Pierre J. Tremblay
Presented
at the Sixth Annual Conference of the Canadian Association for Suicide
Prevention, Banff, Alberta, October 11-14, 1995, (c) Oct 1995. First made
available on the Internet on January 19, 1996.
Notes
Note 1
In a study of 137 gay and bisexual youth, Remafedi et al. (1991) reported
that effeminate gay male youth were three times more like to attempt suicide
than other gay male youth (31).
Note 2
Speaking about this reality in a small group, a male Air Canada flight
attendant also told me that he had known more gay males who had committed
suicide than died of AIDS. Such life experiences occur because the gay
community is cellular in nature. Many gay males now know more gay males
who have died from AIDS than from suicide.
Note 3
The result of this study are most often noted without telling the reader
that, with respect to the attempted youth suicide problem, the data may
not reflect the present situation for GLB youth. The data also does not
reflect the situation as it existed when the study was published.
Note 4
These figures represent estimates for suicide attempters, and not the percentage
of suicide attempts (to the age specified) which would be attributable
to predominantly homosexual males. The fact that some individuals will
attempt suicide more than once must be taken into consideration when making
such estimates.
Note 5
A major recent study (as well as others) has reported on "the pervasiveness
of different forms of victimization in the lives of lesbian, gay, and bisexual
youth" (64:50). This was also the conclusion of
The Massachusetts Governor's Commission on Gay and Lesbian Youth in its
1993 report, Making Schools Safe for Gay and Lesbian Youth: Breaking
the silence in schools and in families (65).
Other papers and a book have been written on the subject (66-70)
Note 6
Books on adolescent suicide have a history of silence about GLB youth being
(or probably being) at risk for attempting (and possibly committing) suicide.
See Appendix B for a summary. Some minor progress,
in this respect, has been made since 1991. This includes the recent publication
of the 1995 Supplement of Suicide and Life-Threatening Behaviour: Research
Issues in Suicide and Sexual Orientation, also noted in Appendix
B.
Note 7
All pamphlets and booklets on suicide and youth suicide available in Calgary,
Alberta, were reviewed. Homosexuality has not been mentioned in them. One
exception occurred in 1992 in the pamphlets about youth problems (including
suicide) made available by Calgary's Canadian Mental Health Association
which has been responsible for suicide prevention in the Calgary area.
As the result of my work, a gay and lesbian youth group had been referenced,
although nothing specific to GLB youth problems was noted in the pamphlets.
By 1995, however, there are no references to GLB organizations in the new
version of the pamphlets. There is also no mention of GLB youth and their
high risk for having many problems, including suicide attempts.
Note 8
Calculated by Dr. Christopher Bagley.
Note 9
Savin-Williams(1994) reports that studies of "homeless and runaway youths"
had produced estimates "in the 2%-to-3% range." Noting the high concentrations
of gay and bisexual youths missed by their sampling method, he then emphasized
that these "percentages are probably a gross underestimation because few
youths are likely to tell authorities and staff their sexual identity."
The higher estimates given above, as obtained by professionals (who knew
how to get homosexual orientation information from adolescents) were then
cited (35:264).
Note 10
During the summer of 1995, a CTV Canada AM segment outlined the problems
of street youth in Toronto in the light of a program recently implemented
to help them. It was noted that depression was a major problem for these
youth, that their suicide attempt rate was about 50%, and that a significant
number of these youth were gay, lesbian, or bisexual.
Note 11
Memory (1989) calculated the American suicide rate for juveniles in juvenile
detention centers in 1978 to be 57/100,000/year, and juveniles in adult
jails to be 2,041/100,000/year, compared to the rate of 12.4/100,000/year
for males aged 12-24. (43:460-461). A summary
of the Canadian prison situation with respect to the elevated suicide and
attempted suicide problem for inmates was given in Suicide in Canada(1995),
but nothing specific to juvenile and young adult offender was mentioned.
Suicide rates for federal penitentiary inmates have ranged from 87-197/100,000/year,
compared to 12.7-14.8/100,000/year for the general male/female population
(101:25-27).
Note 12
In 1990, the Center for Disease Control (CDC) in the United States reported
that studies had produced lifetime adolescent attempted suicide rates ranging
from 9% to 14% (44:1011). The range given by Garland
& Zigler (1993) is 6% to 13% (9:170), but studies
not representing lifetime rates were including in the tally. Males also
attempt suicide at lower rates than females, meaning that 25% to 30% of
adolescent suicide attempters are male (9, 45,
46),
and the lifetime attempted suicide rate for adolescent males would therefore
range between 2.2% and 5.2%. The rate for a group of young adult males,
having a mean age of about 23, as in the Bagley et al. (1994) sample, would
also be a little higher than the reported lifetime adolescent rates.
Note 13
The Canada Youth & AIDS Study (1988) reported that, for the Grade-7
youths in their study sample of 38,002 Canadian youths, 45% believed that
"homosexuality is wrong," only 33 believed that "homosexuals should be
allowed to be teachers, an still fewer (18%) reported that they "would
be comfortable talking with a homosexual person" (108:7,
73) Therefore, at the age when the average GLB youth are discovering their
homosexual desires, there is a 60% to 80% probability that they will respond
negatively to discovering such inner realities. If they were taught to
have a murderous hatred for homosexuals, this hatred may be turned on themselves,
yielding suicide problems or other behaviours, such as projection. Their
hatred for homosexuals may be vocal, thus intensely hating in others what
essentially exists in themselves. A number of GLB have reported going through
such a stage. Some males in this category even have sex with gay males,
but then assault them, and may even kill them. Money(1988) has labelled
the phenomenon, well documented in gay history, "the exorcist syndrome"
(109:110). With such responses they are 'saying':
"I am not like him. I am not homosexual, I hate homosexuals." Other pathologies
may also result from socially induced self- hatred.
Note 14
One of the reasons why these youth may be really trying to kill themselves
may be related to the knowledge that failure will result in intervention,
thus forcing them to tell others what, in many cases, they did not want
to even accept about themselves. That is, they will have to "out" themselves.
One Calgary gay youth I met at the age of 14 had attempted suicide by hanging
soon after his thirteenth birthday. When he regained consciousness after
the failed attempt, which he had evaluated to surely result in his desired
death after he failed to locate a gun, he panicked. Members of his family
would now discover the truth about him, because he will have to explain
why he did this. He invented an explanation for the bleeding burns on his
neck to avoid revealing the real reason for his injury.
Note 15
A gay male in Calgary attempted suicide at the age of 10 by throwing himself
in front of a car. He was taken to the Alberta Children's Hospital where
they sought to discover the reason why he did this. At that age, he already
knew he could not tell the truth to anyone. At the age of 20, when he came
out to his mother, the reason why he had attempted suicide was revealed.
His mother wrote his story for a presentation to officials in the Calgary
Board of Education, and it is now part of The Gay, Lesbian, and Bisexual
Factor in the Youth Suicide Problem (107).
Another gay male (interviewed at the age of 19) attempted suicide at the
age of 14 and was in hospital for 1.5 months before he revealed the reason
why he had wanted to die: because he was gay. He only admitted this fact
about himself after his older lesbian sister came out to him while he was
still in hospital. To this date he has needed help but has only been harmed
by mental health professionals. After assimilating the historical facts
he was giving me, I asked: How the hell do you cope? The answer: "I drink
until I black out."
The closet factor has been so pronounced for GLB youth involved with
professionals that the Alberta Alcohol and Drug Abuse Commission's Adolescent
Program had never, until September 1995, encountered a youth who revealed
his/her homosexual orientation on intake. They have now had their first
experience in this respect with two gay youth I know. Their adolescent
treatment professionals have not yet been educated and trained to effectively
address GLB substance abuse problems, and all the GLB issues which factor
into these youths having such problems.
Note 16
One of the suicide attempters in the Bagley et al. (1994) sample was homosexually
active in the "occasional" category, and two were in the "regularly" category.
This means that gay and bisexual young adult males are 8.4 times and 3.8
times more likely to have attempted suicide than heterosexual males.
Note 17
Male victims of child sexual abuse most often code their abuse to have
been homosexual acts, and they are correct, even though it is mostly heterosexual-identified
males who sexually abuse boys. Homosexuality, by definition, is male-male
sexual behaviour occurring between same-sex same-species individuals. For
this reason, the Journal of Homosexuality has published papers on
male-male paedophilia, and bisexuality. For the same reason, the book,
Ritualized
Homosexuality in Melanesia(1984) edited by Gilbert Herdt, is correctly
titled. It describes the ritual of older males repeatedly having sex with
boys (sometimes beginning at the age of 8), most often lasting for a number
of years.
Note 18
CTYS also produced the 1988 book, Often Invisible: Counselling Gay and
Lesbian Youth (71) and the 1992 video Pride
& Prejudice: The Life and Times of Lesbian and Gay Youth.
Note 19
They are not the only ones who have avoided addressing GLB youth issues,
often for "fear" reasons. In the spring of 1994, I was meeting with a gay/lesbian
mental health professional and expressed my feelings given that Calgary's
only youth group had folded due to lack of support. "What really troubles
me is that not one gay or lesbian mental health professional in this city
has ever come forward to help GLB youth." The reason supplied to explain
this was fear, given that there was "too much to lose" if anyone ventured
out alone to help these kids. Now, Calgary had a GLB youth group, I-DENTITY,
with about 130 youth, and a multidisciplinary group of more than 30 gay,
lesbian, and heterosexual professionals working to help GLB youth and educate
professionals about GLB youth problems. The group is based in Family Therapy
in the Faculty of Medicine, University of Calgary, and Dr. Gary Sanders
(Associate Director of Family Therapy), Dr. Joel Fagan (former president
of the Alberta Pediatric Society) now living in Victoria, B.C., and myself,
were responsible for its inception.
Note 20
One of the major reasons why the GLB youth attempted suicide problem has
about doubled in the last 40 years may be related to the age of self-identification
which has dropped from about the age of 18-19(21)
to 14 and 15(31,110).
Remafedi et al.'s 1991 analysis of gay and bisexual males reveals that,
for each year of delay in this process, the risk of an attempted suicide
decreases by 80%(31).
Note 21
Two recent AIDS studies (reported on in the gay media) have revealed that
a significant relationship exist between gay males who contract HIV, a
sense of fatalism, and a history of child sexual and physical abuse (111,
112).
These factors would be predictable given the information rendered in this
paper. A 1995 study of 136 14- to 19-year-old GB youth concludes with:
"[The intervention these youth have been getting in New York] is far more
comprehensive than what is available to most homosexual and bisexual youths
nationally, and yet the results of this study indicate that [GB] youths
who are most distressed require even more intensive intervention to change
their sexual risk behavior." "Emotional distress, substance abuse, and
conduct problems are linked to HIV-related behaviors and may interfere
with preventative efforts... HIV-preventative programs need to be offered
in the context of comprehensive health and mental health care" (114:594).
Note 22
Given the information made available by the journalist about Bobby
Steele, he would have been classified to be homosexual by the Shaffer
et al. (1995) researchers. However, the method they used to identify gay
or homosexually active male youth victims would have resulted in classifying
him to be heterosexual.
Note 23
The Advocate is the flagship publication of the American gay/lesbian
community. The first cover story "Teen Suicide: The government's cover-up
and America's lost children", was published on Sept. 22, 1991, and the
second, "Suicidal Tendencies: Is sexual orientation causing gay and lesbian
teens to kill themselves?" on April 8, 1994.
Note 24
A soon to be published paper by Bagley et al. will report the results of
a study of 1,087 Grade 7-12 boys and 1,025 girls. "The results suggest
that experiencing unwanted sexual contacts in families and community are
a major risk factor for poor mental health and frequent suicidal behaviors
in adolescent males and females. In making this conclusion we assume that
there is a direct causal link between sexual assault and mental health
impairment." (83, emphasis mine.)
Note 25
At the time of writing, the numbers in this category was only available
for 700 of the 750 males studied. The Bagley results may be more valid
that the 1994 Sex in America study. Even though this study used
a random sample of 3,432 men and women, there would have been only 400
males in the 18- to 27-year-old category. The Bagley random sample contains
almost twice the number of males, thus producing statistically more significant
results, at least for estimating homosexual realities in the young adult
male population.
Note 26
Gonsiorek et al. (1995) reviewed the exiting studies and doubled Diamond's
1993 5% estimate (86). "[T]he available research
suggests that the prevalence of predominant same-sex orientation (i.e.,
regular behavior or substantial attraction or both) in the United States
is currently in a range from 4% to 17%, with the most reliable estimates
likely in the middle of that range" (86:47), or
about 10%. The Bagley (1994) results are more in support of this estimate
than Diamond's 5% estimate.
Note 27
This reality about boys having sex with men is highly taboo. The boys know
this and will usually not tell anyone, including parents, teachers, or
peers what they are doing. About one-third of gay males report that they
had sex with a man before the age of 15, because they wanted to. These
boys are also at great risk for contacting HIV, but most AIDS prevention
work have ignored their existence.
