Worrying findings: Bisexual women are three times more likely to attempt suicide

A recent study by researchers at York University and ICES revealed that bisexual women are three times more likely to attempt suicide than their heterosexual counterparts.

This groundbreaking research, which links population-based survey data with the medical records of more than 123,000 individuals, also found that suicide-related behavior (SRB) events, both fatal and non-fatal, are twice as likely among gay men and lesbians as among heterosexual individuals. These findings underscore the critical need for better mental health support within the LGBTQ+ community.

We wanted to better characterize the disparity in suicide-related behaviors between sexual orientations and gender, says lead author Antony Chum, a Faculty of Health assistant professor and Canada Research Chair in Population Health Data Science at York University and adjunct scientist at ICES. Previous research on suicide attempts has relied mostly on self-reported survey data, meaning we have no information on people who are too sick to participate or who have died by suicide.

Published inAmerican Journal of Psychiatrythe study looked at Ontario participants of the Canadian Community Health Survey, which was linked to anonymous administrative health data such as emergency room visits or admissions for non-fatal self-harm and fatal suicide between 2002 and 2019.

The researchers, which include York University postdoctoral fellows Gabriel John Dusing and Chungah Kim, found:

• The overall prevalence of one or more SRB events was approximately two percent in heterosexual individuals, five percent in gay/lesbian individuals, and eight percent in bisexual individuals.
• Sexual minority individuals were at higher risk of SRB events, 2.10 to 4.23 times more likely than heterosexual individuals.
• After adjusting for age and sex, the risk of a SRB event was more than threefold greater among bisexual individuals, and this risk was more pronounced for bisexual women.

The higher risk for bisexual women could be attributed to greater discrimination bisexual people face within the LGBTQ+ community, as well as higher rates of violence, trauma and care burden bisexual women may experience in opposite-sex relationships, Chum says.

A limitation of the study is that data was not available for non-binary individuals and sexual orientations such as asexual and queer. However, this was the first study to use a large representative sample linked to medical records, which improves the generalizability of the results to other regions and populations.

The study shows a clear need for better funding, policies and programs to address LGBTQ+ suicide risk, Chum says. We also need more training for healthcare professionals to address LGBTQ+ suicide risk. We also want to encourage hospitals and clinics to collect sexual orientation data as part of routine patient care.

Chum also notes the growing insinuation that healthcare privatization and publicly funded mental health supports need to be scaled up not just for LGBTQ+ people, but across the board.

Reference: Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using Linked Health Administrative Data by Antony Chum, Ph.D., Chungah Kim, Ph.D., Andrew Nielsen, M.Sc., Gabriel John Dusing, Ph.D., Patricia OCampo, Ph.D., Flora I. Matheson, Ph.D., Lucy Barker, MD, Simone Vigod, MD, Vicki Ling, M.Sc., Kinwah Fung, M.Sc. and Sidney Kennedy, MD, June 7, 2023, American Journal of Psychiatry.
DOI: 10.1176/appi.ajp.20220763

The findings are in line with the authors’ study published in March inPLOS One, which found that both sexual minority status and residence in resource-limited neighborhoods with poor access to health care were independent risk factors for suicide-related behaviors. Future research must explore interventions that improve the mental health of LGBTQ+ people while addressing social determinants of health, such as neighborhood-level disparities and barriers to health care.