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Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using
Antony Chum1, Chungah Kim1, Andrew Nielsen1
1School of Kinesiology and Health Science, York University, Toronto (Chum, Kim, Dusing); Dalla Lana School of Public Health, University of Toronto, Toronto (Chum, Matheson); MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto (Chum, Nielsen, O'Campo, Matheson); Department of Psychiatry, Women's College Hospital, Toronto (Barker, Vigod); Department of Psychiatry, University of Toronto, Toronto (Vigod); Institute for Clinical Evaluative Sciences, Toronto (Ling, Fung); Centre for Depression and Suicide Studies, St. Michael's Hospital, Toronto (Kennedy).
Objective:
The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals.
Methods:
Data from a population-based survey (N=123,995) were linked to health administrative data (2002-2019), and differences in time to suicide-related behavior events across sexual orientations were examined using Cox proportional hazards regression.
Results:
The crude incidence rates of suicide-related behavior events per 100,000 person-years were 224.7 for heterosexuals, 664.7 for gay/lesbian individuals, and 5,911.9 for bisexual individuals. In fully adjusted (gender-combined) models, bisexual individuals were 2.98 times (95% CI=2.08-4.27) more likely to have an event, and gay men and lesbians 2.10 times (95% CI=1.18-3.71) more likely, compared with heterosexual individuals.
Conclusions:
In a large population-based sample of Ontario residents, using clinically relevant outcomes, the study found gay/lesbian and bisexual individuals to be at elevated risk of suicide-related behavior events. Increased education among psychiatric professionals is needed to improve awareness of and sensitivity to the elevated risk of suicide-related behavior among sexual minority individuals, and further research on interventions is needed to reduce such behaviors.
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