Legalizing same-sex marriage leads to a substantial drop in suicide rates among gay and lesbian people. However, new research demonstrates that despite these results, sexual minority couples remain at a heightened risk for suicide, and more advocacy and policy work is needed to address discrimination and increase protective factors.
The latest study, published in the Journal of Epidemiology and Community Health, compares the suicide rates of same-sex and opposite-sex married couples in Demark and Sweden from 1989 to 2016. Despite an overall decrease in suicide rates among same-sex couples as a result of increased rights and recognition, the study finds that people who entered a same-sex marriage continue to have a higher risk of suicide than people in opposite-sex marriages.
“We found that persons who had ever entered a same-sex marriage experienced a suicide rate twice that of those who entered an opposite-sex marriage,” the lead researcher, Annette Erlangsen, from the Danish Research Institute for Suicide Prevention, writes. “We also found particularly elevated rate rations among younger individuals while the excess suicide mortality has decreased in recent years.”
Denmark became the first county in the world to legalize same-sex civil union in 1989, and Sweden followed in 1995. While the suicide rates in the general population of Denmark and Sweden have been decreasing in recent decades, recent Swedish research shows that sexual minority individuals still have higher rates of suicide attempts than their heterosexual peers.
Past research has documented that pro-LGBT policies and the availability of gender affirmative treatments significantly reduce suicide rates among sexual minority people. Based on the sexual minority hypothesis, sexual minority individuals are more likely to report severe suicidal ideation and suicide attempts due to higher levels of distress from greater exposure to prejudices, stigmatization, and discrimination. As a result, the researchers set out to explain the higher rates of suicide attempts in sexual minorities. They write:
“With the data from the Danish and Swedish registers, we want to determine whether males and females who entered a same-sex marriage had higher rates of suicide than those who entered an opposite-sex marriage.”
The researchers applied a cohort study design, and data were obtained from national population registers maintained by Denmark and Sweden, which include information on the date of birth, changes to civil status, and causes of death. Data from two countries were obtained from when the same-sex unions were first legalized in 1989 for Denmark and 1995 for Sweden to December 2016.
The analysis showed that there were 6171 suicide deaths among 28,649 individuals in a same-sex marriage while there were 6073 deaths among 3,918,617 individuals in opposite-sex marriage.
“A higher rate of suicide was found for both males and females who lived in a same-sex marriage (comparing to the opposite-sex marriage),” the study authors report. “Among persons who entered same-sex marriage, males had a higher suicide rate than females.” Regardless the gender, individuals in either same-sex marriage or opposite-sex marriage had a lower suicide rate than individuals who are divorced or widowed.
The analysis also showed that the suicide rate among individuals in same-sex marriage reduced by 46% from 1989-2002 to 2003-2016. The authors explain that, as a result of the legalization of same-sex marriage and the expansion of rights and protections to same-sex couples, those minorities have become much more accepted in the Nordic countries and elsewhere, which explains the reduced suicide risk. They believe the decrease in stigmatization reduced the psychological distress experienced by sexual minorities.
The authors conclude:
“Our findings support previous studies in relation to suicide risks in sexual minorities in Scandinavia and underline the plausible and harmful role of minority stress.”
“Our more robust findings, based on a larger study population, support the notion that protective effects of marriage.”
Erlangsen, A., Drefahl, S., Haas, A., Bjorkenstam, C., Nordentoft, M., & Andersson, G. (2020). Suicide among persons who entered same-sex and opposite-sex marriage in Denmark and Sweden, 1989–2016: A binational, register-based cohort study. Journal of Epidemiol Community Health, 74(1), 78-83. (Link)