Disparities in Suicide Risk Among Lesbian, Gay, and Bisexual Adults

Available with English captions and subtitles in Spanish.

Rajeev Ramchand, PhD, RAND Corporation, presents as part of the 2022 Suicide-Focused Assessment and Treatment: An Update for Professionals course.

LGBTQ+ and Suicide

In this talk, Ramchand discusses challenges in conducting suicide research in LGBTQ populations. He describes two empirical papers he and his colleagues wrote about suicide in lesbian, gay, and bisexual adults. Their findings show increased ideation, planning, and attempts in these populations.

Watch now to learn more about:

  • Why more data on LGBTQ suicide is needed
  • How rates of LGBTQ suicide are higher than heterosexual peers
  • Why bisexual individuals may face unique stigmas

Ramchand points out that studying suicide risk among LGBTQ populations is challenging because insufficient data exists on suicide deaths in the population. The fact that sexual orientation is not included in most death investigation jurisdictions across the United States remains a barrier.

Researchers have examined suicide mortality risk in LGBTQ populations in other ways, including linked survey data, diagnostic codes, and natural language processing.

In their study on the topic, Ramchand and his colleagues used the National Survey of Drug Use and Health to review rates of suicide ideation, plans, and attempts among lesbian, gay, and bisexual adults. Their research did not include transgender individuals—not from a lack of interest, but from a lack of data and resources.

Ramchand and his colleagues found that in both males and females, suicide ideation, planning, and attempts were significantly higher in gay individuals than in heterosexual individuals.

The research team only had data for bisexual individuals for the ideation category, but found that rates of ideation among this group far exceeded the numbers for heterosexual and even gay populations.

“These mostly consistent results reveal elevated suicide behaviors among LGBT adults that give evidence to what’s been deemed minority stress theory,” Ramchand says.

“The stigma of prejudice and discrimination of LGBT individuals may exacerbate the risk of mental health problems thereby increasing suicide practices.”

View the Slides

In addressing the evidence of higher rates showing adverse outcomes among bisexual adults, Ramchand states, “The unique issue is that bisexual people may not only have internalized biphobia, but they may experience it both from their heterosexual peers, and from those who identify as gay and lesbian.”

Ramchand also discusses a separate study, in which he and his colleagues found that nearly two thirds of people identifying as lesbian, gay, or bisexual who had a suicide attempt in the past year sought mental health treatment. Of those who did not seek care, the most common reasons included cost, fear of being forced to take medication, or not knowing where to go for treatment.

He says continued efforts should be made from a mental health community standpoint.

“We should be thinking about cost, but we should also consider how we market mental health services,” he shares. “We need to address concerns that some adults might have about being [hospitalized] or forced to take prescription mental health drugs.”

In his closing remarks, Ramchand points out that mental health care providers are seeing many lesbian, gay, and bisexual adults who are at risk of suicide, either because these individuals just attempted suicide, or they might attempt in the future.

“It’s really important to provide evidence-based mental health treatment and make sure that the care provided affirms patients’ sexual identities,” Ramchand says.


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About Rajeev Ramchand

Dr. Rajeev Ramchand is co-director of the RAND Epstein Family Veterans Policy Research Institute and a senior behavioral scientist at the RAND Corporation. He studies the prevalence, prevention, and treatment of mental health and substance use disorders in adolescents, service members and veterans, and minority populations.

His many studies include environmental scans of suicide prevention programs, epidemiologic studies on risk factors for suicide, and evaluations of suicide prevention programs.