BMJ 2000;320:1617-1618 ( 17 June )

Editorials

Suicidal behaviour in gay, lesbian, and bisexual youth

It's an international problem that is associated with homophobic legislation

There is now a bitter debate in the United Kingdom over the repeal of Section 28 of the Local Government Act 1988, which forbids the promotion of homosexuality. This debate should be enlightened by accumulating research on the development of sexual orientation in adolescence and the mental health consequences of growing up in a climate of homophobic intolerance.1 British research documenting the impact of homophobia has been corroborated by extensive research in the United States, Canada, and New Zealand.2-4

Sexual orientation emerges strongly during early adolescence. Youths with emerging identities that are gay, lesbian, or bisexual, living in generally hostile climates, face particular dilemmas. They are well aware that in many secondary schools the words "fag" and "dyke" are terms of denigration and that anyone who is openly gay, lesbian, or bisexual is open to social exclusion and psychological and physical persecution.4 Some of their families too will express negative feelings about people who are gay, lesbian, or bisexual; youths in such families may be victimised if they disclose that they are not heterosexual. 5 6

Youths who feel that they are gay must either hide their feelings from others for many years or face the risk of "coming out" to family and peers. Either course is perilous, and for some, one consequence of the confusion over their identity in a climate of intense intolerance and victimisation may be suicidal behaviour.7 Epidemiological studies from North America and New Zealand show that gay and bisexual males are at least four times as likely to report a serious suicide attempt. 3 4 8-11

Many schools allow a climate of homophobia
In the United States, more youths are disclosing their gay, lesbian, or bisexual orientation during high school, especially as more support services are being made available. However, many schools provide no assistance and allow a climate of homophobia to persist. For example, legislation in the state of Utah (now repealed) was enacted to eliminate after school clubs that supported gay, lesbian, and bisexual youths. Additionally, many families remain unable to respond positively to their gay, lesbian, and bisexual children and have little access to information and support; this in turn may contribute to the stresses in adolescents' lives---stresses that can lead to despair.12

Thus, Section 28 must be seen as homophobic legislation that may contribute to the mental health problems---such as depression, substance misuse, and suicide---of gay, lesbian, and bisexual youths. The limbo into which these youths are assigned by Section 28 regulations must be ended.

Christopher Bagley, professor

Department of Social Work Studies, University of Southampton, Southampton SO17 1BJ (cb5{at}socsci.soton.ac.uk)

Anthony R D'Augelli, professor

Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA 16802, USA (ard{at}psu.edu)



1. D'Augelli AR. Developmental implications of victimization of lesbian, gay, and bisexual youths. In: Herek GM, ed. Stigma and sexual orientation: understanding prejudice against lesbians, gay men, and bisexuals. Thousand Oaks, CA: Sage Publications, 1998:187-210.
2. Rivers I. School exclusion, absenteeism, and sexual minority youth. Support for Learning: British Journal of Learning Support 2000; 15: 13-18.
3. Tremblay P. Suicide attempt research data: thirty G(L)B samples. www.virtualcity.com/youthsuicide/news/studies.htm (accessed 5 June 2000).
4. Bagley C, Tremblay P. Suicidal behaviors in homosexual and bisexual males. Crisis 1997; 18: 24-34[Medline].
5. Remafedi G. Death by denial: studies of suicide in gay and lesbian teenagers. Boston: Alyson Books, 1994.
6. D'Augelli AR, Hershberger SL, Pilkington NW. Lesbian, gay, and bisexual youths and their families: disclosure of sexual orientation and its consequences. Am J Orthopsychiatry 1998; 68: 361-371[Medline].
7. Savin-Williams R. Verbal and physical abuse as stressors in health and risk behaviors among bisexual and homosexual adolescents: association with school problems, running away, substance abuse, prostitution, and suicide. J Consult Clin Psychol 1994; 62: 261-269[CrossRef][Medline].
8. D'Augelli A, Hershberger S. Lesbian, gay and bisexual youth in community settings: personal challenges and mental health problems. Am J Community Psychol 1993; 21: 421-448[CrossRef][Medline].
9. Remafedi G, French S, Story M, Resnick M, Blum R. The relationship between suicide risk and sexual orientation: results of a population-based study. Am J Public Health 1998; 88: 57-60[Abstract/Free Full Text].
10. Garofalo R, Wolf R, Lawrence M, Wissow S. Sexual orientation and risk of suicide attempts among a representative sample of youth. Arch Pediatr Adolesc Med 1999; 152: 487-493.
11. Remafedi G. Suicide and sexual orientation: nearing the end of the controversy? Arch Gen Psychiatry 1999; 56: 876-885[Abstract/Free Full Text].
12. Hershberger S, D'Augelli A. The impact of victimization on the mental health and suicidality of lesbian, gay and bisexual youth. Dev Psychol 1995; 31: 65-74.


© BMJ 2000

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