ideation or attempts.  An LGBT youth who may face rejection at home might envision school or the community as a safe place.  Having been violently attacked, they could lose any sense of safety, which is one of Maslow’s hierarchy of needs, (Maslow, 1943).  Violence could contribute to other risk factors because youth who have been attacked would likely feel rejected by society and God for allowing the attack to happen.  Additionally they could become isolated by fear of being attacked again, hopeless that society will never be a kind place for them, so why should they even try?  

Herek (1984), as cited by Proctor and Groze, found evidence of negative societal attitudes toward homosexuality via attitude statements of male and female undergraduate students.  Cramer and Roach (1988) suggested that these negative attitudes influence the decision to come out, and that suicidal ideation may be a response to the negative pressures of society rather than an indication of pathology.  This is an interesting finding because it suggests that negative societal attitudes about homosexuality create a hostile environment, and that hostile environment may have a bigger impact on suicidal ideation in LGBT youth than pathology such as depression.  This finding suggests that the suicide risk of LGBT individuals may decrease profoundly if society as a whole were able to accept and adopt a more positive attitude toward homosexuality.  

McDermott et al. (2008) approach the risk factor of homophobia in a study with four groups of young people aged 16-25 years.  For three of the groups, LGBT individuals were specifically recruited; for the fourth group, the researchers did not attempt to obtain LGBT participants. The study participants defined homophobia as punishment for the transgression of heterosexual norms through physical and verbal abuse, rejection or isolation that works to punish at a deep individual level to create psychological distress.  This mistreatment may be causal and is likely at least correlated to shame and may cause LGBT youth to feel disgusting and abnormal because of their sexual orientation.  In the same article, McDermott et al. go on to describe research they conducted with young LGBT individuals.  Those results suggest that each individual employs his or her own unique strategies, tactics, and maneuvers to cope with homophobic discrimination.  The way in which these adolescents cope was thought to be influenced by personal, economic, and social factors, as well as the setting in which the discrimination occurred.  Some adolescents coped by moving schools or avoiding eye contact, while others coped by self-harm and fighting.  

Those LGBT adolescents who acknowledged experiencing homophobic treatment also indicated the homophobia was expected, ordinary and routine.  This routinization and minimization that the adolescent’s employed may have been an attempt to deflect shame and to be unaffected by the abuse.  This strategy may help protect them against the negative effects of homophobia, but McDermott et al. suggest it comes at a price.  McDermott et al. (2008) are concerned that by minimizing and routinizing homophobic behaviors, LGBT youth may be hesitant or unlikely to seek help and instead try to cope on their own.  Homophobia is a very complex risk factor because it is thought to be a risk factor for suicide; it may be causal to or at least correlated with other risk factors, and it may be a contributor to why many LGBT youth don’t seek help.    

Post Traumatic Stress Disorder (PTSD) is another risk factor for suicide that has been studied in the Veteran population, where it is thought to be most prevalent.   Many LGBT youth experience severe trauma from homophobic treatment.  In an article on gay, lesbian, and bisexual adult recollections of bullying during the time they were in school, Rivers (2004) studied the effects of PTSD in the LGBT population.  Twenty-six percent of the study participants identified their continued, regular distressfulness from recollections of school bullying. 

With regard to PTSD symptoms, 26% identified experiencing psychological distress when in a situation reminding them of school victimization.  Twenty-one percent reported memories of being bullied that were distressing or intrusive.  The number of participants who indicated having recurrent dreams or nightmares about school bullying was four percent.  Nine percent reported experiencing flashbacks in the form of illusions, hallucinations, dissociative episodes, or a feeling of reliving events while awake.  After analyzing the data collected, Rivers identified 20 participants (14 gay and bisexual men and six gay and bisexual women, comprising 17% of the total sample) who met DSM criteria for a valid diagnosis.  Fifty-three percent of the sample reported contemplating suicidal or self-harm behaviors as a result of bullying and 40% attempted self harm or suicide at least once.  Three quarters of the attempters identified more than one occasion of attempting.  PTSD may not be a risk factor that affects school-age LGBT adolescents because it is believed to be more likely to occur among adults.  Even so, it is thought to develop because of the severe trauma LGBT adolescents may be forced to experience and is a risk factor for suicide that can plague LGBT individuals throughout their lives.  This is a risk factor that warrants further investigation because it can put LGBT individuals at a constant elevated risk for suicide, long after exposure to homophobic bullying has ceased.  

In his article on gay adolescents and suicide, Kitts (2005) relates that gayness in itself is not what puts the LGBT population at a high risk of suicide.  Rather, the increased risk is a result of the psychosocial distress associated with being gay. Remafedi (1999), as cited by Kitts (2005), concluded from his evaluation and analysis of six studies that suicide attempts in the LGBT adolescent population may be significantly associated with psychosocial stressors.  Remafedi also found in his analysis that psychosocial stressors such as gender nonconformity, early awareness of being gay, victimization, lack of support, school dropout, family problems, acquaintances’ suicide attempts, homelessness, substance abuse, and other psychiatric disorders were more prevalent among LGBT adolescents than their heterosexual counterparts.  

Russell and Joyner (2001), as cited by Kitts (2005), observed in a study using national data that adolescents reporting homosexual orientation also reported significantly more of the previously mentioned risk factors along with depression, another risk factor.  These studies shed further light on the risk factors affecting LGBT adolescents and further insight is gained into why these risk factors are more prevalent in this population.  Victimization, lack of support, school dropout, family problems, and substance abuse are serious risk factors that may be directly brought about by society’s negative attitudes about homosexuals.  Adolescents are thought to observe from a young age religion’s condemnation of homosexuals, negative parental and other adult attitudes regarding homosexuals, and a negative homosexual school climate where “gay” is used as an insult.  Because of society, familial and peer perceived negative attitudes regarding homosexuals, it is apparent that many LGBT adolescents could fear being “discovered” because they may connect it to previously observed finger pointing, discrimination, homophobic bullying, familial and peer rejection, all thought to be risk factors for suicide.  This fear of coming out due to LGBT adolescent’s perceived ultimate rejection may be why many complete and attempt suicide before coming out to others.  

The fear of being discovered is thought to cause many LGBT adolescents to stay in the closet and not be open about their sexuality.  Because they fear discovery and because of perceived rejection by society, they may close themselves off to society and become socially isolated.  Sas (1992), as cited by Sullivan and Woodarski (2002), indicate that social alienation may inevitably lead to shame and self-stigmatization, which are both likely risk factors for suicide.  Additionally, Sullivan and Woodarski indicate that social alienation may provoke hopelessness, and if that is allowed to permeate the adolescent’s affective state, loneliness, apathy, and feelings of a loss of connectedness to peers, family, and social institutions are likely to come about.  There also seem to be very few role models available for LGBT adolescents due to society’s lack of acceptance of homosexuality.   Sullivan and Woodarski suggest that homosexuals are unique as a minority in facing hatred and discrimination because these adolescents in most cases have no relatable role model or family member who can relate from having gone through the same experience.  

When an LGBT adolescent feels that no one is on his or her side, it may catalyze serious issues with identity formation.  Sullivan and Woodarski talk about how adolescence is a time when peers, rather than family, start to take on a major role in where individuals obtain support and guidance.  They indicate that many adolescents may face a new, stronger need to gain peer approval.  As a result, adolescents’ peer networks and school environments increase dramatically in their capacity and scope of influence on their identity development.  When peer networks are rejecting and school environments hostile, the resulting social isolation and withdrawal may produce negative self-esteem, another serious risk factor for suicide.  

As noted earlier, homophobia is thought to be a risk factor for suicide in LGBT adolescents.  It is also thought to be causal to or at least correlated with many other risk factors.  Sullivan and Woodarski (2002) indicate that negative self esteem may be created as a result of internalizing homophobic attitudes and values from society, peers, and family.  Again, it is clear how risk factors can start compounding for LGBT adolescents, and we gain a window into why they are at such high risk.  

Compounding risk factors is something that wasn’t directly addressed in any of the literature, and is an area that warrants investigation.  That being said, as risk factors start to compile, it seems likely that suicide risk would increase because each risk factor may be like a blow to the adolescent, making it harder for him or her not to turn to suicide.  One would likely feel more and more despondent and that nobody cares about him or her.  Hopelessness that one will never be accepted by society, peers, or family may be an important factor to consider with regard to compounding risk factors because when there is no hope for a miserable situation to ever be different, it is understandable why the choice could seem reasonable to end one’s life.  

Homophobia and the negative climate in society toward homosexuals could potentially be the primary underlying reason for why the LGBT population is at such high risk for suicide.  All other risk factors are likely secondary to these because they comprise the beliefs that continue to be passed on that fuel LGBT discrimination, negative attitudes, and homophobia.  

Protective Factors

When risk factors for suicide affect an LGBT adolescent, there may or may not be protective factors involved as well that can add some semblance of balance to the chaos that the adolescent may experience.   In this section I address specific protective factors for suicide that exist for LGBT adolescents, and to what extent they are effective at mitigating risk factors.  

Savin-Williams (1989a), as cited by Proctor and Groze (1994), observed via study results that lesbians were more likely to feel comfortable being gay if they experienced high degrees of parental acceptance.  Parental acceptance of adolescent homosexuality is a protective factor because it protects adolescents from experiencing familial rejection, a risk factor for suicide.  Savin-Williams also observed that parental acceptance may be causal to, but is at least correlated with other protective factors for gay males, two of which may be feeling comfortable being gay and having high self-esteem.  Since internalizing homophobia and low self-esteem are converse risk factors, it is easy to see why these are protective factors.  

Savin-Williams (1989b), as cited by Proctor and Groze, later found that lesbian adolescents typically had more satisfying parental relations than gay males, and that lesbians also possessed significantly higher self esteem.  They also identified for lesbian adolescents a strong, positive correlation between lesbian-parent contact and satisfaction with parents.  Regarding gay males, a positive correlation was identified between contact with fathers and satisfaction with their paternal relationship.  Additionally Savin-Williams found that gay males with high self-esteem possessed satisfying relationships with both parents and had a mother who was aware of their orientation.  

These findings again illustrate the importance of parental acceptance for LGBT adolescents.  When parental acceptance is in place, familial problems may be greatly reduced, or at least not involve an individual’s sexuality.  It is critical for all children, adolescents, and teens to feel like all parts of them are accepted by their parents, not just their masculine or feminine side, and certainly their sexuality.  As suggested earlier, this acceptance may be noteworthy in identity formation.  Schneider (1989), as cited by Proctor and Groze (1994), suggests that having a strong, positive identity (a protective factor, McDermott et al. (2008)) may be causal to or at least correlated with high self-esteem (a protective factor, Savin-Williams (1989b)).  Schneider goes on to discuss his study on self-identified lesbians, in which he found that lesbians typically have good resources as well as external social supports that are encouraging to their positive homosexual identity formation.  He also found that lesbians may be at lower risk for suicide than gay men, but that it warrants further investigation.  

It is possible that lesbians have access to better resources and social supports, and ultimately a lower risk for suicide than gay males for this reason: lesbian behavior is erotic to many heterosexual males and therefore accepted as normal.  Further investigation of this hypothesis is warranted.  

Relating to previously discussed protective factors such as high self-esteem and self acceptance is having a proud identity, which was identified by McDermott et al. (2008) as a potential protective factor.  A proud identify may constitute feeling satisfied, fulfilled, and confident about one’s homosexuality.  This sense of pride may also ward off shame, which is a previously mentioned potential risk factor for suicide.  Hershberger & D’Augelli (1995), as cited by Rivers (2004), indicate the best predictor of mental health in LGB youth may be self acceptance.  These protective factors could be considered as protective layers: before one good layer or protective factor can be added, the right conditions likely need to be preexistent.  For example, identity formation may be the first layer, and for the layer of high self-esteem to be applied, that identity needs to be positive.  

The next protective layers of self-esteem and self-acceptance may be prerequisites for pride, satisfaction, and confidence.  Hershberger and D’Augelli also discovered that self-acceptance may moderate impact of bullying, and that self-acceptance may be correlated with having received family support, but only for individuals who haven’t endured high levels of bullying.  This last set of findings enlighten us in a few areas regarding effectiveness of protective factors at combating risk factors.  It makes sense that self-acceptance may moderate the effects of bullying because being in a state of self-acceptance implies self-esteem, and those with high self esteem and a strong identity are more likely to stand up for themselves.  It also makes sense that self-acceptance was correlated with having received familial support because negative family interactions may create negative self-esteem, self-rejection, or hatred.  Having a positive family environment where it is clear the adolescent is loved, respected, and accepted unconditionally may be a very powerful protective factor.  

Espelage et al. (2008) suggest the ultimate goal of adolescence is to actualize the capability to merge with another in a truly intimate relationship.  While the realization of this goal may come easier for some than others, this is a goal that may be especially difficult for many LGBT adolescents to realize because of the stigmatization of homosexuality.  Having a close intimate relationship is a protective factor that may modulate some risk factors, especially homophobic attitudes and social isolation.  Having Gay and Lesbian Alliance clubs and other types of meetings can help LGBT adolescents feel a sense of belonging.  This sense of belonging may compound with other protective factors, lowering risk of suicide.  If LGBT adolescents have just one caring individual that accepts them for who they are and shows them genuine compassion and empathy, it may be enough to offset risk factors in some cases.

The protective factors I have reviewed in this paper show some degree of effectiveness in mitigating risk factors for suicide in the Lesbian, Gay, Bisexual, and Transgender populations.  Ultimately however, the relationship between protective factors and risk factors remains elusive.  Unfortunately, many LGBT adolescents may be in hostile situations in which protective layers are unable to develop and risk factors are allowed to compound unchallenged.  In these situations, adolescents may be left to fend for themselves in hostile territory without family or peer groups for support.  

Religiosity is an ambiguous factor that one can imagine could be a risk factor or a protective factor.  I wanted to include religiosity in this literature review, but there is a lack of research in the area with regard to LGBT adolescents.  This is a very important topic that warrants investigation because, as there is so much variability in religious beliefs, it makes sense that religious beliefs could either be nurturing toward an LGBT adolescent or hostile and rejecting. Some religions condemn homosexuals to hell, suggest that they should be fired from jobs involving children, that they are wrong and dirty, and that they shouldn’t enjoy basic human rights.  Having to face these strong judgments and attitudes could have a profoundly negative impact on identity development and progression through Erik Erikson’s stages of development, (Erikson, 1956).  Conversely, understanding the protective factor side of religiosity may also prove valuable, as it has been shown that having faith in a creator, and/or afterlife may act as its own support network.  

Discussion

This literature review has evaluated and discussed some of the existing research regarding LGBT adolescent suicide.  Although it offers an in-depth view of risk factors and protective factors for suicide, and it identifies some gaps in the research, it fails to adequately discuss the complex relationship between risk factors and protective factors.  This is a fault of the research, and exists due to the nature of the factors which makes them very difficult to separate.    

The complex relationship between risk and protective factors may need to be understood before effective short-term interventions can be implemented.  However, as repeated throughout this paper, to fix the root of the problem, underlying negative societal attitudes need to be corrected. Even if negative societal attitudes toward LGBT individuals are not the root cause of these individuals’ elevated suicide risk, they still need to be corrected because these attitudes can hardly be helpful or conducive to a positive mental state.  These attitudes directly interfere with LGBT individuals’ ability to pursue life, liberty, and happiness.  

Countless minorities have been discriminated against and treated poorly in the past, and many still continue to face negative attitudes and treatment today.  Just as women and blacks were accepted as equals to white men by society, (even though there are those who continue to fight against this equality,) homosexuality must be accepted by society as normal, an acceptable deviation from the standard of traditional marriage.

It may be possible to moderate the suicide risk of LGBT adolescents by increasing awareness of the illegitimacy of anti-gay propaganda, and working with families, schools, and religious institutions in hopes of catalyzing a paradigm shift in the values and attitudes they instill in others.  Additionally, risk factors may also be moderated by identifying and strengthening protective factors.  As counselors we need to look at the bigger picture and attack the real problem: negative societal attitudes toward homosexuals, lack of acceptance, and homophobia.  Still, it will be necessary to pursue normal counseling endeavors with this population.  If this paradigm shift can be brought about, LGBT adolescents could potentially be at the same level of suicide risk as their non LGBT peers.  

The literature was clear that the LGBT population is indeed at a higher risk for suicide. There was, however, some disagreement about how much greater the adolescent’s suicide risk is than their heterosexual peers.  I believe the discrepancies can be accounted for by understanding that risk is something that can be computed most accurately on an individual level since every situation is unique. 

It is difficult to obtain information on LGBT individuals in general, but especially LGBT adolescents for a variety of complex reasons including lack of access and the private nature of sexuality. Some risk or protective factors may be measurable, but without being inside someone’s head it can prove difficult to know if they are contemplating suicide.  Another gap that exists in the research relates to transgender individuals.  Although they may be completely relatable to gay, lesbian, and bisexual individuals, I’m not sure to what degree my findings can be applied to this group because they weren’t addressed more than briefly in the research.  More studies need to be conducted in order to close this gap.  

Before starting this literature review, I had preconceived notions of why LGBT adolescents are at an elevated risk of suicide.  As a disabled individual living in a society that caters to the healthy and able-bodied, I am aware of the discrimination that minorities face.  I myself attempted suicide as a newly disabled adolescent.  I was drowning in risk factors such as internalizing negative attitudes and treatment of my disabled self, depression, social isolation, low self-esteem, peer rejection, hopelessness, helplessness, and anger, that many adolescents face, but especially minorities such as LGBT adolescents.  

I was crying out for help from my peers, desperately trying to show them I was still the same me, and that I still mattered.  No one in the school system or in my life was there to recognize my pain and the risk factors that were slowly suffocating me.  Thankfully, I had protective factors in place during that time, such as my strong, positive familial connection and having a well developed positive identity.  I am grateful for not succeeding in my attempt and for being allowed the chance to blossom into an adult and become a counselor so I can help and give back to others.  I have a deep desire to help minorities such as LGBT adolescents, people with disabilities, and those who have experienced loss and trauma.  

As repeated throughout this paper, I think the only way to drastically reduce LGBT adolescent and other minority suicides short of a total societal paradigm shift, is for someone in each adolescent’s life to take responsibility to see them safely through adolescence; becoming their suicide prevention guardian, checking in with them often, asking them about their life, and showing them someone cares.  For students attending school, this person could be the counselor.

References

Coleman, E., & Remafedi, G. (1989). Gay, lesbian, and bisexual adolescents: A critical challenge to counselors. Journal of Counseling and Development, 68(1), 36-40. 

Espelage, D. L., Aragon, S. R., Birkett, M., & Koenig, B. W. (2008). Homophobic teasing, psychological outcomes, and sexual orientation among high school students: What influence do parents and schools have? School Psychology Review, 37(2), 202-216. 

Li Kitts, R. (2005). Gay adolescents and suicide: Understanding the association. Adolescence, 40(159), 621-628. 

McDermott, E., Roen, K., & Scourfield, J. (2008). Avoiding shame: Young LGBT people, homophobia and self-destructive behaviours. Culture, Health & Sexuality, 10(8), 815-829. doi:10.1080/13691050802380974 

Proctor, C. D., & Groze, V. K. (1994). Risk factors for suicide among gay, lesbian, and bisexual youths. Social Work, 39(5), 504-513. 

Rivers, I. (2004). Recollections of bullying at school and their long-term implications for lesbians, gay men, and bisexuals. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 25(4), 169-175. doi:10.1027/0227-5910.25.4.169 

Sullivan, M., & Woodarski, J. S. (2002). Social alienation in gay youth. Journal of Human Behavior in the Social Environment, 5(1), 1-17. doi:10.1300/J137v05n02

2 thoughts on “My Graduate Thesis: Gay Adolescent Suicide

  1. Good work, but I’m intrigued by you used first person in the essay, at my university, our professor said we could not use first person in the any essay.

    Liked by 1 person

    1. Thank you, I appreciate that. I can’t remember but I think there was general guidance not to overuse first person but there wasn’t a steadfast rule. I believe it must have been ok in limited usage because this underwent a few edits with feedback from my professor

      Liked by 1 person

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