SALT LAKE CITY — Suicidal thoughts and behavior are declining among LGBTQ youths in the United States, according to two studies published Monday in Pediatrics, the official journal of the American Academy of Pediatrics.
The studies did not attempt to determine the cause of the decline. But Julia Raifman, an assistant professor of health policy at Boston University who led one of the studies, said stigma — expressed by family members, peers or state level policies — is highly associated with suicide attempts among LGBTQ youths, and a growing culture of acceptance in the U.S. could be saving kids’ lives.
Raifman and her colleagues analyzed data from the Youth Risk Behavior Surveillance Survey in seven different states including Maine, Illinois and North Dakota. They found the number of high school students in those states who identify as gay, lesbian, bisexual or unsure doubled between 2009 and 2017, from 7% to 14%. During that same time period, suicide attempts among those kids declined from 27% to 20%.
Another study, led by Richard T. Liu, associate professor of psychiatry and human behavior at Brown University, looked at Youth Risk Behavior Surveillance Survey data from Massachusetts, the first state in the U.S. to survey students about sexual orientation and behavior beginning in 1995. That data showed that not just suicidal ideation, but suicide plans and attempts have decreased significantly among sexual minority youths over the past several decades in that state.
Neither of the studies considered Utah, which has the sixth highest suicide rate in the country, according to 2017 data from the Centers for Disease Control and Prevention. That’s because historically, Utah has not collected data on teens’ sexual orientation. Last year, the state added questions to the biennial SHARP survey that allowed researchers to measure youth suicidal ideation as it relates to sexual orientation for the first time.
Even though Utah does not have any long-term data on LGBTQ youth suicides, Troy Williams, executive director of the LGBTQ rights advocacy group Equality Utah, is confident Utah is headed in the right direction.
“As we continue to foster a community of inclusion and belonging, we will see Utah suicide rates decline dramatically,” he said.
Both of the new studies highlighted the fact that while suicidal ideation rates are declining overall, disparities persist, and LGBTQ youths remain at a higher risk.
Raifman’s study showed gay, lesbian and bisexual students were nearly four times more likely to attempt suicide than heterosexual students.
“As human beings, we are hardwired to belong and to have deep connections,” said Williams. “When LGBTQ youth are exiled from their families, or schools or their jobs because of who they are, that leads to alienation, isolation loneliness — all the factors that increase the risk suicide.”
Utah data
2019 was the first year that Utah collected data on sexual orientation and gender identity from eighth, 10th and 12th graders as part of the statewide SHARP survey, administered every two years by the Department of Human Services.
According to the results of that survey, gay and lesbian teens in Utah were more than twice as likely as their heterosexual classmates to say they felt sad or hopeless every day for two weeks or more.
Fifteen percent of heterosexual students said they had seriously considered suicide in the past year, compared to 48% of gay and lesbian students who said the same thing. Bisexual students were even more at risk, with 68% saying they felt sad or hopeless every day for two weeks or more and 53% saying they had seriously considered suicide.
“We don’t have any good comparisons to say whether those numbers are going up or down,” said Michael Staley, suicide prevention research coordinator with the Utah Department of Health. “Because we just now got this data for the first time.”
Staley said discussions about adding questions on sexual orientation and gender identity to the SHARP survey started back in 2015, but the survey is optional and multiple school districts said they wouldn’t administer the survey if the questions appeared. In 2019, 39 out of 41 school districts participated in the survey.
Some Utahns feared that if students were asked about their sexual orientation, it would cause more to identify as LGBTQ, said Stephanie Larsen, the CEO of Encircle, an LGBTQ youth and family resource center with locations in Provo and Salt Lake City.
“In Utah, there’s been a sense of not wanting to look at the numbers — if we don’t look at the numbers, the problem will go away, or it won’t reflect poorly on us as a state,” said Larsen. “It is crucial that we be willing to look at what we can do better.”
What is being done
Larsen is a member of Gov. Gary Herbert’s youth suicide task force, which was launched in 2018 after 42 Utah kids ages 10-17 died by suicide the year before.
So far, the task force, which is made up of suicide prevention advocates, health care professionals and religious leaders, among others, has had good conversations but made little progress, said Larsen. She hopes the state’s focus will broaden from simply promoting resources to help people in crisis, to considering the root causes of suicidality as well.
“I still think we have a long ways to go,” she said.
Williams, who resigned from the Governor’s task force last year over disagreements about a bill banning conversion therapy, is heartened by the state’s recent move to prohibit conversion therapy for youths via therapist licensing rules.
Cathy Davis, suicide prevention specialist for the Utah Department of Education, said a 2019 state bill that called for expanded suicide prevention programs has helped schools “create more accepting environments for students.”
And Staley has spent the last year gathering new data for the Utah Youth Suicide Research Project, which he hopes will end up being one of the most comprehensive studies on youth suicide in the world.
“I think a lot of people came around to understanding just how important it is to study these things and really get the facts,” Staley said.
“We can see there are disparities in suicide attempts,” said Raifman. “But it’s impossible to study these disparities and how to address them unless we collect data on who is LGBT.”