Youth who self-identify as gay, lesbian or bisexual at higher suicide risk, say Montreal researchers

Mental health professionals have long known that gay, lesbian and bisexual (GLB) teens face significantly elevated risks of mental health problems, including suicidal thoughts and suicidal attempts. However, a group of McGill University researchers in Montreal has now come to the conclusion that self-identity is the crucial risk factor, rather than actual sexual behaviours. Their results were published in February in the Journal of the American Academy of Child & Adolescent Psychiatry.

The researchers administered a detailed, anonymous questionnaire to nearly 1,900 students in 14 Montreal-area high schools, and found that those teens who self-identified as gay, lesbian or bisexual, or who were unsure of their sexual identity, were indeed at higher risk for suicidal ideation and attempts. However, teens who had same-sex attractions or sexual experiences - but thought of themselves as heterosexual - were at no greater risk than the population at large. Perhaps surprisingly, but consistent with previous studies, the majority of teens with same-sex sexual attraction or experience considered themselves to be heterosexual.

"This is the first study that has separated sexual identity from sexual attractions and behaviours in looking at risk for poor mental health outcomes," said corresponding author Dr. Brett Thombs, of the Lady Davis Institute for Medical Research (LDI) at the Jewish General Hospital.

"It's important to realize that a large proportion of people who have sex with or are attracted to people of the same sex do not identify themselves as gay, lesbian or bisexual. They consider themselves heterosexual." added co-author Dr. Richard Montoro of the McGill University Health Centre (MUHC). "Those students were not at all at risk of worse mental health outcomes."

"The main message is that it's the interface between individuals and society that causes students who identify as gay, lesbian, or bisexual the most distress," said study first author Yue Zhao, a McGill University graduate student working with Dr. Thombs. "Sexual orientation has three different components. The first is identity, which is dependent on the society in which one lives; the second is attraction or fantasy; and the third is behaviour. Previous studies have not addressed which of those components may explain why GLB youth are at risk."

"What this all means is that clinicians need to look not just at individuals and their sexuality, they really need to assess the environment they are coming from and how they see themselves within it," said study co-author Dr. Karine Igartua. Igartua and Montoro are co-directors of the McGill University Sexual Identity Centre (MUSIC), the first gay and lesbian mental health centre in Canada.

"Our findings also clearly suggest that further study of the link between anti-gay sentiment and suicidality need to be undertaken," added Thombs.