Editor in Chief, Care for Your Mind
June is Pride Month, a time when we celebrate the creative, intellectual, and cultural contributions of people who are lesbian, gay, bisexual, or transgender to our society, while we also protest the inequalities and unfair treatment that LGBT+ people continue to face in modern times.
It has been 45 years since the American Psychiatric Association determined that homosexuality is not a mental disorder and removed it from the DSM, yet the need to explain that sexuality is neither a disorder nor a choice persists. Moving away from classifying sexuality as a mental disorder has allowed the health professions to better address the health needs of LGBT people.
One vestige of the long-ago views of sexuality is the practice of so-called “conversion therapy” (also known as “reparative therapy”), the prohibition of which is high on the public policy agendas of suicide prevention organizations and LGBT+ advocates.
A 2015 SAMHSA report noted that
conversion therapy—efforts to change an individual’s sexual orientation, gender identity, or gender expression—is a practice that is not supported by credible evidence and has been disavowed by behavioral health experts and associations. Conversion therapy perpetuates outdated views of gender roles and identities as well as the negative stereotype that being a sexual or gender minority or identifying as LGBTQ is an abnormal aspect of human development. Most importantly, it may put young people at risk of serious harm.
While this harm may sometimes be physical (e.g., subjecting individuals to electric shocks to deter positive response to same-sex images), there are several potential long-lasting impacts on mental health and wellness. In addition to anxiety, depression, and suicidality, the list of negative effects includes “guilt, helplessness, hopelessness, shame, social withdrawal, substance abuse, stress, self-blame, decreased self-esteem, increased self-hatred, problems in sexual and emotional intimacy, high-risk sexual behaviors, and deterioration of relationships with family.”
There is activity in legislatures nationwide to limit the ability of mental health practitioners to practice conversion therapy. The Trevor Project is engaging in a “50 Bills 50 States” campaign, urging supporters to advocate for laws prohibiting the practice of conversion therapy. The Movement Advancement Project’s map of the U.S. indicates which states have passed legislation to curtail conversion therapy.
Elimination of the practice of conversion therapy will not be enough to address the disproportionate rate of suicide, suicide attempts, and suicidal ideation among LGBT+ youth. While suicide ranks as the second-leading cause of death among youth and young adults (ages 10-24), LBGT+ youth are at increased risk. According to research compiled by The Trevor Project,
- 1 out of 6 students nationwide (grades 9–12) seriously considered suicide in the past year
- LGB youth seriously contemplate suicide at almost three times the rate of heterosexual youth
- LGB youth are almost five times as likely to have attempted suicide compared to heterosexual youth
- Of all the suicide attempts made by youth, LGB youth suicide attempts were almost five times as likely to require medical treatment than those of heterosexual youth
- LGB youth who come from highly rejecting families are 8.4 times as likely to have attempted suicide as LGB peers who reported no or low levels of family rejection.
- Each episode of LGBT victimization, such as physical or verbal harassment or abuse, increases the likelihood of self-harming behavior by 2.5 times on average.
Although the statistics are discouraging, there are changes afoot that are currently helping these at-risk youth or have promise for the near future. Societal views on LGBT people are evolving from intolerance to tolerance to acceptance which, in turn, creates a safer environment for young people and their emerging sexuality. Prior to same-sex marriage becoming legal nationwide, studies were already showing that states that had legalized same-sex marriage also had reduced rates of suicide attempts by adolescents. Social attitudes and actions affect youth’s self-perception, sense of belonging, and self-esteem.
The 2012 National Strategy for Suicide Prevention includes these suicide prevention measures for LGBT populations:
- Support factors that foster and promote resilience in LGBT people, including family acceptance, connection to caring others and a sense of safety, positive sexual/gender identity, and the availability of quality, culturally appropriate mental health treatment.
- Reduce sexual orientation and gender-related discrimination and associated stressors.
- Improve identification of depression, anxiety, substance abuse, and other mental illnesses.
- Increase availability and access to LGBT-affirming treatments and mental health services.
- Reduce bullying and other forms of victimization that contribute to vulnerability within families, schools, and workplaces.
- Enhance factors that promote resilience, including family acceptance and school safety.
- Change discriminatory practices, laws, and policies.
Acting as family members, caring educators, peers, health professionals, policymakers, and members of society, we can continue to reduce the incidence of suicidal behaviors among LGBT+ youth. As the National Strategy for Suicide Prevention emphasizes, “every American has a role in preventing suicide.” What’s yours?
What do you think?
- Which strategies for reducing suicidal behaviors do you believe will be most effective for LGBTQ+ youth, and why?
- What is your role in suicide prevention?
Tell us on Facebook!
Note on the image: The photo of the colorful shoes evokes the rainbow flag associated with LGBTQ+ Pride. In mental health advocacy, shoes are also used to represent people who are missing from our lives due to suicide.
- The Trevor Project is the go-to organization for suicide prevention of LGBTQ youth. If you are a young person in crisis, feeling suicidal, or in need of a safe and judgment-free place to talk,
- Additional suicide prevention crisis services:
- call the National Suicide Prevention Lifeline at 1-800-273-8255
- text HOME to 741741 to reach the Crisis Text Line
- call 211 or visit org to find local services and get help
- The 2012 National Strategy for Suicide Prevention “Groups with Increased Suicide Risk,” the culmination of a joint effort by the Office of the U.S. Surgeon General and the National Action Alliance for Suicide Prevention, is a comprehensive and collaborative long-term approach to suicide prevention that emphasizes that every American has a role in preventing suicide. [Supplemental release regarding High Risk Populations (.pdf download)]
- The American Foundation for Suicide Prevention began a broad initiative in 2007 to increase knowledge about suicide and suicide risk in lesbian, gay, bisexual, transgender and questioning/queer (LGBTQ+) persons, and take steps to reduce that risk.
- The Jed Foundation’s Mental Health Resource Center provides valuable information on supporting teens’ and young adults’ mental health and preventing suicide.
- A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children
- Guidelines for Families – Parents and Caregivers
Action Alliance for Suicide Prevention
- Families Are Forever
Family Acceptance Project
- Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth
- ‘Being LGBTQ is not an illness’: Record number of states banning conversion therapy
- Understanding risk and protective factors for suicide: A primer for preventing suicide
Suicide Prevention Resource Center
- LGBTQ Pride Month, Explained