School of Social Work, Adelphi University, Garden City, New York.
J Adolesc Health. 2022 Nov;71(5):609-615. doi: 10.1016/j.jadohealth.2022.06.017. Epub 2022 Aug 11.
This study describes changes in proportions of lesbian, gay, bisexual, transgender, and other gender/sexual minorities (LGBTQ+) among total deaths by suicide in American 11-29 year olds between 2014 and 2019.
Data came from the Centers for Disease Control and Prevention's (CDC) National Violent Death Reporting System (NVDRS). All cases classified as deaths by suicide since 2014 that had valid data for sexual orientation or transgender identity were included from states that started participating in NVDRS before 2016. The latest year of data available was 2019. Valid n = 4,086, including 673 LGBTQ+ cases. Analyses used "reverse regression" with gender/sexual orientation as the dependent variable, essentially estimating contributions of timing of fatal self-injury and other variables to relative risk of a case being LGBTQ+.
The proportion of decedents who were LGBTQ+ increased between 2014 and 2019. Post-hoc analyses suggested an inflection point or break in the trend at November 9, 2016. The proportion of decedents who were LGBTQ+ increased from 13% before to 20% after that date, driven largely by increases from 2.0% to 6.5% among transgender youth and from 0.5% to 1.7% among those described in medical examiner and law enforcement reports as "struggling" or questioning. Asian bisexual females and gay males were especially overrepresented.
Previous research found that the policy environment affects LGBTQ+ youths' mental health; this study generalizes those findings to actual deaths by suicide. LGBTQ+ youth at risk should be assessed for anxiety, trauma, and perceived physical threat from the political and rhetorical environment.
本研究描述了 2014 年至 2019 年期间，美国 11-29 岁人群中自杀总死亡人数中，女同性恋、男同性恋、双性恋、跨性别和其他性别/性少数群体（LGBTQ+）的比例变化。
数据来自疾病控制与预防中心（CDC）的国家暴力死亡报告系统（NVDRS）。从 2016 年之前开始参与 NVDRS 的州中，选取所有自 2014 年以来具有有效性别倾向或跨性别认同数据的自杀死亡案例。可用的最新数据年份为 2019 年。有效 n=4086，包括 673 例 LGBTQ+案例。分析采用“反向回归”，将性别/性取向作为因变量，本质上是估计致命自我伤害时间和其他变量对案例 LGBTQ+相对风险的贡献。
2014 年至 2019 年期间，被认定为 LGBTQ+的死者比例有所增加。事后分析表明，2016 年 11 月 9 日存在拐点或趋势中断。在该日期之前，被认定为 LGBTQ+的死者比例从 13%增加到 20%，主要原因是跨性别青年的比例从 2.0%增加到 6.5%，以及法医和执法报告中描述为“挣扎”或质疑的人的比例从 0.5%增加到 1.7%。亚洲双性恋女性和同性恋男性的比例尤其过高。
之前的研究发现政策环境会影响 LGBTQ+青少年的心理健康；本研究将这些发现推广到实际的自杀死亡人数。有风险的 LGBTQ+青年应评估其焦虑、创伤和对政治和言论环境的身体威胁感知。
