M. Patten1, H. Carmichael1, A. Moore1, C. G. Velopulos1 1University Of Colorado Denver,Division Of GI, Trauma, And Endocrine Surgery (GITES),Aurora, CO, USA
Introduction: Suicide rates for sexual minorities are higher than the heterosexual population, particularly for the young. The purpose of this study is to explore circumstances surrounding suicide completion for identified men and women in these populations as compared to their heterosexual counterparts to inform future intervention strategies for suicide among lesbian, gay, bisexual and transgender (LGBT) individuals.
Methods: We completed an analysis of data from the National Violent Death Reporting System (NVDRS) from 2013-2017. Victims identified as transgender were considered separately, as this is an important population with unique characteristics. Data was further excluded from state/year combinations when sexual orientation was documented for <20% of patients. We stratified analysis by identified sex of the victim (male or female) for the LGB population.
Results: Of the 16,831 victims whose sexual orientation or transgender status was known, 3886 (23.1%) were identified as female and 12,945 (76.9%) were identified as male. 479 (2.8%) were identified as LGBT; of these, 53 (11%) were transgender. LGBT victims were younger than non-LGBT victims. Male LGB victims were more likely to have a history of prior suicide attempts, past or current mental illness diagnosis, and were less likely to use firearms than male heterosexual victims. Female LGB victims were more likely to have known problems in an intimate partner relationship (IPV) than heterosexual women, while LGB men were more likely to have problems in family or other relationships. Transgender victims were again more likely to have mental health problems and a history of prior attempts, but less likely to have intimate partner problems and more likely to have a history of child abuse (6% vs. 1%, p=0.01). All LGBT victims were more likely to disclose intent, with female LGB victims most often disclosing to an intimate partner, while male LGB and transgender individuals most likely to disclose to a family member.
Conclusion: Our analysis reveals that circumstances surrounding suicide have important distinctions between LGBT and heterosexual individuals. It is important to note that post-mortem identification of sex presents issues of misgendering, and could contribute to a degree of bias in understanding the way suicide circumstances differ in LGBT individuals, particularly for transgender individuals. These results highlight the importance of promoting suicide interventions that recognize the complex intersection between stated gender, sex, and sexuality and the different cultural impacts these interplaying identities can have, which underscores the importance of being able to identify these patients correctly in the context of large datasets.
