A recent article, published in the Sexuality Research and Social Policy, reviews extensive international surveys and finds that low levels of LGBT acceptance are significantly associated with higher suicide rates. In contrast, countries with higher levels of acceptance of lesbian, gay, and bisexual people were associated with lower rates of suicide.
The study authors, led by Heiner Stuke from the Department of Psychiatry and Psychotherapy at Berlin University of Medicine, write:
“To improve our understanding of the increased suicide risk in sexual minorities, it is hence crucial to study the relationship between rates of completed suicides and a measure of LGB discrimination. In our work, we show that generalized negative attitude towards homosexuality as revealed by large international surveys is statistically associated with increased suicide rates at the country level.”
There have been many studies that show social policies have a direct impact on physical and mental health, especially for marginalized groups. For example, studies found that pro-LGBT policies decrease the suicide rate in both LGBT adults and teens.
Based on the minority stress framework, LGBT people are exposed to greater stress from discrimination and social stigma, which leads to compromised physical and mental health.
The authors used regression models to examine relationships between country-specific age-standardized suicide rates and LGB acceptance. The WHO published the suicide data in 2016, and the LGB acceptance index combines information from four data sources that were collected in 2017. The index calculates the country-specific average response to the question, “Please tell me whether you think homosexuality can always be justified, never be justified, or something in between on scale from 1 to 10.” In the end, 34 OECD counties were included in the analysis.
The authors also recognized the importance of ruling out possible confounding factors in their analysis. To do so, they included several other variables that can be related to suicide rates, based on the previous literature, as covariates into their research. They identified religiosity, female labor force participation, fertility rates, health expenditure per capita, economic data, gross domestic product (GDP), unemployment rate, and income inequality in their analysis.
They then applied rigorous model selection methods to select a subset of predictors with independent explanatory power about variance in country-level suicide rates. All applied methods favored a 4-predictor model, in which LGB acceptance, fertility rate, unemployment rate, and religiosity were included as significant predictors.
“Higher LGB acceptance was the only variable significantly related to lower suicide rates in the full model. In the selected model, higher fertility rates, LGB acceptance, unemployment rates, and religiosity were related to lower suicide rates,” the authors highlighted. “Our results thereby complement emerging evidence, which identifies the lack of acceptance of minorities as a risk factor for suicides.”
Their study could have significant implications for suicide prevention in terms of creating policies that could improve the general attitude toward LGB people and reduce minority stress experienced by LGB people. The authors concluded that, with the collaboration from public health researchers, policymakers, and clinicians, there are evidence-based measures that can reduce health disparities.
“Based on these findings, it might be suggested that a public policy targeting stigmatization of sexual minorities could impact positively on national suicide levels.”
Stuke, H., Heinz, A., & Bermpohl, F. (2020). Acceptance Towards LGB Persons Is an Independent Protective Factor Against Suicide on a Country Level. Sexuality Research and Social Policy, 1-6. (Link)