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          Two Spirit, Queer... Suicide Issues
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High "Attempted Suicide" Incidences
Suicidality Studies: Europe
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"While interventions aimed at addressing suicide risk factors for all youth are being implemented and many have proven effective in the general population, no evidence- based intervention currently exists to reduce suicide risk within [the LGBT] population." Marshall A (2016). Suicide Prevention Interventions for Sexual & Gender Minority Youth: An Unmet Need. Yale Journal of Biology and Medicine, 89: 205-213. PDF Download.

A World First! - - Jacobs R, Morris S (2016). National LGBTI Mental Health and Suicide Prevention Strategy: A New Strategy for Inclusion and Change: An Australian Government initiative. Related Article. Document PDF Download.


Talking About Suicide & LGBT Populations (2011): Suggestions & Recommendations.

Webpages
Available
At Website

Suicidality Studies Index: All Studies. - All Random & Special Sample Studies. - All American & Canadian Studies. - All European Studies (This Page). - Transgender Studies. - The Results of Additional School-Based North American Youth Risk Behavior Surveys or Similar Surveys - Random Sampling - are Located at Another Location.

Other Pages: Homosexually Oriented People Are Generally at Greater Risk for the More Serious Suicidal Behaviors. - "Attempting Suicide" as Related To Gender Nonconformity & Transgender Issues. - Bell & Weinberg (1978) Homosexualities Study: "Attempted Suicide" Study Results.

Special Section: The 2013 Paper, "Suicide Risk and Sexual Orientation: A Critical Review," Reverses the Conclusions of Two Previously Published Papers. The Re-Analyses - Including Many Meta-Analyses & Using Unconditional Tests for Statistical Significance - Indicates that "Gay/Lesbian/Bisexual Adolescents Are at Risk for Suicide." - In Addition, Expanding the "At Risk" Category to Include Adolescents Known to Only Have Been Harassed/Abused - Because They Were Assumed to be Gay/Lesbian - Produces More Conclusive Results, Especially Applying for Males. This Category Represents "An Expanded Homosexuality Factor in Adolescent Suicide." - Associated Pages: Constructing "The Gay Youth Suicide Myth": Thirty Years of Resisting a Likely Truth & Generating Cohen's Effect Size "h" Via Arcsin / Arcsine Transformations.


 This page contain the results of 39 European studies (19 published in peer reviewed journals) that have reported "attempted suicide" incidences for varying sample of sexual minority individuals most often described or self-described (may be self-identified) as Gay (G), Lesbian (L), Bisexual (B), Homosexual, Predominantly Homosexual, Homosexual/Bisexual, and Same-Sex Sexually Active (Same-Sex Sex).

Risk Ratios (RRs) or Odds Ratios (ORs) were produced when Heterosexual or Predominantly Heterosexual individuals were also a part of a study. As a rule, homosexually oriented people have been at higher risk for attempting suicide, compared to their heterosexual counterparts, and more so for males... as a rule. (Related Information)

Study Samples have been non-random and random.

Results of mostly North American suicidality studies of sexual minority street youth, psychiatric patients, and transgender people have been included in this web page to highlight the need for such studies to be carried out in Europe. Two Transgender studies from Europe based on internet samples became available in 2007 & 2008.

Qin P, Agerbo E, Mortensen PB (2003)Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981-1997. American Journal of Psychiatry, 160(4):765-72. (Abstract) (Full Text) - "...registered [same-sex] partners included as a separate category in the analysis had an odds ratio of 4.31 (95% CI= 2.23–8.36) in the crude analysis and 3.63 (95% CI=1.71– 7.67) in analyses with adjustment for other factors in the full model [for having committed suicide compared to opposite-sex married couples]". Note: This is a First-Time Research Result! See: Frisch M, Bronnum-Hansen H (2009). Mortality among men and women in same-sex marriage: a national cohort study of 8333 Danes. American Journal of Public Health, 99(1): 133-7. Abstract. After 1995, higher risk of death in same-sex marriages occur in first 3 year of the marriage. Note: The paper does NOT mention the Qin et al (2003) suicide results (above), and suicide is only mentioned as possibly being implicated in the higher risk of death for same-sex couples.

Mathy RM, Cochran SD, Olsen J, Mays VM (2009). The association between relationship markers of sexual orientation and suicide: Denmark, 1990-2001. Social Psychiatry and Psychiatric Epidemiology, 46(2): 111-7. PDF Download. PDF Download. . From Abstract: "Using data from death certificates issued between 1990 and 2001 and population estimates from the Danish census, we estimated suicide mortality risk among individuals classified into one of three marital/cohabitation statuses: current/formerly in same-sex RDPs; current/formerly heterosexually married; or never married/registered. RESULTS: Risk for suicide mortality was associated with this proxy indicator of sexual orientation, but only significantly among men. The estimated age-adjusted suicide mortality risk for RDP men was nearly eight times greater than for men with positive histories of heterosexual marriage and nearly twice as high for men who had never married."

Frisch M, Simonsen J (2013). Marriage, cohabitation and mortality in Denmark: national cohort study of 6.5 million persons followed for up to three decades (1982-2011). International Journal of Epidemiology, 42(2): 559-578. Abstract. "Results: HRs for overall mortality changed markedly over time, most notably for persons in same-sex marriage. In 2000-2011, opposite-sex married persons (reference, HR = 1) had consistently lower mortality than persons in other marital status categories in women (HRs 1.37-1.89) and men (HRs 1.37-1.66). Mortality was particularly high for same-sex married women (HR = 1.89), notably from suicide (HR = 6.40) and cancer (HR = 1.62), whereas rates for same-sex married men (HR = 1.38) were equal to or lower than those for unmarried, divorced and widowed men. Prior marriages (whether opposite-sex or same-sex) were associated with increased mortality in both women and men (HR = 1.16-1.45 per additional prior marriage)... Of note, mortality among same-sex married men has declined markedly since the mid-1990s and is now at or below that of unmarried, divorced and widowed men, whereas same-sex married women emerge as the group of women with highest and, in recent years, even further increasing mortality.

Social exclusion of young lesbian, gay, bisexual and transgender (LGBT) people in Europe
(By Judit Takács, ILGA-Europe and IGLYO, PDF Download)



European Sexual Minority Suicidality Studies




"Attempted Suicide" Incidences/Risks: Europe
(Not Including United Kingdom, Ireland & France)
Homosexually Oriented Youth or Adults
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Attempted
Suicide
% (n / N)
Sampling Information
Age
Odds Ratio (95% CI)
Hegna et al.
(1999)

2,988 (MF*)
None (M)
16% (M)
Age Range: 16 to 60+ Years, Norway
Additional Results: By Age Groupings
None (F)
20% (F)
Hanner
(2002)

419 (M)
None
23.5%
Volunteer Sample, Sweden
Pencil & Paper Questionnaire
Age: 16 to 24 years
Homosexual / Bisexual:
84.2% of Females, 90.0% of Males
Additional Results
838 (M)
None
36.8%
Cochand
& Bovet
(1998)
164 (M)
Homosexual
or Bisexual
Identified
None
22.7%
HIV+: 18%
HIV -: 26%
Lifetime
French Part of Switzerland
Snowball Sampling: Volunteers
Mean Age: 36.4 Years,
Age Range: 22 to 66 Years
Attempted Suicide: Lifetime
Cochand
et al.
(2000)

103 (M)
Mostly Gay
Identified
None
24.4%
(25 / 103)
Volunteers: Switzerland
French Speaking
Age Range: 16 to 25 Years
Bonvin-Mullor
(2002)
163 (M)
Homosexual
or Bisexual
Identified

None
37 / 163
22.7%
Note: Appears to be same study sample reported on by
Cochand & Bovet (1998)
Häusermann
& Wang
(2003)
561 (M)
Mostly Gay
Identified?
None
19%
Swiss Volunteers: Gay Venues
Age Range: 15 to 84+ Years
67%: 25 to 44 Years
For Mental Disorder  Results, see: Wang et al. (2007)
Senate
Administration
(1999)

227 (MF)
Homosexual
Bisexual?
Identified
None
18%
Likely Volunteers: Berlin, Germany
Age Range: 15 to 27 Years
Study Results Given by
Cochand et al. (2000)
Pietrantoni
(1999)
64 (M)
Homosexual
Identified
None
26%
Italy: Volunteer Sample
Age Range: 14 to 22 Years
Buffoli & Colucci
 (2007)
.
720 (MF)
605 (M)
115 (f)
None
20% (MF)
17.7% (M)
32.2% (F)
Italy: Internet Sample
Age Range: 18 to 24 years
More than 80% - 82.5% (M), 84.3% (F) - had thought about suicide. Participants in southern Italy's rural areas are most at risk for attempting suicide.
van
Heeringen &Vincke
 (2000)
137 (M)
Homosexual
/ Bisexual
71 (M)
Heterosexual
11.5% ?
(16 / 139 ?) vs.
6.0% (4 / 67)
Belgium: Homo/Bi Participants:
Attending a Homo/Bi Youth Camp
Heterosexual Participants: Schools
Males: OR = 2.5 (0.8, 7.8) ns
Females: OR =
6.2 (2.3, 16.6)
Mean Age: 20.4 (SD: 2.3) Years
Age Range: 15 to 27 Years
82 (F)
Homosexual
/ Bisexual

114 (F)
Heterosexual
25%
(20 / 80)
vs. 5.4%
(6 / 110)
Martens
(2005)
922 (M)
All Ages
None
18%
2004 Male Volunteer Sample, Homosexually Oriented,
Belgium: 533 Pencil & Paper,
409 via Internet.
Ages: 15 to 51+
Mean Age: 35 Years
156 (M)
16-25
Years
None
22%
768 (M)
26 +
Years
None
17%
Quinn
(2006)

100 to 392
per
Sample
None
0.0% to
21%
Average =
10.7%
GLBT Volunteer Samples from: Bosnia & Herzegovina, Macedonia, Hungary, Romania, Moldova. 62.5% to 86% in the samples are 30 Years-Old or Younger.
See Table Below For Sample Results.
Gransell & Hanson
(2009)
Denmark: Suicidality results of an LGBT survey (N = 27,323) compared to results of a Heterosexual control survey (N = 1,334). Includes results from another LGBT survey. Data / Results Tables given.
Results Summary: "LGBT people have four times as large a portion of attempted suicide in comparison to the rest of the population. Bisexual women have the largest portion. The banner study shows that it is bisexuals between the ages of 16-29 and transgenders of 30 years or more who have the largest portion of attempted suicide. All three surveys show that the largest portion of attempted suicides have taken place between the ages of 13-19. Notable is, both the survey and the banner study show that 6-9 % of attempted suicides took place between the ages of 4-12. The heterosexual control survey shows that no attempted suicides have taken place at such an early age.
Baetens
et al.
(2011)

SSI = 53
37.25% with worries about sexual identity
No SSI or NSSI = ??
% ?? Having
worries about sexual identity
OR for SSI having worries about sexual identity ??
Internet Sample: N = 1,417 Flemish
adolescents aged 12 to 18.
Non-Suicidal Self-Injury: NSSI,
N = 183
Suicidal Self-Injury: SSI, N = 53

The gender rates were higher for females than males for NSSI (15.00% vs. 6.98%) and for SSI (4.30% vs. 1.99%). The only significant difference was on educational level, X2 (3, N = 238) = 11.72, p<.01, with SSI adolescents being overrepresented within technical or vocational
education tracks.

NSSI = 183
13.89
% with worries about sexual identity
No NSSI or SSI = ??
% ?? Having
worries about sexual identity
OR for NSSI having worries about sexual identity ??
van Bergen
(2013)
168 (F)
Lesbian /
Bisexual
None
26 / 168
15.5%
Lifetime
Volunteer Gay / Lesbian / Bisexual Multi-Site Sample
Netherlands. Mean Age = 17, approximately.
National Lifetime Male / Female Attempted Suicide incidence: 2.2%. Study Sample, Male / Female Combined: 12.8%
Independent Predictors Given
106 (M)
Gay /
Bisexual
None
9 / 106
8.5%
Lifetime
* M = Males - F = Females




GLBT Suicidality: Central & Eastern Europe
Category /
Country
N
%
Males
%
GLB
Suicidal
Thoughts,
Ever
Attempted
Suicide,
Ever
Bosnia &
Herzegovina
182
61.7%
69.4%
24%
3.8%
Macedonia*
100
65.0%
90.0%
18%
0.0%
Hungary
146
62.5%
96.5%
56.2%
10.2%
Romania
392
81.4%
93.6%
43.4%
19.3%
Moldova
147
69.5%
95.2%
42.2%
21.0%
Data Source: Quinn (2006)
* Macedonia has anomalous "Attempted Suicide" results. Homosexual males there have also been reported to have an anomalous homo-sexuality generally different than that in the western "gay" communities. See Lambevski (1999): "This article pays special attention to the nationalist imperatives that order Macedonian and Albanian ‘gay’ men to use each other’s penises and orifices as weapons and targets of torture."



The Norway Study of 2,988 Gays & Lesbians
Attempted Suicide Incidences
Categories
15-25*
Years
16-24 **
Years
25-34
Years
35-49
Years
+ 50
Years
All
One Suicide Attempt
(Males)

20%
12%
9%
11%
11%
Two or More Suicide Attempts (Males)

7%
5%
5%
2%
5%
Totals
25.8%
27%
17%
14%
13%
16%
One Suicide Attempt
(Females)

14%
13%
14%
15%
13%
Two of More Suicide Attempts (Females)

11%
6%
7%
3%
7%
Totals
26.3%
25%
19%
21%
18%
20%
Data Source: Hegna et al. (1999)
* Data Source: Hegna and Wichstrom (2007a), full suicality analysis, n = 407 youth.
** 72 males and 149 females: Information given by Hanner (2002)



Attempting Suicide by Same-Sex Attracted Youth in Sweden*
Categories
Males, n = 417
%
Females, n = 828
%
Never attempted Suicide
76.5%
63.2%
 One Suicide Attempt
16.5%
20.3%
More Than One Suicide Attempt
7.0%
16.5%
Attempted Suicide
23.5%
36.8%
Thought about Attempting Suicide, Past Year
46.7%
55.1%
Data Source: Hanner (2002)
* Same Sex Attracted Youth: 38.8 percent of girls (n = 846) and 71.9 percent of boys (n = 437) described themselves as "homosexual" or "gay with some heterosexual element"; 45.4 percent of girls and 18.1 percent estimates of the boys as "bisexual"; 8.3 percent of girls and 4.6 percent of the boys as "heterosexual with some homosexual elements"; with 7.6 percent of girls and 5.5 percent of the boys being unsure of their orientation.



"Attempted Suicide" Incidences/Risks: France
Homosexually Oriented Youth or Adults
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Attempted
Suicide
% (n / N)
Sampling Information
Age
Odds Ratio (95% CI)
Shelly (2002)
17% MSM
of ???? (M)
Heterosexual (M)
30%
VS.
5%???
Lifetime
Risk of MSM males for having attempted suicide said to be 6-times greater than for heterosexual males in the sample.
Shelly et al.
(2005)

11.7% MSM of 933 (M*)
[n = 109]**
88.3% of 933 (M)
[n = 824]**
Heterosexual
"1 in 3" %
33% ??
vs.
3.2  %??
Lifetime
France, Sample = 993 males, age = 16 to 39 Years - Note 3.
Attempted Suicide:
Homosexual vs
Heterosexual Males:
OR =  4.0<13.1<42.2
With Control Variables Used
Adam
(2001)

4,753 (M)
None
21%
to
16%
Lifetime
L’Enquête presse gay: 2000, France: % Lifetime Attempters, by Age Category:
< 25 Years-Old: 21%
25+ Years-Old: 16%
Mean Age = 35, Range = 14 to 60+ Years
Velter (2007a)
Velter &
Bouyssou-Michel
(2007b)
6,048 (M)
89.5%
Homosexual
Identified
None
18.9%
1,140 /
6,048
Lifetime
L’Enquête presse gay (Internet & Gay Press): 2004, France: % Lifetime Attempters
by Age Category
<20 (32.0%),  20-24 (22.6%), 25-29 (17.5%), 30-34 (20.3%). 35-44 (18.3%), >44 (14.3%)
Mean Age = 36.6 Years
For Highest Risk Factors, See Below.
Pugnière
(2011)
Volunteer
Sample
Age =
18 to 24
Years
Males
n = 68
Males
n = 358
16.2% vs.
8.7%
p = .057
Some same-sex attraction vs. only opposite sex attraction.
Lifetime
Females
n = 114
Females
n = 361
19.3% vs.
11.9%
p = .045
Males
n = 55
Males
n = 371
18.2% vs.
8.6%
p = .027
Identification: Homosexual, Bisexual & Prefer Not to be Defined vs. Heterosexual.
Lifetime
Females
n = 57
Females
n = 418
24.6% vs.
12.2%
p = .011
Males
n = 55
Males
n = 330
18.2% vs.
9.1%
p = .041
Same-Sex Sex vs. Only
Opposite-Sex Sex.
Lifetime
Females
n = 41
Females
n = 367
24.4% vs.
13.4%
p = .057
Dorais &
Chollet
(2012)
508
(M, F)
None
30%
Lifetime
72% men / 28% women
38% between 15-24 years
26% between 25-34 years
36% > 35 years.
Mean Age: 28.5 Years
* M = Males - F = Females, ** - MSM: Males Who Have Sex With Males



L’Enquête presse gay (2004)
Velter (2007a) Velter & Bouyssou-Michel (2007b)
Variables Related to Highest Attempted Suicide Incidences
Variable
Yes
Attempters (n)
No
Attempters (n)
Attempted Suicide %:
Yes vs. No for Given Variable
University Degree
525
599
13.9% vs. 27.3%
Unemployed
150
963
30.4% vs. 17.7%
Year Earnings: < 1,000 Euros
316
782
30.5% vs. 16.4%
Anti-Homosexuality Parents
233
678
38.0% vs. 15.9%
Verbally Abused: Gay Related
511
607
30.5% vs. 14.1%
Physically Assaulted: Gay Related
167
938
44.7% vs. 17.0%
Abuses at Work: Gay Related
175
923
38.0% vs. 17.0%
No Friends
58
1,063
38.4% vs. 18.2%
Sexually Assaulted
327
797
35.5% vs. 15.7%
N = 6,048 Males - Mean Age = 35, Range = 14 to 60+ Years




"Attempted Suicide" Incidences/Risks: Austria
Homosexually Oriented Youth or Adults
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Attempted
Suicide
% (n / N)
Sampling Information
Age
Odds Ratio (95% CI)
Plöderl &
Fartacek
(2005)
Additional
Results
358 (MF*) 267 (MF)
Matched on
basis of sex,
age, and
education.
34 Attempters
(10%)
vs.
4 Attempters
(2%)
Austrian Volunteers from GLB Organizations & General Population Groups. Mean Age = 36.2 Years
OR = 6.9 (2.4, 19.6)
Criterion 2: True Attempts, Aborted Suicide Attempts Removed
Plöderl &
 Fartacek
(2009)
142 (MF)
148 (MF)
10.6% vs. 2.0%
Lifetime
Volunteers: 142 LGB and 148 Heterosexual participants, 51% women in LGB group and 49% in heterosexual group. Mean age: 35.87 years, men = 39.67 years,  women = 32.06 years. Results are reported for current (in the past year) and past suicidality. Lead author supplied "Lifetime" results.
OR:  1.7<5.7<18.8 – p = .003
For More Results: See Table.
Plöderl
et al.
(2008)
468 (M)
Gay /
Bisexual
None
18%
Lifetime
Austrian Volunteer Internet Sample
Age Range: 18 to 46 years.
Plöderl
et al.
(2010)
Men:
Varied Sex
Orientation
Definitions
Heterosexual
Varies
Odds Ratios: 3.8 to 9.1
More Detailed Results: Table Below.
Total N = 656
Women:
Varied Sex
Orientation
Definitions
Heterosexual
Varies
Odds Ratios: 2.7 to 6.4
More Detailed Results: Table Below.
Total N = 726
* M = Males - F = Females, **



"Attempted Suicide" Risks: Austria
Homosexually vs. Heterosexually Oriented Adults
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Attempted
Suicide
n (%)
Sampling Information
Age
Odds Ratio (95% CI)
Plöderl &
Fartacek
(2005)

358 (MF*)
267 (MF)
Matched on
basis of Sex,
Age, and
Education
51 (14%) vs.
3 (1%)
Austrian Volunteers from GLB Organizations & General Population Groups. Mean Age = 36.2 Years
OR = 14.6 (4.5, 47.4)
All Reporting: Attempted Suicide
47 (13%) vs.
4 (2%)
OR = 9.9 (3.5, 27.9)
Criterion 1: Attempt Confirmed With
Follow-Up Questions. Includes
Aborted Suicide Attempts
34 (10%) vs.
4 (2%)
OR = 6.9 (2.4, 19.6)
Criterion 2: True Attempts, Aborted
Suicide Attempts Removed
11 (3%) vs.
1 (0.4%)
OR = 8.4 (1.1, 65.7)
Suicide Attempts Requiring
Medical Attention
* M = Males - F = Females




"Attempted Suicide" Risks: Austria
Homosexually vs. Heterosexually Oriented Adult
Plöderl & Fartacek (2009)
Categories
Males
Females
Homo- / Bi-
Sexual
N = 70
Hetero-
Sexual
N = 75
* OR
95% CI
p
Homo- / Bi-
Sexual
N = 72
Hetero-
Sexual
N = 73
* OR
95% CI
p
Lifetime Attempted
Suicide: To One Year
Before Survey
5 (7%)
0 (0%)
-
0.024 (F)
0.057 (Y)
0.029 (Y1)
9 (13%)
3 (4%)
3.3
(0.93, 11.9)
0.078 (F)
0.125 (Y)
0.063 (Y1)

Males & Females
Combined
1
Homosexual/Bisexual: 14 / 142 = 9.9% vs.
Heterosexual: 3 / 148 = 2.0%
* OR: 1.6<5.3<17.5 - p = 0.005 (F), 0.010 (Y),
0.005 (Y1)
Lifetime Aborted
Attempted Suicide: To
One Year Before Survey
7 (10%)
1 (1%)
8.2
(1.3, 52.3)
0.029 (F)
0.055 (Y)
0.027 (Y1)
13 (18%)
6 (8%)
2.5
(0.91, 6.7)
0.090 (F)
Males & Females
Combined
1
Homosexual/Bisexual: 20 / 142 = 14.1% vs.
Heterosexual: 7 / 148 = 4.7%
* OR: 1.4<3.3<7.9 - p = 0.008 (F)
Lifetime Attempted
Suicide
2
5 (7%) 0 (0%) -
0.024 (
F)
0.057 (Y)
0.029 (Y1)
10 (14%) 3 (4%) 3.8
(1.06, 13.2)
0.046 (F)
0.077 (Y)
0.038 (Y1)
Males & Females
Combined
1

Homosexual/Bisexual: 15 / 142 = 10.6% vs.
Heterosexual: 3/148 = 2.0%
*OR:  1.7<5.7<18.8 – p = .003 (F),
0.006 (Y), 0.003 (Y1)

Lifetime Aborted
Attempted Suicide
2
7 (10%) 1 (1%) 8.2
(1.3, 52.3)
0.029 (F)
0.055 (Y)
0.027 (Y1)
14 (19%) 7 (10%) 2.3
(0.88, 5.86)
0.104 (F)
Males & Females
Combined
1
Homosexual/Bisexual: 21 / 142 = 14.8% vs.
Heterosexual: 8 / 148 = 5.4 %
* OR:  1.3<3.0<6.7 – p = .010 (F)
Lifetime Significant
Suicidality: Attempted
Suicide & Aborted
Suicide Attempts
2
8 (11%) 1 (1%) 9.5
(1.5, 60.0)
0.015 (F)
0.030 (Y)
0.015 (Y1)
16 (22%) 7 (10%) 2.7
(1.06, 6.84)
0.043 (F)
Males & Females
Combined
1
Homosexual/Bisexual: 24 / 142 = 16.9% vs.
Heterosexual: 8 / 148 = 5.4%
* OR:  1.6<3.6<8.1 – p = .002 (F)
p : Fisher Exact (F) - Yates, Corrected, Two-tailed (Y) - Yates, Corrected, One-tailed (Y1):
Calculation by Webpage Author at: http://statpages.org/ctab2x2.html - http://www.graphpad.com/quickcalcs/contingency1.cfm
All ORs (Odd Ratios)
Calculated by Webpage Author at: http://statpages.org/ctab2x2.html
1. Additions & Calculation by Webpage Author
2. Counts not given in paper. Supplied by Dr. Martin Plöderl



Sexual Orientation Definition & Attempted Suicide Risk
Homosexually Oriented vs. Heterosexually Oriented Adults
Austria: Pl
öderl et al. (2010)
Sexual Orientation
Definition Criteria 1
Men
Odds Ratios 2
Women
Odds Ratios
2
Sexual Fantasies
5.3 (2.2–12.2)*
2.7 (1.3–5.5)*
Preferred Sexual Partner
6.2 (2.4–14.9)*
3.1 (1.5–6.4)*
Identification
7.3 (2.8–17.8)*
3.3 (1.3–7.4)*
Sexual Behavior (past year)
9.1 (2.3–28.8)*
6.4 (1.7–19.3)*
Sexual Behavior (before past year)
3.8 (0.8–12.4)
5.4 (2.0–12.8)*

1.
Total Sample: N = 1,382.  Men = 656.  Women = 726.
-- Men, Heterosexual Categories: From n = 580 to n = 613. -- Women, Heterosexual Categories: From n = 471 to n = 661.
2. Odds Ratios: Heterosexual vs. Heterosexual. 95% Confidence Interval. Controlling for demographic factors.  * p < .01





Lifetime "Self Harm / Attempted Suicide" Incidences
Non-Random GLB Study Populations:
United Kingdom
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Self Harm /
Attempted
Suicide
% (n / N)
Sampling Information
Age
Comments
Rivers
(2000)
116 (MF*)
92 (M)
None
37.1% (43 / 116)
Self Harm /
Suicide Attempt(s)
Lifetime
Volunteers: Advertising in GLB Community Venues. Follow-up Questionnaire to 190 United Kingdom Participants in a Previous Study. Mean Age = 28 Years, 16 to 54 Years
Men: 16 to 54 years, Women: 16 to 44 Years
Age Range Information: Rivers (2004)
Cant
(2002)

85
(MF)
None
32%
Attempted Suicide
35%
Self-Harm
The Metro Centre in Greenwich that is accessed by some young lesbian, gay and bisexual people from Lambeth, Southwark and Lewisham. Data collected on 85 youth registered there from October 2001 to April 2002: 85 young people.
Carragher
& Rivers (2002)
93 (M)
None
33.7% (29 / 86)
Self Harm /
Suicide Attempt(s)
Lifetime
Male Part of Rivers (2000) UK Sample.
Mean Age = 28 Years, SD: 9.0 Years
Age Range:
16 to 54 Years
Webb &
Wright (2001)
1145
(MF)
None
Attempted S.
18.3% (210 / 1145)
Lifetime
90% Living in Brighton & Hove. Women: significantly more likely than men to have self-harmed. No significant differences for attempting suicide. Serious thoughts of suicide, ever: declines from 53.1% to 21.6%, from age group 16-25, to age group 65+
Age = 16 - 65+

Self Harm: 10.6%
(121 / 1145)
Lifetime
Hutchison
et al.
(2003)
95 (M)
None
Self Harm: 28.4%
(27 / 95)
Lifetime
Volunteers: Gay Venues (Edinburgh, Scotland)
Age = 15 - 26 Years
Self Harm = No Intent To Die
42% of Suicide Attempters: Repeat Attempters
Compared to National Male Statistics:
Self Harm: 5.6 Times More likely
Attempted Suicide: 6.7 Times More Likely
Attempted S.
27.4% (26 / 95)
Lifetime
King
et al.
(2003)*
&
Warner
et al.
(2004)*
656 (M)
Gay
505 (M)
Hetero-
sexual
Self Harm**
25%
vs. 13.5%
Snowball Sampling (England, Wales): Gay / Lesbian Venues, Publications, Advertisements,
Followed by Recruitment: Friends, etc.
Mean Age = 36.4 Years
Self-Harm: Lifetime
84 (M)
Bisexual
505 (M)
Hetero-
sexual

Self Harm**
27%
vs. 13.5%
Snowball Sampling (As Above)
Mean Age = 35.5 Years
430 (F)
Lesbian
588 (F)
Hetero-
sexual

Self Harm**
31%
vs. 16.5%
Snowball Sampling (As Above)
Mean Age = 34.2 Years
111 (F)
Bisexual
588 (F)
Hetero-
sexual

Self Harm**
33%
vs. 16.5%
Snowball Sampling (As Above)
Mean Age = 29.8 Years
Cull et al.
(2006)

44
GLBT
Homeless
Youth
None
Attempted
Suicide:
> 66.7%
Lifetime
Volunteer: GLBT Presently/Past Homeless in Brighton and Hove, England - Age = 16 - 25 Years. 'Nearly all reported a history of mental health problems or substance misuse. Half reported alcohol or substance misuse. Over two thirds had a history of attempting suicide.'
Aitken
et al.
(2007)
138 (F)
110 (M)
Mostly
GLB
None
Attempted Suicide:
31 / 224
13.8%
Lifetime
224 GLBT Participants from the City of
Edinburgh, the Lothians and the Borders in Scotland..
Age: 14 to 75, mean = 37 Years (Approx.)
Meads
et al.
(2007)

449 (F)
93.5%
LGB
Identified
None
31.3%
Attempted
Suicide, Lifetime

Volunteer: Measure for Measure 1 Study (2002) Commissioned by the West Midlands
South Strategic Health Authority
166 (F)
77%
LGB
Identified

None
20.0%
Attempted
Suicide, Lifetime

Volunteer: Measure for Measure 2 Study (2005) Commissioned by the West Midlands
South Strategic Health Authority
Hunt &
Fish
(2008)

5,053 (F)
81%
Lesbian
Identified
None
5.0%
Attempted Suicide,
Past Year
England: Volunteer Sample: Online & Pencil/Paper - 82% White British. Age Range: 14 to 84 Years. - Attempted Suicide Incidence Range, in the Past Year, in 10 Regions: 3.5% to 7.4%. See Table Below.
Self-Harm, With No Intention of Killing Self, in the Past Year: Incidence Range: 15.9% to 22.9%, in 10 Regions. See Table Below.
Results Similar for Wales:
See Table Below.
None
20.0%
Self-Harm,
Past Year
Hunt &
Fish
(2008a)
510 (F)
77.8%
Lesbian
Identified

None
4.8%
Attempted Suicide,
Past Year
Scotland: Volunteer Sample: Online & Pencil/Paper - Age Range: 15 to 72 years.
Attempted Suicide Incidence Range, in the Past Year, in 10 Regions: 1.1% to 10.2%.
See Table Below.
Self-Harm, With No Intention of Killing Self, in the Past Year: Incidence Range: 14.6% to 39.1%, in 10 Regions. See Table Below.

None
20.8%
Self-Harm,
Past Year
Guasp
(2012a)


6,861
Gay /
Bisexual
Males
None
3% (Gay)
5% (Bisexual)
Attempted Suicide,
Past Year
Britain: England, Scotland & Wales Internet Sample: 6,861 gay (92%) & Bisexual (8%) Males. Age Range: 16-85.
77% Between Ages 21-50.
95% Caucasian.
Other Attempted Suicide Rates, Past Year:
5%: Black & Ethnic Minorities
10%: Ages 16 to 19
5%: Ages 16 to 24

None
7%: Gay/Bi
11%: Bisexual
21%: GB, Ages 16 to 19
15%: GB, Ages 16-24
Self-Harm,
Past Year
Guasp
(2012b)


633
Gay /
Bisexual
Males

None
3% (Gay)
7% (Bisexual)
Attempted Suicide,
Past Year
Results for Scotland: a part of above sample of 6,861 males. Internet Sample, 633 gay (91%) & Bisexual (9%) Males.
Males. Age Range: 16-84.
79% Between Ages 21-50.
99% Caucasian.

Other Attempted Suicide Rate, Past Year:
6%: Ages 16 to 19

None
6%: Gay/Bi
14%: GB, Ages 16 to 19
Self-Harm,
Past Year
** Described as "Self Harm" in 2003 Paper, but as "Attempted Suicide" in 2004 Paper.
* M = Males - F = Females




Attempted Suicide & Self-Harm: Lesbian & Bisexual Women in United Kingdom
"Prescription For Change" Studies by Hunt & Fish (2008 & 2008a)

Categories /
Strategic Health Authority (SHA)
N's
%
Lesbian *
% Bisexual
Women *
% Attempted
Suicide,
Past Year
% Self-Harm,
No Death Intent
Past year
All England
5,043
80.9%
15.7%
5.0%
20.0%
East of England
415
81.2%
17.6% 7.4%
22.2%
East Midlands
377
82.5%
14.9% 4.2%
17.3%
London
1,330
79.9%
15.7% 3.5%
18.1%
North East
224
79.9%
16.5% 6.4%
22.6%
North West
638
81.3%
15.4% 5.1%
22.0%
South Central
369
78.3%
17.9% 4.9%
23.5%
South East Coast
449
81.1%
15.1% 5.8%
19.0%
South West
376
82.4%
14.4% 5.6%
22.9%
West Midlands
425
81.6%
15.8% 5.2%
15.9%
Yorkshire & Humber
418
82.2%
14.2% 4.6%
19.7%
England (SHA unknown)
22
86.4%
13.6% 31.8%
45.5%
All Wales
267
81.3%
16.1% 6.4%
22.7%
South East (Wales)
135
80.7%
16.3% 4.5%
20.3%
Mid & West (Wales)
81
80.2%
17.3% 11.1%
24.7%
North Wales 51
84.3%
13.7% 3.9%
26.0%
Scotland
510
77.8%
18.2%
4.8%
20.6%
Greater Glasgow & Clyde
157
81.5%
15.9%
5.2%
14.6%
Lothian
149
73.8%
20.8%
3.4%
17.6%
Other Areas
204
74.0% to 81.8%
15.9% to 21.2%
1.1% to 10.2%
19.5% to 39.1%
* Those not Identifying as Lesbian or Bisexual are Classified as "Other".  Study Commentary: "One in five lesbian and bisexual women have  deliberately harmed themselves in the last year, compared to 0.4 per cent of the general population. Half of women under the age of 20 have self-harmed compared to one in fifteen of teenagers generally. Five per cent have attempted to take their life in the last year and sixteen per cent of women under the age of 20 have attempted to take their life. ChildLine estimatethat 0.12 per cent of people under 18 have attempted suicide."



Lifetime "Self Harm / Attempted Suicide" Incidences
Non-Random GLB Study Populations: Ireland
Study Sample
Size (N)
GLB
Compa-
rison
Group
Self Harm /
Attempted
Suicide
% (n / N)
Sampling Information
Age
Comments
Carolan & Redmond
(2003)
362
232 (M)
130 (F
None
Self Harm
26.2%
(95 / 362)
Volunteers: Questionnaire promoted  through youth, community and gay organisations, and online.  Northern Ireland
Age = <= 25 Years
Self-Harm / Attempted Suicide: Lifetime
Attempted S.
28.7%
(104 / 362)
McNamee
(2006)
190 (M)
93.4%
Gay
Bisexual
Identified
None
27.1%
Attempted
Suicide
30.7%
Self-Harmed
Volunteers: Northern Ireland
Mean Age: 20.6 Years, 15 to 25 Years
60% Live in Belfast or Derry/Londonderry.

Self-Harm / Attempted Suicide: Lifetime
CCL
(2006)

107 (F)
85%
Lesbian
Identified
None
14.2%
Attempted
Suicide
23.8%
Self-Harmed
Volunteers: Cork Region,  Northern Ireland
Age: 8.5% (< 23 years),  45% (23-49 Years), 44% (. 49 Years)
Self-Harm / Attempted Suicide: Lifetime
Mayock
et al.
(2009)

Internet
Sample

Age Range:
14-73 years
Mean Age:
30.5 Years
Ireland
Residents:
90%*
Male
n = 707
None 105 / 707
14.8%
Attempted Suicide in Past 12 months, 6 months, 30 days:
1.6% (n = 11), 1.0% (7), 0.42% (3), respectively
Female
n = 377
None 89 / 377
23.6%
Attempted Suicide in Past 12 months, 6 months, 30 days:
3.7% (n = 14), 2.4% (9), 0.79% (3), respectively
Other
n = 22
None 3 / 22
13.6%
Attempted Suicide in Past 12 months, 6 months, 30 days:
0.0% (n = 0), 0.0% (0), 0.0% (0). respectively
All
n = 1,110
None 197 / 1,110
17.7%
Attempted Suicide in Past 12 months, 6 months, 30 days:
2.3% (n = 25), 1.4% (16), 0.54 (6),  respectively
Trans-
gender
n = 46
None
12 / 46
26.1%
Attempted Suicide in Past 12 months, 6 months, 30 days:
6.5% (n = 3), 6.5% (3), 0.0% (9), respectively
Interview Sample
n = 22
None
13 / 22
59.1%
Qualitative Part of the Study.
For Above Qantitative Study: First suicide attempts were Very Much (12%), Very (35%) and Somewhat (25%) related to LGBT Identification
* Over 90% were residents in the Republic of Ireland. 4% were living in Northern Ireland.



"Attempted Suicide" Risks: Random Samples, Europe
Homosexually vs. Heterosexually Oriented Youth/Adults
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Attempted
Suicide
% (n / N)
Sampling Information
Age
Odds Ratio (95% CI)
Wichstrom
& Hegna
(2003)
Additional
Results
6.5% (MF*)
7.0%(F)
5.7% (M)
Same-Sex
Sexual Contact, Ever
93.5%
No Same-Sex
Sexual Contact,
Ever
15.4%
vs.
3.6%
Lifetime
RR: 4.3
Random Survey: Longitudinal
108 Attempters = 4.4%,
N = 2,460 (In Regression Model)
OR = 4.7 (3.1, 7.3), No Controls.
OR = 4.3 (2.1, 5.6),
With 6 Controls Variables
Norlev
et al.
(2005)

Denmark National Random Sample. Ages: 16 to 35 Years. Numbers of homosexual / bisexual individuals said to be small. Nonetheless...
All Homo/Bi who had attempted suicide are reported to have current suicide ideation. In contrast, only a minority of Heterosexuals (maybe about 30 to 40 percent) who attempted suicide are in same category. Most do not have current suicide ideation, meaning that suicidality is not ongoing for most of them. The Odds Ratio (95% CI) for Homosexuals/ Bisexuals vs. Heterosexuals to be in 'having attempted suicide during lifetime and having current suicide ideation' category is: 5.4 (1.8–16.7), p < .05.
de Graaf
et al.
(2006)


82 (M)
Reporting
Male
Sex Partner(s)
Past Year

2,796 (M)
Reporting
Only Female
Sex Partner(s)
Past Year

14.6%
vs.
1.6%
** RR: 9.1
Lifetime
Netherlands' NEMESIS Study
Age = 18 to 64 Years
OR = 10.23 (5.2–20.2)
Control = Age
OR = 5.57 (2.6–12.0)
Controls = Age, Mental Disorders
43 (F)
Reporting
Female
Sex Partner(s)
Past Year

3,077 (F)
Reporting
Only Male
Sex Partner(s)
Past Year

4.4%
vs.
3.1%
RR: 1.3 ns
Lifetime
Netherlands' NEMESIS Study
Age = 18 to 64 Years
OR = 1.52 (0.36–6.4) ns
Control = Age
OR = 0.96 (0.22–4.3) ns
Controls = Age, Mental Disorders
Lhomond & Saurel-
Cubizolles
(2006)


78 (F*)
Reporting
Lifetime
Female
Sex Partner(s)


6,332 (F)
Reporting
Only Lifetime
Male
Sex Partner(s)


25.2%
vs.
6.6%
Lifetime
RR: 3.8
The Enveff (Enquête nationale sur la violence envers les femmes en France, National Survey on Violence  against Women in France) Survey. ORs From: 4.8 (2.8–8.1) to 2.2 (1.2–4.0) With Demographic Control Variable
to All Possible Controls Variables.
7.5% (7 / 78)
vs. 0.3%
(19 / 6,332)
Past Year
RR: 25.0
Attempted Suicide in the Past Year:
OR = 32.8 (13.4, 80.4)

Multiple Suicide Attempts, Lifetime:
OR = 5.9 (3.1, 11.4)

Note: Counts
Estimated From Given Percentages. ORs are Estimates. Non-responders Likely.
No Control Variables.

14.8% (11 / 78) vs. 2.7%
(171 / 6332)
Life, Multiple Attempts
RR: 5.5
Jouvin et al.
(2007)

L’enquête Baromètre
santé 2005 de l’INPES
Results also
given in:
MSJSVA (2008)

2.9% (M)
1.5% Homo-Sex &
1.4 Bi-Sex
n = 245??
Yes
10.0%
vs.
3.0%
RR: 3.3
Lifetime
16,883 Men & Women,
Age Range = 15 to 75 Years
Elsewhere, total number said to be 30,514 for age range 12-75 years
(Site)
Note: It would be important to know the distribution of GLB individuals and suicide attempters over the age range. For example, what would be the results in the 15 to 40 years of age category?
GLB: determined on the basis of having been sexually active with at least one member of the same sex, in the past year.
GLB Demographic Summary.
The Questionnaire
1.4% (F)
0.6% Homo-Sex &
0.8% Bi-Sex
n = 118??
Yes
10.5%
vs 5.9%
RR: 1.8 ns
Lifetime
L’enquête Baromètre
santé 2005 de l’INPES
Results
Unknown
For
Youth
Males
Yes
??

Lifetime, and in the Past 12 Months
15-25 Years: Les Jeunes: The Questionnaire. Some Reports are Done Separately For These Regions and are avaiable online:  Nord–Pas-de-Calais, Picardie, Pays de la Loire, Champagne-Ardenne, Lorraine, Poitou-Charentes, and L'Ile-de-France. Maybe Others?
Data Sets could be grouped and the likely greater suicidality risks for homosexually oriented youth could likely be determined. Example: Westermann (2007), for Nord-Pas-de-Calais, N = 1,466, 5% of males had homo-sex in the past year (n = approx. 35), and 2% of females (n = approx 14). Blais et al. (2006), Pays de la Loire, N = 1,517, 4% of males had homo-sex in the past year (n = approx. 35), and  2% of females (n = approx. 15). A subsample of 100 is sufficient to so a suicidality analysis and more than 100 homo-sex males would be available if the data sets are integrated.
Females
Yes
??
Lifetime, and in the Past 12 Months
FHI
Rapport
(2005)

(M)
(M)
See Tabled Results: 2005 National Public Health Survey, Sweden:
Sexual Orientation & Transgender Related Suicidality.
Results for Males & Females in Four Age Categories.
(F)
(F)
Ungdoms-
styrelsen (2010)

(M)
(M)
(M)
11% vs. 3%
2005 & 2008 National Public Health Surveys, Combined,
Sweden.
More Results in Table Below.

(F)
(F) (F)
26% vs. 8%
Hawton
et al.
(2002)

82 Males:
Worries
about
SO ***
2,973 Males:
No Worries
About SO
(Sexual Orientation)
11.0%
vs.
3.0%
Representative Sample (N = 6,020): 16- to 17-Year-Old Secondary school Students Living in England.
Data Collected in 2000-01.
Lifetime Prevalence of Self-Harm: Boys (6.9%), Girls (19.9%)
Greater Risk for Lifetime Self-Harm for Those Reporting Sexual Orientation Worries in Bivariate Analysis:
OR, Boys: 2.0<4.0<8.3
OR, Girls: 1.6<2.7<4.3
No Contol Variables.
Not Significant in Multivariate Analysis
101 Females:
Worries
about
SO ***
2,590 Females:
No Worries
About SO
(Sexual Orientation)
23.8%
vs.
10.5%
O'Connor
et al.
(2009)
Males:
Worries
about
SO ***
Males:
No Worries
About SO
(Sexual Orientation)
??
Deliberate
Self-Harm
Representative Sample (N = 2,008): 16- to 17-Year-Old Secondary school Students Living in Glasgow, Scotland.
Data Collected in 2006-07.
Lifetime Prevalence of Self-Harm: Boys (6.9%), Girls (19.9%)
Greater Risk for Lifetime Self-Harm for Those Reporting Sexual Orientation Worries in Multivariate Analysis:
OR, Boys: 1.5<3.8<9.5
OR, Girls: 1.3<2.6<5.2
Using about 9 Contol Variables.
Bivariate ORs: Not Given
Females:
Worries
about
SO ***

Females:
No Worries
About SO
(Sexual Orientation)
??
Deliberate
Self-Harm


McMahon
et al.
(2010a)
Males:
Worries
about
SO ***
Males:
No Worries
About SO
(Sexual Orientation)
Deliberate
Self-Harm:
Definition
Below
Cross-sectional study, 3881 adolescents in 39 schools, anonymous questionnaire. Part of the Child and Adolescent Self-harm in Europe (CASE) study. Equal genders, 53.1% of students were 16 years old.
Ages: 15 to 17 Years.
Greater Risk for Lifetime Self-Harm for Those Reporting Sexual Orientation Worries in Bivariate Analysis:
Males, Age Adjusted OR:
7.08 (4.10–12.23)
Females, Age Adjusted OR:
5.01 (3.46–7.25)

Females:
Worries
about
SO ***
Females:
No Worries
About SO
(Sexual Orientation)
Deliberate
Self-Harm
:
Definition
Below
Self-Harm
Definition in
McMahon
et al.
(2010a)
(2010b)
"[Participants reporting] self-harm were asked to describe, in their own words, the method(s) they had used to harm themselves. This description was later coded according to a standardized definition of deliberate self-harm : ‘An act with non-fatal outcome in which an individual deliberately did one or more of the following: initiated behaviour (for example, self cutting, jumping from a height), which they intended to cause self-harm ; ingested a substance in excess of the prescribed or generally recognizable therapeutic dose; ingested a recreational or illicit drug that was an act that the person regarded as self-harm; or ingested a non-ingestible substance or object ’ (Madge et al. 2008). Episodes of DSH were classified as a ‘yes’, ‘no’ or ‘no information given’ by three independent raters using the standardized definition above (Cohen’s k=0.77). When participants reported that they had harmed themselves in the past but did not describe the act, they were classified ‘no information given’ and were not included as a DSH case. The definition used allowed for a wide range of motives and levels of suicidal intent." (p. 1812-3)
McMahon
et al.
(2010b)
Males: Worries
about SO ***
School Bullying
History
Males: No Worries About SO (Sexual
Orientation)
School Bullying
History
Deliberate
Self-Harm
:
Definition
Above
Cross-sectional study, 1870 boys in 39 schools, anonymous questionnaire. Part of the Child and Adolescent Self-harm in Europe (CASE) study. 53.3% of boys were 16 years old.
Study Sample Ages: 15 to 17.

Greater Risk for Lifetime Self-Harm for Boys Bullied in School and Reporting SO Worries in Bivariate Analysis: 5.59 (2.63-11.88)

Greater Risk for Lifetime Self-Harm for Boys not Bullied in School and Reporting SO Worries in Bivariate Analysis:
4.70 (1.89-11.71)
Males: Worries
about SO ***
No
School Bullying History
Males: No Worries About SO (Sexual
Orientation)
No School Bullying History
Deliberate
Self-Harm
:
Definition
Above
Chakraborty
et al.
(2011)

Non-Heterosexual
N = 659
Includes: All,
from "Mostly
Heterosexual" to "Entirely Homosexual" and "Other"
100% (Entirely)
Heterosexual

N = 6,811
Attempted
Suicide, Lifetime
8.9% vs. 5.3%
1.7<2.3<3.1
a
1.6<2.2<3.0 b
The Adult Psychiatric Morbidity Survey 2007 (n = 7403): representative of the population living in private UK households.
a. Unajusted OR. - b. OR Adjusted for gender, age, ethnicity and education.
Note: Study also reports results for "Self-Harm, Lifetime" and for "Suicidal thoughts, lifetime."
Chakraborty
et al.
(2011)

Life Sexual Experiences:
All Same-Sex to Some Same-Sex.
N = 667
Life Sexual Experiences:
Only With Opposite Sex,
Never Same-Sex

N = 6,794
Attempted
Suicide, Lifetime
9.2% vs. 5.1%
1.4<1.9<2.6
a
1.3<1.8<2.5 b
The Adult Psychiatric Morbidity Survey 2007 (n = 7403): representative of the population living in private UK households.
a. Unajusted OR. - b. OR Adjusted for gender, age, ethnicity and education.
Those reporting no sexual partners in lifetime were removed from the analysis.
Note: Study also reports results for "Self-Harm, Lifetime" and for "Suicidal thoughts, lifetime."
Wang
et al.
(2012)

Bisexual to
Homosexual Group:
n = 64
100%
Heterosexual:
n = 2,903
The 'Mostly
Heterosexual'
Removed
From Analysis.
Lifetime:
14.1%
(5.6-22.6)
vs.
3.0% (2.4-3.6)
OR:
5.36
(2.57-11.2)

Swiss Multicenter Adolescent Survey on Health (SMASH): 4044 males, in school, age: 16 to 20 years-old, random sampling in 2002. 72.5% only
heterosexual, 23.3% mostly heterosexual, 0.8% equally bisexual, 0.4% mostly homosexual, 0.4% only homosexual, and 2.6% nonresponse.
Wang
et al.
(2012)

Bisexual to
Homosexual Group:
n = 296
100%
Heterosexual:
n = 17,072
The 'Mostly
Heterosexual'
Removed
From Analysis.
Lifetime:
5.1%
(2.6-7.6)
vs.
1.3%
(1.1-1.5)
OR:
4.68
(3.06-7.15)
Swiss Recruit Survey (ch-x): 22,191 males, mostly 20 years old, 50% selected for study & all completing questionnaire in 2002-03. 91.7% only heterosexual, 5.3% mostly
heterosexual, 0.9% equally bisexual, 0% mostly homosexual, 0.7%
only homosexual, and 1.2% non-response.
Note: The second Swiss Recruit Survey (ch-x) drew its sample from new recruits of the Swiss army. Non-Swiss citizens (22% of the resident population) were excluded from the survey, as were Swiss men with health exemptions and those opting for civil service. A significant proportion of Swiss gay men avoid compulsory military service through those means.

* M = Males - F = Females
-- ** RR = Risk Ratio, Estimated - "ns" = Not Statistically Significant
*** Somewhat of a proxy for having a homosexual orientation. SO: Sexual Orientation.





Youth "Attempted Suicide" Risks: Norway
Homosexually Oriented Youth
Study
Sample
Size (N)
GLB
Compa-
rison
Group
Attempted
Suicide
% (n / N)
Sampling Information
Age
Odds Ratio (95% CI)
Wichstrom
& Hegna
(2003)



6.5% (MF*)
7.0%(F)
5.7% (M)
Same-Sex
Sexual Contact, Ever
93.5%
No Same-Sex
Sexual Contact,
Ever
15.4%
vs.
3.6%
Lifetime
RR: 4.3
108 Attempters = 4.4%,
N = 2,460 (In Regression Model)
OR = 4.7 (3.1, 7.3), No Controls.
OR = 4.3 (2.1, 5.6),
With 6 Controls Variables
20.9% (F)
8.6% (M)
Some Same
-Sex Sexual
Attraction
--
9.1%
vs.
3.6%
Lifetime
RR: 2.5
ORs not Generated
13.5% (F)
8.9% (M)
Some GLB
Identity
--
9.1%
vs.3.6%
Lifetime
RR: 2.5
ORs not Generated
7.0% (F)
Same-Sex
Sexual Contact, Ever

93.0%
No Same-Sex
Sexual Contact,
Ever

19.4%
vs. 4.2%
From T-2
to T-3 **
RR: 4.6
N = 1,327 Females
*** Predicting Suicide Attempt
from 1994 to 1999:
OR = 5.9 (3.2, 10.8)
, No Controls.
OR = 5.0 (2.3, 10.6), 3 Controls
Wichstrom
(2009)
(M) (F)
Non-Heterosexual
Sexual Interests
At Time 1
(M) (F)
No Same-Sex
Sexual Interests
Reported At Time 1
(M) (F)
Attempted Suicide From T1 to T2
OR = 6.8 (3.7, 12.5)
With Control Variables.
See Below.
Same Longitudinal Student Survey: In Multivariate Nominal Regression, students who had reported having had same-sex-sexual contacts before T1 or had been aware of their same-sex sexual interest before T1 were classified as having non-heterosexual sexual interest... and this category produced the strongest predictors (not including NSSI & Attempting Suicide at Time 1) for Non-suicidal Self-Injury (NSSI) [OR: 4.06, 1.95 - 8.47] and Attempting Suicide [OR: 6.81, 3.70 - 12.55] from Time 1 to Time 2.
* M = Males - F = Females
** Longitudinal Study, 3 Questionnaires from T-1 to T3: 1992 (T-1): 12,287 students, Grades 7 - 12. - 1994 (T-2): 9,679 students, Grade 9 - 12+. - 1999 (T-3): 2,924 Youth.. - Mean Ages: 14.9 years (SD: 1.7, T-1) to 16.5 years (SD: 1.9, T-2) to 22.1 years (SD: 1.9, T-3).
***
No Homo-Sex male suicide attempters from 1994 to 1999. Comparing the N's in both regression models reveals that there are only about 1,133 males (2460 - 1,327) available for analysis.
Responders to "Attempted Suicide" and "Same-Sex Sex" questions:  Males = 1,239; Females = 1,567: Total = 2,806, but the numbers are lower in regression analyses due to non-responses to other variables: 1,133 and 1,327 (Total = 2,460), respectively.
Is An Estimate of the Percentage of Suicide Attempters Who are Homo-Sex Males Possible?  Maybe not possible to calculate given the data supplied by the authors. Males & Females Reporting Homo-Sex, Ever: 2,806 X 6.5% = 182. For Females: 1,567 X 7.0% = 109.7 = 100. For Males: 1,239 X 5.7% = 70.6 = 71. Homo-Sex Males & Females Who Attempted Suicide: 182 X 15.4% = 28 Suicide Attempters. Homo-Sex Females Who Attempted Suicide from T-2 to T-3: 110 X 19.4% = 21 Suicide Attempters. This would mean that only a maximum of 7 Homo-Sex male suicide attempters could exist up to T-2, the number likely being less. Furthermore, it would seem that the great majority of Homo-Sex females who attempted suicide between T-2 and T-3 (All? Almost All?) are repeat suicide attempters. Assuming "All", this would mean that there are 7 Homo-Sex male suicide attempters, for an "Attempted Suicide" Incidence of 9.9% (7 / 71), all having occurred up to T-2. Unfortunately, the authors did not report any "Attempted Suicide" results specific to Homo-Sex males, other males, or all males up to T-2. The lifetime "Attempted Suicide" incidence for males is 2.2%; 1.6% for Non-Homo-Sex males from T-2 to T-3.



2005 National Public Health Survey, Sweden
Sexual Orientation & Transgender Related Suicidality

Categories
Attempted Suicide, Ever % - Suicidal Thoughts, Ever [%]
Transgender *
n = 374
Males **
Females **
Homo-Bi
Others
Homo/Bi
Others
16 - 29 Years
27%
n = ?
11% [47%]
n = ?
4% [14%]
n = ?
21% [53%]
n = ?
8% [21%]
n = ?
30 - 44 Years
28%
n = ?
3% [30%]
n = ?
3% [12%]
n = ?
8% [17%]
n = ?
5% [14%]
n = ?
45 - 54 Year
12%
n = ?
16% [21%]
n = ?
3% [9%]
n = ?
11% [25%]
n = ?
5% [13%]
n = ?
54 - 64 Years
21%
n = ?
11% [33%]
n = ?
4% [12%]
n = ?
12% [27%]
n = ?
6% [16%]
n = ?

* Web Survey Data: Reported in
National Public Health Survey, 2005. - ** National Public Health Survey, 2005. Results also given in Winzer & Boström (2007).

It 'appears" like 1,028 persons did not answer the "sexual orientation" question, and were removed from the analysis. The same applies for those "not sure" of their sexual oreintation. The final sample - 29,190 persons: '648 persons (2 percent) indicated that they were not exclusively heterosexual. The largest group among those who were not exclusively heterosexual were heterosexual with some homosexual elements (here called "hetero-homo") (304 persons) followed  bisexual (221 persons), homosexuals (99 persons) and homosexuals with some heterosexual elements (here called "homo hetero") (24 persons)'.




2005 & 2008 National Public Health Survey, Combined
Sweden - Sexual Orientation
& Lifetime Suicidality

Men & Women: Ages 16 - 29 Years
Categories
Hetero-
Sexual

n = 12,560
Homo-
Sexual /
Bisexual
n = 554
Unsure of
Sexual
Orientation
n = 215
Men

Seriously Considered
Taking Your Life
12%
42%
RR: 3.5
29%
RR: 2.4
Ever Tried to
Commit Suicide
3%
11%
RR: 3.7
17%
RR: 5.7
Women

Seriously Considered
Taking Your Life
20%
47%
RR: 2.3
34%
RR: 1.7
Ever Tried to
Commit Suicide
8%
26%
RR: 3.2
21%
RR: 2.6
Data Source: Ungdomsstyrelsen (2010)
See: Figur 1.7 & 1.8, Kapitel [Chapter] 1




The 2015 National Canadian
Homeless Youth Survey 1

Categories
n, %
of Sample
Lifetime
Attempted  Suicide
Cisgender
Males
620, 56%
39%
Cisgender
Females
390, 35%
59%
Cisgender  &
Heterosexual
752, 68%
39%
Sexual & Gender
Identities
319, 28%
70% 3
Aboriginal /
First Nations 2
314, 29%
54%
Black
142, 13%
Black, Latin
American + Other
Racial Minorities
41%

Latin
American
38, 3.5%
Indigenous /
White

51%
White
676, 61%
?

Data Source: Kidd et al. (2017-18)

1. "A total of 1161 youth completed the survey, and after cleaning, 1,103 were retained (cases with key demographic data and measures omitted were excluded). Data were collected from the Nunavut territory and all provinces except for Prince Edward Island... The largest amounts of data were collected from Ontario (n = 482; 44%), British Columbia (n = 238; 22%), and Alberta (n = 154; 14%) and the least from Nunavut (n = 2; 0.2%) and Manitoba (n = 16; 1.4%). Data were primarily gathered in large urban centres such as Toronto (n = 193; 18%), Vancouver (n = 167; 15%), Edmonton (n = 82; 7.4%), Ottawa (n = 67; 6.1%), and St. John’s (n = 67; 6.1%)."
2. The attempted suicide incidence for aboriginal LGBTQ2S (lesbian, gay, bisexual, transgender, queer, and 2 spirit) individuals is not reported. Aboriginal youth are overrepresented in the Canadian homeless youth population as is also the case for the general LGBTQ2S population that is overrepresented in the suicide attempter population
3. The "attempted suicide" Risk Ratio & Odds Ratio relationship between sexual & gender identity minorities and cisgender & heterosexual homeless youth (70% vs.39%) is RR = 1.8, OR =  3.6. RR / OR generated at http://statpages.info/ctab2x2.html 




Suicide/Suicidality Risk: Psychiatric Patients
Homosexuality & Bisexuality
Study
Homosexuality As
Suicide/Suicidality
Risk Factor
Study
Information
Motto
et al.
(1985)
High Risk For Suicide:
Being bisexual and sexually
 active, or homosexual
and inactive (celibate)
Follow-up USA study of  2,753 adults "hospitalized
due to a depressive or suicidal state" USA
Marten
et al.
(1985)

Homosexuals accounted
for one-third of
the suicide deaths
A prospective USA study of 500 randomly
selected psychiatric outpatients during
a mean follow-up period of seven years.
Pretorius
(1992)
Thesis
For males, subsequent
suicide attempts were
associated with:
Being Single,
Homosexuality,
and Other Factors
All cases of attempted suicide referred to the Department
of Psychiatry at the University of Pretoria were studied
over a period of a year.
A total of 307 patients, 86 males
and 221 females, were evaluated. After 5 years, as many
as possible were traced: 59 males and 205 females.
Note: After 1985, homosexuality issues have generally been ignored
in studies of the suicide & suicidality of psychiatric patients.






Suicide Risk: Transsexual Populations
Study
Transsexual Suicide Risk Factors
Study
Information
Asscheman
et al.
(1989)
303 Male-to-Female Transsexuals (MtF)
Suicide: 3 (0.63-8.8) vs. 0.208
Age When Hormone Treatment Began:
Median: 32.0 Years, Range: 16-67

Attempted suicide by MtF before the start of sex reassignment treatment
: 14%

122 Female-to-Male Transsexuals (FtM)
No Suicides
Age When Hormone Treatment Began:
Median: 25.4 Years, Range: 16-54

425 Transsexual Patients With Cross-Gender
Hormone Treatment (1972-1986,
Free University Hospital clinic, Amsterdam, The Netherlands).Compared With
Average Population.
"The observed and the expected mortalities in male to-female transsexuals treated with estrogens and cyproterone acetate are shown in Table 1. The total number of deaths in the treatment group represented a 2.5- to 9-fold increase over the general population. The increased mortality was in particular due to an increase of suicides and of deaths by unknown cause." "The increased number of deaths by unknown cause does raise concern. Two of these three deaths might have been suicide, according to friends and relatives."
van Kesteren
et al.
(1997)
SMR: Standard Mortality Ratio (MtF)
Suicide Risk Compared to Average Population:
13 Suicides - SMR: 4.9<9.3<15.9
.

No Suicide: Female to Male (FtM) Transsexuals.

Attempted suicide by MtF before the start of sex reassignment treatment: ? %. After?
Suicide Risk in 816 Male-to-Female Transsexuals
Treated With Oestrogens and Anti-Androgens at Free University Hospital clinic (Amsterdam,
The Netherlands) from 1977 to 1994.

Mean Age (MtF): 41 (18-860 Years
Mean Age (FtM, N = 282): 34 (17-70) Years
Dhejne
et al.
(2011)


Adjusted Hazard Ratios (aHR)
Suicide: 19.1 (5.8–62.9) - 1973 to 2003

Attempted Suicide
4.9 (2.9–8.5) - 1973 to 2003
7.9 (4.1–15.3) - 1973 to 1988
2.0 (0.7–5.3) - 1989 to 2003
324 sex-reassigned persons (191 male-to-females: MtF,
133 female-to-males: FtM) in Sweden, 1973–2003.
Study Entry Age: MtF: 36.3 (10.1, 21–69),
FtM: 33.3 (8.7, 20–62)
Random population controls (10:1) matched for birth year and sex (Table 2).
Outcomes: Post Sex-reassignment
Hazard Ratios Calculated on basis of Outcome incidence rates per 1000 person-years, 1973–2003
Adjusted Hazard Ratios (aHR), 95% CI
Suicide
MtF (N=191): 13.9 (3.9-49.6)
FtM (N=133) 40.0 (4.5-357.9)
MtF & MtF (N=324) 19.1 (6.5-55.9)

Attempted Suicide
MtF (N=191): 15.4 (7.9-30.2)
FtM (N=133) 2.9 (1.3-6.8)
MtF & MtF (N=324) 7.6 (4.7-12.4)
Matched With Birth Sex and Birth Year: Table S1
(Separate Download)
Outcomes: Post Sex-reassignment


Hazard Ratios Calculated on basis of Outcome incidence rates per 1000 person-years, 1973–2003

Adjusted Hazard Ratios (aHR), 95% CI
Suicide
MtF (N=191): 60.0 (7.2-498.4)
FtM (N=133) 5.4 (1.6-18.6)
MtF & MtF (N=324) 12.1 (4.8-30.8)


Attempted Suicide
MtF (N=191): 10.9 (5.9-20.0)
FtM (N=133) 4.9 (2.0-12.1)
MtF & MtF (N=324) 8.4 (5.1-13.8)
Matched With Final Sex and Birth Year: Table S2
(Separate Download)
Outcomes: Post Sex-reassignment

Hazard Ratios Calculated on basis of Outcome incidence
rates per 1000 person-years, 1973–2003

Asscheman
et al.
(2011)
SMR (Standard Mortality Rate) for Suicide:

MtF: n = 17 Suicides
SMR: 5.70 (4.93–6.54), 95% CI

FtM: n = 1 Suicide
SMR: 2.22 (0.53–6.18), 95% CI

( Related Article)
Netherlands: VU University Medical Center
All transsexual subjects referred to our
outpatient department since 1975.
966 (72.6%) MtF transsexuals, with a mean
age of 31.4 years at the start of cross-sex hormones (range: 16–76 years), with 18 678 patient-years of follow-up, and 365 (27.4%) FtM transsexuals, with a mean age 26.1 years (range: 16–57 years) at the start of hormone therapy with 6866 patient-years of follow-up.
Blosnich
et al.
(2014a)
"The study population consisted of VHA patients identified as having any one of four diagnosis codes indicating transgender status (n = 5,117) gathered from the VA National Patient Care Database. Mortality data were gathered from the National Death Index from 2000–2009 for 1,277 veterans with transgender-related ICD-9-CM diagnoses."
"Approximately 9.3% (n = 309) veterans with transgender-related ICD-9-CM diagnoses died across the study period... The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses across the 10-year period was approximately 82/100,000 person-years, which approximated the crude suicide death rates for other serious mental illness in VHA (e.g., depression, schizophrenia). The average age of suicide decedents was 49.4 years... The crude suicide rate among veterans with transgender-related ICD-9-CM diagnoses is higher than in the general population, and they may be dying by suicide at younger ages than their veteran peers without transgender-related ICD-9-CM diagnoses. Future research, such as age-adjusted rates or accounting for psychiatric co-morbidities, will help to better clarify if the all-cause and suicide mortality rates are elevated for veterans with transgender-related ICD-9-CM diagnoses."
* MtF: Male to Female - FtM: Female to Male







"Attempted Suicide" Incidences/Risks
Transgender (TG) Populations: 2000 to 2017
Study
Sample
Size (N)
TG
Compa-
rison
Group
Attempted
Suicide
% (n / N)
Sampling Information
Risk Ratio,
p
Odd Ratios, Specified
Xavier
(2000)
Washington
D.C.
252
*MTF: 189
None
16%
70% African-American,
22% Latino/a, 8% Others.
Age Range: 13 to 61 Years
Nearly 80% = 36 years and under
** Nemoto (2001)
San
Francisco

MTF: 245
None
32%
MTF Of Color
?
51%
African American
?
31%
Latina
?
18%
Asian / Pacific Islander
Nemoto
et al.
(2002)
San
Francisco

MTF: 332
None
29%
MTF Of Color ***8
112
41%
African American - Mean Age: 36.5***
110
45%
Latina - Mean Age: 32.9
110
15%
Asian/Pacific Islander - Mean Age: 32.9
Mathy
(2002b)

Additional
Results

North
American
73 TG

61 TG =
Canadians
12 TG =
Americans
1,083
23.3% vs
11.4%
TG vs. Random Heterosexual Females
2.9, p
< .01
1,077
23.3% vs
5.0
TG vs. Random Heterosexual Males
4.7, p
< .001
73
23.3% vs
11.0%
TG vs. Matched Females
2.1, p
< .05
73
23.3% vs
4.1%
TG vs. Matched Males
5.7, p < .001
256
23.3% vs
16.0%
TG vs. Random Homosexual Females
1.5, ns
356
23.3% vs
8.7%
TG vs. Random Homosexual Males
2.7, p < .001
Kenagy
(2005)
Philadelphia
All MTF: 182
None
30.1% Volunteers: Face-to-Face Interview
or Questionnaire - 41.3: African American, 33.0% white, 10.1% multiracial, 6.1& Hispanic, 5.6% biracial, 3.9% others.
See also: Kenagy (1998)
MTF: 113
32.4%
* FTM: 69
26.2%
Operario
& Nemoto
(2005)
San
Francisco
MTF: 110
Asian
Pacific
Islanders
None
15%
Same Sample
as in
Nemoto et al.
(2002)
Volunteers: San Francisco ****
Mean Age: 33, Range: 18 to 57 Years
46% of FTM = Filipino, 9% Laotian, 7% Vietnamese, 4% Hawaiian, remainder identifying as other Asian/PI ethnicities.
Clements-
Nolle et al.
(2006)
San
Francisco

Additional
Results

All TG: 515
None
32.2%
63.7% Non-White, 36.3% White
MTF: 391
MTF vs.
FTM
32.5%
OR = 1.04 (0.67, 1.6) ns, No Controls
OR = 1.1 (0.59, 1.9),  9 Controls
FTM: 123
31.7%
White: 188
White vs.
Non-
White

37.8% OR = 1.5 (1.02, 2.2), No Controls
OR = 1.5 (0.92, 2.4),  9 Controls
Others: 323
28.8%
< 25 Yrs: 66
< 25 vs
25 + Yrs

47.0%
OR = 2.1 (1.2, 3.5), No Controls
OR = 2.17 (1.17, 4.01),  9 Controls
25+ Yrs: 449 30.1%
Zians
(2006)

TG: 136
None
17.6%
(24 / 136)
San Diego, California
Mean Age: 38.3 (SD: 13.1)
Age Range: 9 to 79 Years
48.3% White, 16.2% Latino,
14% African  American, 10.3% Biracial
Kim et. al.
(2006)

MTF: 43
49 Matched
non-FTMs
62.8%
(27 / 43)
Presenting at compulsory military service in 3 Korean Cities.
Age Range: 19 to 23 Years
Taylor
(2006)

TG: 73
None
28%
Winnipeg, Manitoba, Canada
49 Born Male, 21 Born Female, 3 Intersexed. 20 Aboriginal
Age Range: 18 to 60+
Grossman &
D'Augelli
(2007)
31 MTF
Mean Age: 17.5
None
6 / 31
19.3%
Volunteer Sample via two New York City GLBT Community Service Organizations. Age: 15-21 years
Suicide Attempters were asked where, how, why, and lethality of suicide attempt(s) also determined.
50% Attempted at Age 15-16 years, Age Range: 10-17 Years. Note: These are serious suicide attempts as determined for GLB youth by D'Augelli et al. (2005): For NYC similarly sampled GLB Individuals, Attempted Suicide Incidence = 14.8%
24 FTM
Mean Age: 19.5
None
8 / 24
33.3%
Xavier
et al.
(2007)
MTF &
FTM
N = 350
None
25.4%
'With participants from 60 of the 136 cities and counties in the State of Virginia, this is the first truly statewide needs assessment survey of a transgender population in the U.S.'
*Not given and cannot be calculated exactly from given results.
Note: Same sample as Testa et al. (2012)
& Goldblum et al (2012) below
MTF
n = 229
None
< 25.4%*
FTM
n = 121
None
> 25.4%*
Malavé
Lebrón &
González
Rivera
(2009)
MTF
n = 31
None
8 / 31 =
25.8%
Puerto Rico Volunteer transgender -
transsexual (masculine to feminine). Ages of 20-45 years (MD= 29 years).
McNeil
et al.
(2012)
MTF, FTM +
N = 581 ?
None
35% Once.
25% More
Than Once.
See Information Table Below.
Testa
et al.
(2012)

MTF &
FTM
N = 350
Study Sample: 271
None
-
Odds Ratio, having attempted suicide if also exposed to physical violence:
FTM OR: 5.1 -- MTF OR: 3.5
Odds Ratio, having attempted suicide if also exposed to physical violence:
FTM OR: 5.0 -- MTF OR: 3.6
Note: Same online sample as Xavier et al. (2007) above & Goldblum et al (2012) below.
State of Virginia study sample.
MTF
n = 179
None
26.3%
FTM
n = 92
None
34.0%
Goldblum
et al.
(2012)
MTF &
FTM
N = 350
Study Sample: 290
None
28.5%
Odds Ratio, having attempted suicide if also exposed to in-school gender-based victimization (GBV).:
FTM OR: 4.5 -- MTF OR: 3.1
Note: Same online sample as Xavier et al. (2007) & Testa et al (2012) above.
State of Virginia study sample.

MTF
None
26.5%
FTM
None
31/2%
Nuttbrock
et al.
(2010)

All MTF
N = 571
-
-
MTFs recruited in conjunction with the baseline component of the New York Transgender Project, a large ongoing study of this population in the New York Metropolitan Area. Ages = 19 to 59, mean age = 37.
Younger:
19-39
Years
None
31.2%
Older:
39-59
Years
None
28.0%
Maguen &
Shipherd
(2010)

All: 153
None
18%
27 / 153
American Transgender participants (N = 153), 18-75 years, recruited at First Event, a regional transgender conference sponsored by the Tiffany Club of New England on January16 and 17, 2004.
Trans Men
MTF
None
41%
9 / 22
Trans Women
FTM
None
20%
12 / 60
Bigender
None
9%
3 of 32
male crossdressers
None

7%
2 / 28
Grant et al.
(2010)

All: 6,450
Transgender
None
41%
American: Internet Sample
"Attempted Suicide" Results by Age Groups, Employment Status and Race/Ethnicity
See Table Below.
Discrimination Results by
Herman et al (2014): Table Below.
For suicidality results related to many demographic factors, see: Haas et al (2014)..
Scanlon et al.
(2010)

Bauer
et al.
(2013)
All: 433
Transgender
None

Attempted
Suicide:

Lifetime:
43%
Past year:
10%
Ontario, Canada Sample:
Trans PULSE Survey.
See Additional Suicidality Results, Including :"Attempted Suicide" Incidences as related to age and having experienced verbal or physical assault: Table Below.
Bauer
et al.
(2015)
All: 380
Transgender
None
Attempted
Suicide:
Past year:
11,2%
Same  non-random study sample as above: Scanlon et al (2010) & Bauer et al. 2013). Analysis to identify suicidality related factors that could be targeted in suicide prevention efforts.
Terada
et al.
(2011)

MTF
N = 189
None
31.7%: See
"Suicidality
Variable"
Study Sample: 500 consecutive Japanese GID patients without any other psychiatric comorbidity at outpatient GID Clinic of Okayama University Hospital.
GID: Gender Identity Disorder.
"Suicidality Variable": Self-mutilation including suicide attempts.
Risk Factors: Early onset and less education.
FTM
N = 311
None
31.8%: See
"Suicidality
Variable"
Effrig
et al.
(2011)
Transgender,
Combined,
2 Study
Samples:
32 Clinical,
65
Nonclinical.
Total = 97
Attempted Suicide,
Lifetime:
8.4%, men & Women,
Clinical
Sample.
4.9%, men & Women,
Nonclinical
Sample.
Transgender
Attempted Suicide,
Lifetime:
25.7%
27 / 97

Nonclinical Participants: random national sample of 21, 686 college students. Average age of participants:  22 years (SD = 9.52).
Clinical Sample Participants: 27,616 college students who sought counseling services at one of 66 CCMH counseling centers.
Singh
(2012)
48 GID Males (of
139 GID
Males) who
had related
data.
None
Attempted
Suicide
Since the Age
of 13 Years:

15 / 48
31.2%
The participants were biological males referred to and then assessed in the Gender Identity Service, Child, Youth, and Family Program at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario during their childhood and were adolescents or adults at the time of follow-up. Data collection occurred over three decades, 1986-2011.
Jones &
Hillier
(2013)
91 Trans-spectrum
Youth.
1,265
Cisgender
SSAY: Same
Sex Attracted
Youth.

Age Range:
14 to 21
Average:
17 Years

Cisgender
30.12%
Trans-
Spectrum
Lifetime
Self-Harm
46.15%
p < 0.01
Writing Themselves In” 2010: an Australian online survey. 91 trans-spectrum youth: 43 elected
their sex as “Gender Queer,” 21 as “Transgender f-m,” 18 as “Trans-gender m-f,” and 9 as “Other.” The 3,043 cisgender SSAY youth: 1,265 were males (vast majority described themselves as gay/homosexual), 1,766 females with identifications more evenly divided between bisexual and gay/homosexual).
Cisgender
16.10%
Trans-
Spectrum

Lifetime
Attempted
Suicide
27.47%
p < 0.01
Blosnich
et al.
(2013)

GID
Diagnosed
VHA
Population.

General VHA Population.
[USA Veteran
Health
Adminis-tration]
GID:
Suicide-
Related
Events =
Planning
Suicide,
Attempting
Suicide
.
"GID prevalence in the VHA is higher (22.9/100 000 persons) than are previous estimates of GID in the general US population (4.3/100 000 persons). The rate of suicide-related events among GID-diagnosed VHA veterans was more than 20 times higher than were rates for the general VHA population."
Moody &
Smith
(2013)
133
Transgender
Adults
None
26.3%
35 / 133
Attempted
Suicide,
Lifetime
Internet Sampling: Recruitment e-mails sent to possible participants via LGBT and trans LISTSERVs and organizations: September 2010 to February 2011. 133 Volunteer Canadian Participants, self-identified as trans adults, ranging in age from 18 to 75 years (M=36.75, SD=13.01).
Boza &
Perry
(2014)
255
Transgender
Adults
None
43.6%
106 / 243
Attempted
Suicide,
Lifetime
Internet Non-Random Sampling; Online Study Advertisements & Snowballing for Australian Transgender Residents.
Sample: 87 Born Female. 168 Born Male. Mean Age: 38.15 years (SD = 13.56, range = 18–73). Participants were predominantly of Oceanic (60.9%) or European (33.3%) ethnicity.
Clark
et al.
(2014)
Transgender
n = 83 to 95.

Non-
Transgender:
Attempted
Suicide:

315 / 7,678
= 4.1%
Transgender:
Attempted
Suicide:
19 / 95 =
19.8%

Odds Ratio:
5.0 (2.9-8.8)
Youth’12: a national, crosssectional, population-based survey: secondary school youth health, New Zealand.
Self-Harm: 45.5% vs. 23.4%.
OR: 2.7 (1.7-4.3).
Depression: 41.3% vs. 11,8%
OR: 5.7 (3.6-9.2)
de Bolger
et al.
(2014)
Trans Men
n = 230
Female at
birth.
None
Attempted
Suicide:
79 / 222 =
35.1%
Self-Harm
150 / 222 =
67.6%
Australian trans men aged 16 years and over. Recruited via gender centres, gender clinics, and government and non-government organisations. Survey completed online. Age range = 16 to 64 years. Mean = 30.5 years.
Reisner
et al.
(2014)
Transgender
n =31
Cisgender
n = 2,622

Attempted
Suicide,
Lifetime:
8.5%
Transgender
Attempted
Suicide,
Lifetime:
29.0%
Results from the Core Data Project survey of patients engaged in medical care from 2001–2002 at Fenway Community Health Center (FCHC) in Boston, Massachusetts.
Reisner
et al.
(2015)
Transgender
n =31
Cisgender
n = 180

Attempted
Suicide,
Lifetime:
6.1%
Transgender
Attempted
Suicide,
Lifetime:
17.2%
RR, With Controls:
3.2 (1.5-6.7)
A retrospective cohort study of electronic health record data from 180 transgender patients aged 12-29 years seen between 2002 and 2011 at at the Fenway Community Health Center (FCHC) in Boston, Massachusetts. Transgender compared with matched cisgender (nontransgender) youth patients.
Veale
et al.
(2015)
923
Trans
Youth:

14 to 25
Years Old

None
Suicidality, past 12 months,
younger youth
(14-18 years old):

Attempted suicide: 37%   

Had seriously considered suicide: 65%   

Lifetime
suicidality
, older youth (19-25 years old):

Attempted suicide:
37%

Had seriously considered suicide:
65%
Youth could participate in the study if they were between 14 and 25 years old, lived in Canada, and identified as trans or genderqueer, or felt their gender didn’t match their body. The survey was open from October 1, 2013 to May 31, 2014.Volunteer study participant: 923 youth, average age = 20 years old, 70% white. Overall, 1 in 10 participants identified as Aboriginal, which included First Nations, Inuit, and Métis. This number was much higher in the Prairie Provinces.

Same study sample as
Veale et al. (2017).

Guzmán-
Parra
(2015)
MTF
n=101

FTM
n = 96
None
Attempted Suicide,
Lifetime:
21.8%, MTF

Attempted Suicide,
Lifetime:
24.0%, FTM

Study of the sociodemographic characteristics and the psychological adjustment of transsexuals in Andalusia (Spain), with an analysis of the differences between
female-to-male (FtM) and male-to-female (MtF) transsexuals.

The sample was selected from patients attending theTGIU [Transsexuality and Gender
Identity Unit (TGIU) at the Carlos Haya Hospital in Malaga] who met the Transsexualism criteria for the ICD-10 (F64.0) standards and did not meet any of the exclusion criteria
for sex reassignment set by the unit.
Marshall
et al.
(2015-16)
Transwomen
n = 438
Transwomen
n = 44
N = 482
None
Attempted Suicide,
Lifetime:

Transwomen
141 / 438 = 25,1%
Transmen
18/ 44 = 40.9%
All:
159 / 482 = 33.0%
Non-random - as representative as possible - nation-wide, cross-sectional 2013 survey of transgender individuals living in Argentina.
Median Age = 30 Years
Perez-Brumer
et`al.
(2015)
MTF
n = 697
FTM
n = 532
All:
N = 1,229
None
Attempted Suicide,
Lifetime:
355 / 1,097
= 32.4%
Attempted Suicide,
Past Year
51 / 796
= 6.4%
2003 cross-sectional Internet-based health assessment of American transgender adults.
Only 1,097 transgender individuals supplied lifetime suicidality information.
Only 796 transgender individuals supplies past-year suicidality information.
Olsen
et al.
(2015)
MTF
n = 50
FTM
n = 51
All:
N = 101
None
Attempted Suicide,
Lifetime:
Transfeminine
27%
Transmasculine
33%
Baseline Characteristics, Trans-gender Youth Seeking Care for Gender Dysphoria in Los Angeles. Mean Ages: Transfeminine (19.8 Years), Transmasculine (18.6 Years).
Brown
et al.
(2015)
Transgender
n = 5,135
Non-
transgender
n = 15,405

Suicide Ideation and/or
Attempted Suicide,
Lifetime:

4.5%
Suicide Ideation and/or
Attempted Suicide,
Lifetime:
19.4%
ORs, Not Adjusted /
Adjusted:
5.22 (4.7–5.8)
4.10 (3.7–4.6)
Study of a cohort of 5,135 TG veterans treated in the Veterans Health Administration (VHA) between 1996 and 2013. A matched 1:3  case–control design used to determine medical and/or mental health disparities existing in the TG veteran population.
See Brown et al. (2014) for Transgender White / Black
Veterans' Suicide Ideation and/or Attempted Suicide  Incidences: 19.2% / 21.2%
Su et al.
(2016)
Transgender
n = 85
LGB
Nontrans-
gender
n = 665
Attempted Suicide,
Lifetime:
15.9%
Attempted Suicide,
Lifetime:
37.6%
2010 online survey over the large geographical area of Nebraska, USA.
Participants were self-identified lesbian, gay, bisexual, and/or transgender persons over the age of 19. A multipronged recruitment strategy was used. 770 LGBT Nebraskans in the study
Aitken
et al.
(2016)
Gender Dysphoric
Children
n =
572
Siblings
n = 425
Lifetime.
Self-Harm /
Attempted
Suicide:
2.2%
Lifetime.
Self-Harm or
Attempted
Suicide:
6.6%

Gender Dysphoric Children
n =
572, 463 Boys, 109 Girls, Age: 3 to 12 Years.  Siblings, n = 425, 239 Boys, 186 Girls. Age: 3 to 12 Years.
Other comparisons also given: Other clinic referred and non-referred children. Plus results from another somewhat similar study.
Barboza
et al.
(2016)
Transgender
Men and Women
n =
350
None

Attempted Suicide,
Lifetime:
25%
Virginia Transgender Health Initiative Survey (THIS).
Most identified their gender as man (19.4%), woman (25.4%) or transgender (41.7%), their sexual preference as heterosexual (20.9%), gay (15.4%), lesbian (13.4%) or bisexual (17.1%). 39% under the age of 30. A majority = low socioeconomic status
Grossman
et al.
(2016)
Transgender
/ Gender Non-
conforming
TGNC
n =129
None
Attempted Suicide,
Lifetime:
TGNC: 24.4%
29 / 119
FTM:
18.4%
7 / 38
MTF: 15.4%
6 /39
FTDG: 46.4%
13 / 28
MTDG: 21.4%
3 / 14
Youth recruited in three U.S. cities from community organizations and college groups for LGBTQ youth, by invitations placed on websites frequented by LGBTQ youth in those cities and by inviting youth participating in LGBTQ Pride activities.
14 (11%) female to male (FTM), 44 (34%) male to female (MTF), 31 (24%) female to different gender (FTDG), and 14 (11%) male to different gender. Age Range = 15 to 21 Years, Mean = 18 Years.
Kaplan
et al.
(2016)
Trans
Feminine
Individuals
n = 54
None
Attempted Suicide,
Lifetime:
46.3%
25 / 54
Age Range = 18 to 58 Years
Average Age = 27 Years
Long chain referral sampling of volunteer transgender individuals assigned male sex at birth, currently identifying as a woman or trans, age 18 years or older, residing in greater Beirut, Lebanon.
Lehavot
et al.
(2016)
USA
Transgender
Veterans
n = 212
None
Attempted Suicide,
Lifetime:
32.1%
68 / 212
Did not want
to die: n = 17
Really hoped
to die: n = 51
Online, convenience sample of 212 U.S. transgender veterans surveyed from February to May, 2014.
Lytle
et al.
(2016-17)
White
Non-Hispanic
Transgender
& Cisgender
College
Students
n =77,775
Cisgender
n = 77,685
Attempted Suicide,
One Year:
0.9%

Transgender
n = 90
Attempted Suicide,
One Year:
10.0%
OR = 12.2
Fall 2008 and Spring 2009 surveys of the American College Health Association (ACHA) National College Health Assessment-II.
For Additional Information, including comparisons within the GLBQ & Heterosexual groups, and also for Self-Harm comparisons,
see Table Below.
Non-White
Transgender
& Cisgender
College
Students
n = 30,574
Cisgender
n = 30,501
Attempted Suicide,
One Year:
1.5%
Transgender
n = 73
Attempted Suicide,
One Year:
29.6%
OR = 27.6
Peterson
et al.
(2016-17)
96 transgender adolescents and emerging adults (aged 12–22 years) presenting with gender dysphoria. None
Attempted Suicide,
Lifetime:
30.3%
27 / 89
Self-Harm,
Lifetime:
41.8%
Data from a retrospective
chart review of  96 patients at Cincinnati Children’s Hospital Medical Center Transgender Clinic.
Mean age of 17.1 years (SD = 2.3).
Study Sample = 54 FTM*, 31 MTF, and 15 nonbinary/gender fluid.
Veale
et al.
(2017)
839 transgender youth
sampled online,
non-random
2 other
Canadian study results
used as comparisons
with study results
14-18 Years:
Attempted
Suicide,
Past Year: 36.1%

19-25 Years:

Attempted Suicide,
Lifetime:
37.8%
Attempted
Suicide,
Past Year:
11.3%
For results on
identity basis,
see  Table
Below
.
Canadian Trans Youth Health Survey (2014, Online, French, English): Recruited via transgender and queer community organizations, distributing a call for participants through social media, and the study’s research team, and network including pediatric endocrinology clinics across Canada.

Age = 14 to 25 years. 14-18 years (n - 300): 32 transgender girls/women (11%), 140 transgender boys/men (47%), and 128 (42%) nonbinary youth. 19-25 years (n = 539): 107 transgender girls/women (20%), 216 transgender boys/men (40%), and 216 nonbinary youth (40%).
14-18 Years: Self-Harm, Past Year: 74.9%
* MTF: Male to Female - FTM: Female to Male
** The
Nemoto (2001) Study Sample is Likely a Subset of  Nemoto et al. (2002) Study Sample.
*** Mean Ages are from Nemoto et al. (2004). **** Face-to-Face Interviews.




The Mathy (2002b) Study of Transgender Suicidality
North America: Internet Survey
Categories
TG
Random
Heterosexual
Matched
Homosexual
Gender *
TG
F
M
F
M
F
M
N's
73
1,083
1,077
73
73
256
356
Mean Age
SD
Age Range
36.9
(10.0)
19-58
30.1
(9.3)
18-76
33.7
(11.0)
18-80
36.0
(9.8)
19-53
37.0
(10.0)
19-56
33.7
(8.9)
18-69
33.0
(9.7)
18-70
Attempted Suicide /
Self-Harm **
23.3%
11.4%
5.0%
11.0%
4.1%
16.0%
8.7%
*** Risk Ratio: TG vs.
Specified Category

2.9
4.7
2.1
5.7
1.5
2.7
p
< .01
< .001
< .05
< .001
ns
< .001
* TG = Transgender - M = Males - F = Females -- *** Not Given in Mathy (2002b)
** Suicide Question: "I have made a serious suicide attempt or gesture." Yes/No
Sampling: News Web Site: MSNBC - Every 1000th visitor: USA, Canada - A Sexuality Survey
Using mostly counts from random sample, but also from volunteer sample.
TG (Transgender) Sample: N = 73, 61 Canadian, 12 American, with 12 / 73 from random sample.



The Clements-Nolle et al. (2006) Study of Suicidality*
In The San Francisco Transgender Population
Categories
Attempted Suicide
Lifetime: % (n / n)
Odds Ratio (95%CI)
Unadjusted **
Odds Ratio (95%CI)
Adjusted
All, N = 515
32.2%
(166 / 515)


MTF, n = 391
Male-to-Female
32.5%
(127 / 391)
1.04 (0.67, 1.6)
ns
1.1 (0.59, 1.9)
Controls: 9 Variables
FTM, n = 123
Female-to-Male
31.7%
(39 / 123_
White
37.8%
(71 / 188)
1.5 (1.02, 2.2)
p = 0.036
1.5 (0.92, 2.4)
Controls: 9 Variables
Non-White
28.8%
(93 / 323)
< 25 Years-Old
47.0%
(31 / 66)
2.1 (1.2, 3.5)
p = 0.006

2.17 (1.17, 4.01)
Controls: 9 Variables
25 + Years-Old
30.1%
(135 / 449)

Volunteers Interviewed. 37% White, 23% Black, 23% Latino/a, 11% Asian/PI, 5% Native American

Median Age: 34, Age Range: 18 to 67 Years
The "Attempted Suicide" 32% Lifetime Incidence was First Reported by Clements-Nolle et al. (2001)
** Odds Ratios Not Given. Calculated From Given Counts





Transgender and Transsexual People in Sweden
An Internet Sample, N = 374 *

Age Group
Attempted Suicide Incidence,  Lifetime
16 - 29 Years
27%, n = ?
30 - 44 years
28%, n = ?
45 - 54 years
12%,  n = ?
55 - 64 Years
21%,  n = ?
* Web Survey Data: Reported in National Public Health Survey, 2005.
Results also reported by Winzer &
Boström (2007)
For comparison of Transgender Suicidality results to GLB & Heterosexual Results, See Table.



Transgender and Transsexual People in France
An Internet Sample, N = 90

Group
16 to 26 Years-Old
Attempted Suicide Incidence,  Lifetime
All
N = 90
34%
FTM
n = 60 Approximately
34%
MTF
n = 30 Approximately
32%
Data Source:
L’équipe Trans du MAG / La Commission Trans d’HES (2009)




Irish Transgender Study
An Internet Sample: N = 106

Frequency
Attempted Suicide, Lifetime
n = 85
Once
12%
Two to Five Times
22%
More Than Five Times
6%
One or More Times
40%
Data Source: TENI: Transgender Equality Network Ireland (2012)
Additional Suicidality & Self-Harm Data is Given




Transgender and Transsexual People in the United Kingdom
An Internet Sample, N = 872**

Frequency
Attempted Suicide / Self-Harmed in Adulthood*
Once
14%
Twice
7%
Three or More Times
14%
One or More Times
34.4%

*Resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans.

Note: Data was solicited on suicidality before the age of 21 years, but the results were not reported. In Whittle et al. (2008), the incidence in this category was reported to be also 34%. ** Sample may include duplicates?
Data Source: Whittle et al. (2007)



Transgender and Transsexual People in Europe
An Internet Sample, N = 985 (UK = 322)**

Frequency
Attempted Suicide / Self-Harmed in Adulthood*
Once
?
Twice
?
Three or More Times
?
One or More Times
29.9%

*Resulting from being a crossdresser, transgender/transsexual person or because of other people’s reactions to them being trans.

Note: Data was solicited on suicidality before the age of 21 years, but the results were not reported. ** Duplicates Removed.
Data Source: Whittle et al. (2008)





National Transgender Discrimination Survey Report On
Health and Health Care (USA, 2010): Attempted Suicide

Categories
Attempted
Suicide,
Lifetime
Categories
(% of Sample)
Attempted
Suicide,
Lifetime
All: 6,450
41%
White (76%)
38%
Age: 18-44
45%
Asian (2%)
39%
Age: > 65
16%
Latino/Latina (5%)
44%
Employed
37%
African American (5%)
45%
Unemployed
51%
Multi-Racial (11%)
54%
Lost Job Due to Bias
55%
Native American (1%)
56%
Street Economy
60%


Data Source: Grant et al. (2010)
See More Results Below:
By Herman et al. (2014)



National Transgender Discrimination Survey:
Some Discrimination Related Attempted Suicide Results
Categories
Attempted Suicide,
Lifetime Incidence
All: 6,456
41%
Family chose not to speak/spend time with them.
57%
Harassed or bullied at school: any level.
50-54%
Experienced discrimination or harassment at work.
50-59%
Doctor or health care provider refused to treat them.
60%
Suffered physical or sexual violence at work.
64-65%
Suffered physical or sexual violence at school (any level).
63-78%
Disrespected or harassed by law enforcement officers.
57-61%
Suffered physical or sexual violence by law enforcement officers.
60-70%
Experienced homelessness. 69%
Data Source: Herman et al. (2014)




Ontario’s Trans Communities and Suicide (Canada, 2010): Seriously Considered Suicide & Attempted Suicide
Categories
Age:
16-24
Years
Age:
25 +
Years
Experienced
Physical or
Sexual
Assault
Experienced
Verbal
Harassment
or Threats
No Assaults
or Verbal
Harassment
or Threats
All
N =
433
Attempted Suicide,
Lifetime
-
-
-
-
-
43%
Seriously Considered
Suicide, Lifetime
-
-
-
-
-
77%
Seriously Considered
Suicide, Lifetime,
Because of Being trans
-
-
-
-
-
50%
Attempted Suicide,
Past Year
19%
7%
29%
8%
4%
10%
Seriously Considered
Suicide, Past Year
47%
27%
47%
33%
26%
32%
Data Source: Scanlon et al. (2010), Bauer et al. (2013):
'Data collected via respondent-driven sampling (RDS) in 2009–2010 as part of the
Trans PULSE Project, a community-based research study in Ontario, Canada.'
'The information was collected using a unique research method that allowed us
to take  the most statistically accurate picture of trans people possible.'





Transgender Self-Harm & Attempted Suicide
USA National College Health Assessment: 2008-09
Groups
Compared
Self-Harm
%
1
Odds
Ratio 2
Attempted
Suicide %
1
Odds
Ratio
2
Racial / Ethnic Minorities (Non-White)
Transgender
n = 73
38.0%
10.9
29.6%
27.6
Cisgender
n = 30,501
5.3%
1.5%
Non-Hispanic White
Transgender
n = 90
27.8%
7.3
10.0%
12.2
Cisgender
n = 77,685
5.0%
0.9%
LGBQ (Lesbian / Gay / Bisexual / Questioning)
Transgender
n = 123
41.3%
4.2
25.6%
9.8
Cisgender
n = 7,388
14.4%
3.4%
Heterosexual
Transgender
n = 45
13.3%
3.3
4.4%
5.1
Cisgender
n = 103,025
4.5%
0.9%

Data Source: Lytle et al. (2016)

1. Incidences (percent), if occurring in the past year, given by study authors. Similar incidences for depression, suicide ideation, and having sought suicide prevention information were also produced. Note: Average age for study sample = 21.15 years, for cisgender students = 21.14 years, and for transgender students = 28.24 years.

2. Transgender vs. Cisgender (Non-Transgender) within specified groups. Basic ORs calculated by webpage author using this calculator: http://statpages.info/ctab2x2.html . n = 100 assumed for both groups with percentages becoming the Present / Absent numbers. Example: 38.0 Present / 62.0 Absent vs. 5.3 Present / 94.7 Absent. This quickly produces accurate ORs (10.9 for this example), but the 95% confidence intervals are not accurate. However, given the n sizes and large ORs, it is expected that all ORs produced would be statistically significant.






Suicidality, Transgender / Transsexual
Internet Sample, United Kingdom
Demography
Living Location / Race / Age (n = 518)
England: 84%
Scotland: 11%
Wales: 4%
Northern Ireland,
Ireland; < 1%
White: 86%
Age: 18 to 78 Years
Gender Identity (N = 794)
Constant and clear gender identity as a woman (40%), man (25%). Variable or fluid non-binary (15%). Constant and clear non-binary (85). Unsure (6%), Other (3%), and No gender identity (3%)
Sexual Orientation (N = 530)
Bisexual (27%), Queer (24%), Straight or heterosexual (20%), Pansexual (15%), BDSM/Kink (14%), Lesbian (13%), Not sure or questioning (12%), Other (11%), Don’t define (10%), Gay (10%), Polyamorous (9%), Asexual (8%).

Suicidality
"The majority of participants, 84%, had thought about ending their lives at some point (N=581). These participants were then asked for more information about their experiences. 27% of those who had thought about ending their lives at some point, had thought about attempting suicide within the last week (N=471) with 4% thinking about it every day. In the last year 63% had thought about attempting suicide (N=472) with 3% thinking about it daily.

Prevalence of actual suicide attempts, among those who had thought about ending their lives at some point, was 11% within the last year (N=427), however lifetime prevalence was substantially higher, at 48% (N=436). 33% had attempted to take their life more than once in their lifetime, 3% attempting suicide more than 10 times. More significantly, 11% of the respondents were unsure as to whether they were planning to attempt suicide in the near future, and 3.2% were planning to (N=473).

When the participants who had never thought about suicide (and therefore were not asked further questions about suicidal ideation and attempts) are factored back in, this results in overall suicide attempt rates (N=581) of 35% attempting suicide at least once and 25% attempting suicide more than once.

Suicidal ideation and actual attempts reduced after transition, with 63% thinking about or attempting suicide more before they transitioned and only 3% thinking about or attempting suicide more post-transition. 7% found that this increased during transition, which has implications for the support provided to those undergoing these processes (N=316)." P. 59

Data Source: McNeil (2012)





Suicidality & Self-Harm
Canadian Trans Youth Health Survey (2014)

Categories
Transgender
Boys/
Men
n, %
Transgender
Girls/
Women
n, %
Nonbinary 1
n, %
Ages: 14 to18 Years
Seriously Considered
Suicide, Past Year
90, 68.9%
20, 55.0%
93, 64.5%
Attempted Suicide,
Past Year
90, 44.2%
20, 21.1%
94, 34.4%
Self-Harm,
Past Year
106, 79.2%
24, 50.0%
100, 77.0%
Ages: 19 to 25 Years
Seriously Considered
Suicide, Lifetime
138, 76.8%
65, 66.2%
129, 76.7%
Attempted Suicide,
Lifetime
51, 43.1%
33, 21.2%
69, 42.0%
Seriously Considered
Suicide, Past Year
141, 36.9%
68, 46.2%
97, 41.7%
Attempted Suicide,
Past Year
53, 11.3%
34, 8.8%
70, 11.4%
Self-Harm,
Past Year
150, 48.0%
77, 40.3%
150, 60.7%

Data Source: Veale et al. (2017)

1. Participants who responded as “transgender and identify in some other way,” rather than as boys/men or girls/women.



Review & Meta-Analysis Papers
Sexual Minority Suicidality & Mental Disorders

Review Papers
Saunders JM, Valente SM (1987). Suicide risk among gay men and lesbians: A review. Death Studies, 11(1): 1-23. Abstract.
Remafedi G (1999). Suicide and sexual orientation: nearing the end of controversy? Archives of General Psychiatry, 56(10): 885-6. PDF Download.
Bagley C, Tremblay P (2000). Elevated rates of suicidal behavior in gay, lesbian and bisexual youth. Crisis, 21(3): 111-17. (Review) Internet draft of the paper: Full Text. PubMed Abstract.
Tremblay P, Ramsay R (2000). Orientations homosexuelles ou bisexuelles chez les jeunes présentant des problème suicidaires: recherche, problématique et propositions. Le Vis-À-Vie, 10(2): 5-8. (Review) Internet English version of the paper: Full Text. Full Text (French). Translation.
Kulkin HS, Chauvin EA, Percle GA (2000). Suicide among gay and lesbian adolescents and young adults: a review of the literature. Journal of Homosexuality, 40(1): 1-29. (Review) PubMed Abstract.
Morrison LL, L'Heureux J (2001). Suicide and gay / lesbian / bisexual youth: implications for clinicians. Journal of Adolescence, 24(1): 39-49. PubMed Abstract. Full Text: PDF Download. PDF Download

McDaniel JS, Purcell DW, D'Augelli AR (2001). The relationship between sexual orientation and risk for suicide: research findings and future directions for research and prevention.. Suicide and Life-Threatening Behavior, 31(Suppl.): 84-105. (Review)  In: DHHS / CDC (2001). Suicide Prevention Now: Linking Research to Practice, pp. 190-218.  PDF Download. PubMed Reference.

Lebson M (2002). Suicide among homosexual youth. Journal of Homosexuality, 42(4): 107-17. Abstract.
Meyer, IH (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5): 674–697. SummaryAbstract. Full Text.
Russell ST (2003). Sexual minority youth and suicide risk. American Behavioral Scientist, 46(9): 1241-1257. Abstract. PDF Download.
McAndrew S, Warne T (2004). Ignoring the evidence dictating the practice: sexual orientation, suicidality and the dichotomy of the mental health nurse. Journal of Psychiatric and Mental Health Nursing, 11(4): 428-34. PubMed Abstract.
Julien D, Chartrand E (2005). Recension des études utilisant un échantillon probabiliste sur la santé des personnes gaies, lesbiennes et bisexuelles. Canadian Psychology/Psychologie canadienne, 46(4): 235-250. Abstract. Summary / Extract (French). Translation.
Schlatter J, Irala J, Escamilla I (2005). Psicopatología asociada a la homosexualidad [Psychopathology related to homosexuality.]. Revista de Medicina de la Universidad de Navarra, 49(3): 69-79. PDF Download. Translation.

Suicide Prevention Resource Center (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Newton, MA: Education Development Center, Inc. Prepared by the Suicide Prevention Resource Center for the Center for Mental Health Services Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services. Download: http://www.sprc.org/library/SPRC_LGBT_Youth.pdf. Download Page.

King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, Nazareth I (2008). A Systematic Review of Mental Disorder, Suicide, and Deliberate Self Harm in Lesbian, Gay and Bisexual People. BMC Psychiatry. Full Text. Full Text. Abstract.
Leu, Christian (2008). Orientation sexuelle et comportements suicidaires: Une enquête sur les résultats de la recherche internationale et nationale sur les facteurs de risque et de protection pour les adolescents homosexuels et bisexuels. Berne, La Suisse / Switzerland: Le collectif Formation de PINK CROSS, LOS et fels. Full Text N/A. Download Page N/A. Word Download. Translation N/A. Download Page N/A. Full Text. Download Page. Translation.

Leu, Christian (2008). Sexuelle Orientierung und Suizidalität: Eine Untersuchung der internationalen und nationalen Forschungs-ergebnisse der Risiko- und Schutzfaktoren für adoleszente Homo- und Bisexuelle. bern, Switzrland: PINK CROSS, LOS und fels. Full Text N/A. Download Page N/A. Word Download. Download Page N/A. Translation N/A. PDF Download N/A. Translation N/A. Full Text. Download Page Translation.

Lhomond B, Saurel-Cubizolles MJ (2009). Orientation sexuelle et santé mentale: une revue de la littérature [Sexual orientation and mental health: a review]. Revue d'épidémiologie et de santé publique, 57(6): 437-50. Abstract. Download Page: In two Documents: Text & Tables. Download Page. Word Download.
Haas AP, Eliason M, Mays VM, Mathy RM, Cochran SD, D'Augelli AR, Silverman MM, Fisher PW, Hughes T, Rosario M, Russell ST, Malley E, Reed J, Litts DA, Haller E, Sell RL, Remafedi G, Bradford J, Beautrais AL, Brown GK, Diamond GM, Friedman MS, Garofalo R, Turner MS, Hollibaugh A, Clayton PJ (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of Homosexuality, 58(1): 10-51. Abstract. Full Text: Open Access. Full Text.
Meta-Analyses
Plŏderl M, Wagenmakers EJ, Tremblay P,  Ramsay R, Kralovec K, Fartacek C, Fartacek R (2013). Suicide Risk and Sexual Orientation: A Critical Review. Archives of Sexual Behavior, 42(5): 715-727. Includes a meta-analysis. Download Page for Paper Draft PDF @ Dr. Martin Plöderl's Website. ResearchGate Full Text.

Online Additions to the Paper: "A Critical Examination of the Shaffer et al. (1995) & Renaud et al. (2010) Psychological Autopsy Studies of Adolescent Suicides" & "An Expanded Homosexuality Factor in Adolescent Suicide."
Stone DM, Luo F, Ouyang L, Lippy C, Hertz MF, Crosby AE (2014). Sexual orientation and suicide ideation, plans, attempts, and medically serious attempts: evidence from local youth risk behavior surveys, 2001-2009. American Journal of Public Health, 104(2): 262-71. Abstract. Suicidality results for 2001 to 2009 Youth Risk Behavior Surveys used in large American cities generally with large Hispanic and African American populations: Boston, Chicago, New York, San Diego, San Francisco. The "more at risk for the more serious suicidal behaviors" often does not apply, also depending on the sexual minority group being described and the sex of individuals.
For more on this issue see related webpage.

Marshal MP, Dietz LJ, Friedman MS, Stall R, Smith HA, McGinley J, Thoma BC, Murray PJ, D'Augelli AR, Brent DA (2011). Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review. Journal of Adolescent Health, 49(2): 115-123. Abstract. PDF Download. "SMY [Sexual Minority Youth] reported significantly higher rates of suicidality (odds ratio [OR] = 2.92) and depression symptoms (standardized mean difference, d = .33) as compared with the heterosexual youth. Disparities increased with the increase in the severity of suicidality (ideation [OR = 1.96], intent/plans [OR = 2.20], suicide attempts [OR = 3.18], suicide attempts requiring medical attention [OR = 4.17]). Effects did not vary across gender, recruitment source, and sexual orientation definition.'

Kann L, Olsen EO, McManus T, Kinchen S, Chyen D, Harris WA, Wechsler H; Centers for Disease Control and Prevention (CDC) (2011). Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9-12: Youth Risk Behavior Surveillance, Selected Sites, United States, 2001- 2009. MMWR Early Release 2011; 60. June 6: 1-113. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss60e0606a1.htm?s_cid=ss60e0606a1_w.  http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6007a1.htm. Results, problem and related issues are presented in another webpage. A major problem seems to exist when combining sexual minority Youth Risk Behavior Survey suicidality results from large cities and states.
Plöderl M, Kralovec K, Fartacek C, Fartacek R (2009). Homosexualität als Risikofaktor für Depression und Suizidalität bei Männern. Blickpunkt DER MANN: 7(4): 28-37. PDF Download. Translation. Download Page for Paper PDF @ Dr. Martin Plöderl's Website.
Plöderl M, Sauer J,  Reinhold FR (2006). Suizidalität und psychische Gesundheit von homo- und bisexuellen Männern und Frauen – Eine Metaanalyse internationaler Zufallsstichproben. Verhaltenstherapie & psychosoziale Praxis, 38(2): 283-302. Abstract. Related Conference Presentation PDF. Translation. Download Page for Paper PDF @ Dr. Martin Plöderl's Website.
Dennert G (2006). Die psychische Gesundheit von Lesben und Schwulen - eine Übersicht europäischer Studien. Verhaltenstherapie & psychosoziale Praxis, 38(3): 559-576.



Note 1

Study (France): Homosexual males are 13 times more likely to have attempted suicide, compared to heterosexual males. Result for the sample of 993 men - sampled in 3 locations - were generated by controlling for age, living area, education level, professional status, parental status, marital/partner status.

Homosexual/Heterosexual Male Study Results Reported by Chemin (2005) in Le Monde: "Les résultats préliminaires du travail de Marc Shelly, médecin de santé publique et responsable du centre de dépistage anonyme et gratuit de l'hôpital parisien Fernand-Widal, font apparaître que, "toutes choses égales par ailleurs" ­ - âge, lieu de résidence, niveau d'études, catégorie socioprofessionnelle, structure familiale parentale, modes de vie (couple ou célibat) ­-, les jeunes homosexuels ont treize fois plus de risque de faire une tentative de suicide que les jeunes hétérosexuels. Ces résultats confirment les chiffres issus des études américaines, canadiennes et australiennes : elles aboutissent, chez les homosexuels, à des chiffres de "sursuicidalité" variant de six à treize.

Les chiffres français ont été obtenus à partir d'un échantillon de 993 hommes âgés de 16 à 39 ans. Tous ont raconté leur trajectoire "socio-biographique" en remplissant un long questionnaire informatisé installé, de 2000 à 2004, sur trois sites : le festival de lutte contre le sida Solidays, qui a lieu tous les ans en région parisienne, le Centre d'information et de documentation pour la jeunesse (CIDJ), à Paris, et le centre de sélection des appelés du contingent de Blois, dans le Loir-et-Cher."

Preliminary Results for a subsample of the above study (Shelly et al. 2002): Homosexual males are 6 times more that risk for having attempted suicide than are heterosexual males. Suicide Attempt incidence for homosexual males: 30%.

The Same Study: Homosexual males more at risk for having been sexually abused as children. Internet Reference: http://www.thewarning.info/IMG/doc/aremedia_abus.pdf .

Summary of Study Status: "Menée entre 1998 et 2003 auprès de 933 hommes, âgés de 16 à 39 ans, l'étude réalisée par Marc Shelly (médecin en santé publique à l'hôpital parisien Fernand-Widal ) et David Moreau (ingénieur de recherche à l'association de prévention Aremedia) a été préparée et validée par Pascale Tubert-Bitter, directrice de recherche à l'Institut national de la santé et de la recherche médicale (Inserm) à l'unité biostatistique et épidémiologie. Les résultats de cette enquête menée en dehors des associations et chercheurs LGBT sont encore en cours d’étude, seuls les résultats sur les homos et les bisexuels masculins étant actuellement totalement traités. " Internet Reference:  http://v2.e-llico.com/article-retro.htm?articleID=4003&rubrique=actu&oldRubrique=actu .

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