Gender differences in suicide
||This article may require copy editing for style and cohesion. (December 2014)|
Gender differences in suicide rates have been shown to be significant; there are highly asymmetric rates of attempted and completed suicide between males and females. The gap, also called the gender paradox of suicidal behavior, can vary significantly between different countries. Statistics indicate that males die much more often by means of suicide than do females; however, reported suicide attempts and thoughts are much more common among females than males.
|2||Republic of Korea||35.6||18.5||26.3||2009|
The role that gender plays as a risk factor for suicide has been studied extensively. While females tend to show higher rates of reported nonfatal suicidal behavior, males have a much higher rate of completed suicide. A 2008 study of suicide attempts by gender found that females have a higher rate of attempted suicide than males earlier in life, which decreases with age. For males the rate of attempted suicide remains fairly constant when controlled for age. Males and females also tend to differ in their methods of suicide and responses to suicidal feelings.
Many researchers have attempted to find explanations for why gender is such a significant indicator for suicide. One common explanation relies on the social constructions of hegemonic masculinity and femininity. In a review of the literature on gender and suicide, male suicide rates were explained in terms of traditional gender roles. Male gender roles tend to emphasize greater levels of strength, independence, and risk-taking behavior. Reinforcement of this gender role often prevents males from seeking help for suicidal feelings and depression.
Numerous other factors have been put forward as the cause of the gender paradox. Part of the gap may be explained by heightened levels of stress that result from traditional gender roles. For example, death of a spouse and divorce are risk factors for suicide in both genders, but the effect is somewhat mitigated for females. In the Western world, females are more likely to maintain social and familial connections that they can turn to for support after losing their spouse. Another factor closely tied to gender roles is employment status. Males' vulnerability may be heightened during times of unemployment because of gendered expectations that males should provide for themselves and their families.
It has been noted that the gender gap is less stark in developing nations. One theory put forward for the smaller gap is the increased burden of motherhood due to cultural norms. In regions where the identity of females is constructed around the family, having young children may correlate with lower risks for suicide. At the same time, stigma attached to infertility or having children outside of marriage can contribute to higher rates of suicide among women.
In 2003, a group of sociologists examined the gender and suicide gap by considering how cultural factors impacted suicide rates. The four cultural factors; power-difference, individualism, uncertainty avoidance, and masculinity, were measured for 66 countries using data from the World Health Organization. Cultural beliefs regarding individualism were most closely tied to the gender gap; countries that placed a higher value on individualism showed higher rates of male suicide. Power-difference, defined as the social separation of people based on finances or status, was a negative correlate to suicide, however countries with high levels of power-difference had higher rates of female suicide. The study ultimately found that stabilizing cultural factors had a stronger effect on suicide rates for women than men.
Differing methods by gender
The reported difference in suicide rates for males and females is partially a result of the methods used by each gender. Although females attempt suicide at a higher rate, they are more likely to use methods that are less immediately lethal. Males frequently complete suicide via high mortality actions such as hanging, carbon-monoxide poisoning, and firearms. This is in contrast to females, who tend to rely on drug overdosing. While overdosing can be deadly, it is less immediate and therefore more likely to be caught before death occurs. In Europe, where the gender discrepancy is the greatest, a study found that the most frequent method of suicide among both genders was hanging, however the use of hanging was much higher in males (54.3%) than in females (35.6%). The same study found that the second most common methods were fire arms for men and poisoning for women.
Methods of suicide are frequently correlated with both with traditional gender roles and availability of different methods. Men are more likely than women to both use and own firearms, which could account for the higher rates of firearm death among males. In nations where firearms have been banned, there is a drop in male suicides via gun but no change in females. Females may tend towards less lethal methods of suicide because of gendered ideas about attractiveness.
Public policy in most nations does not reflect the reality of gender-based factors on suicide. In the United States both the Department of Health and Human Services and the American Foundation for Suicide Prevention address different methods of reducing suicide but do not recognize the separate needs of males and females. In 2002, the English Department of Health launched a suicide prevention campaign that was aimed at high-risk groups including young men, prisoners, and those with mental health disorders. Campaign Against Living Miserably is a charity in the UK that attempts to highlight this issue for public discussion. Researchers have also recommended more aggressive and long-term treatment and follow up for males that show indications of suicidal thoughts. Shifting cultural attitudes about gender roles and norms, and especially ideas about masculinity, may also contribute to closing the gender gap. Some studies have found that because young females are at a higher risk of attempting suicide, policies tailored towards this demographic are most effective at reducing overall rates.
It is important to note that there is no specifically male or female suicide pattern that applies in all cases. Prevention policies tailored towards males can also apply to females cases, and vice versa.
The incidence of completed suicide is vastly higher among males than females among all age groups in most of the world.
In the United States, the male to female suicide death ratio varies between 3:1 to 10:1. Typically males die from suicide attempts three to four times more often as females, and not unusually five or more times as often. Females report attempting suicide at a higher rate than males in the United States. When accounting for failed attempts at suicide, the rate between males and females shifts to 1:2. This is likely due to several factors, including a higher risk for depression among females in the United States. Use of mental health resources may be a significant contributor to gendered suicide rates in the US. Studies have shown that females are 13-21% more likely than males to receive a psychiatric affective diagnosis. While 72-89% of females who committed suicide had contact with a mental health professional at some point in their life, only 41-58% of males who committed suicide had made use of this resource.
Within the US there are variances in gendered rates of suicide by ethnic group. A 2008 study showed that the rate of suicide death is highest among American Indian and Alaskan Native males, and lowest among African American females. Rates of attempted suicide are highest among American Indian and Alaskan Native females and lowest among African American and White males. This reflects the general trend expected by the gender paradox. Explanations for why rates of attempted and completed suicide vary by ethnicity are often based on cultural differences. Among African American victims, it has been suggested that females usually have better access to communal and familial relations that may mitigate other risk factors for suicide. Among Hispanic populations, the same study showed that cultural values of marianismo, which emphasizes female docility and deference to males, may help explain the higher rate of suicide among Latinas relative to Latinos. The authors of this study did not extrapolate their conclusions on ethnicity to populations outside the United States.
The gender-suicide gap is generally highest in Western countries. Among the nations of Europe, the gender gap is particularly large in Eastern European countries such as Lithuania, Belarus, and Hungary. Some researchers attribute the higher rates in former Soviet countries to be a remnant of recent political instability. An increased focus on family under Soviet control led to females becoming more highly valued. Rapid economic fluctuations prevented males from providing fully for their families, which prevented them from fulfilling their traditional gender role. Combined, these factors could account for the gender gap. Other research indicates that higher instances of alcoholism among males in these nations may be to blame. In 2014, suicides rates amongst under-45 men in UK reached a 15-year high of 78% of the total 5,140. 
Excess male mortality from suicide is also evident from data from non-Western countries. In 1979-81, out of 74 countries with a non-zero suicide rate, 69 countries had male suicide rates greater than females, two reported equal rates for the sexes (Seychelles and Kenya), three reported female rates exceeding male rates (Papua New Guinea, Macau, and French Guiana). The contrast is even greater today, with WHO statistics showing China as the only country where the suicide rate of female matches or exceeds that of males. Barraclough found that the female rates of those aged 5–14 equaled or exceeded the male rates only in 14 countries, mainly in South America and Asia.
In most countries, most committed suicides are made by men, but in China women are 40% more likely to commit suicide. Traditional gender roles in China hold women responsible for keeping the family happy and intact. Suicide for women in China is shown in literature to be an acceptable way to avoid disgrace that may be brought to themselves or their families. One explanation for increased suicide in women in China is that pesticides are easily accessible and tend to be used in many suicide attempts made by women. Another explanation is that women are seen as subservient to men due to Chinese gender roles. Thirdly, difficult living conditions and strict views on marriage and family values cause women high stress which is a risk factor for suicidal behavior. The rate of nonlethal suicidal behavior is 40 to 60 percent higher in women as it is in men. This is due to the fact that more women are diagnosed as depressed than men, and also that depression is correlated with suicide attempts.
- Udry, J. Richard (November 1994). "The Nature of Gender". Demography 31 (4): 561–573. doi:10.2307/2061790. JSTOR 2061790. PMID 7890091.
- Canetto, Silvia. "The Gender Paradox in Suicide". Suicide and Life Threatening Behavior 28 (1): 5. doi:10.1111/j.1943-278X.1998.tb00622.x.
- "Suicide Statistics at Suicide.org". Suicide prevention, awareness, and support. Suicide.org. 2005.
- Crosby AE, Han B, Ortega LAG, Parks SE, Gfoerer J. "Suicidal thoughts and behaviors among adults aged ≥18 years-United States, 2008-2009." MMWR Surveillance Summaries 2011;60(no. SS-13).
- WHO on Suicide Prevention, World Health Organization. Retrieved May 16, 2014.
- Data from WHO online databank using "intentional self harm" causes of death
- Thompson, Martie; Laney S. Light (2011). "Examining Gender Differences in Risk Factors for Suicide Attempts Made 1 and 7 Years Later in a Nationally Representative Sample". Journal of Adolescent Health 48: 391–397. doi:10.1016/j.jadohealth.2010.07.018.
- Payne, Sarah, et al. "The social construction of gender and its influence on suicide: a review of the literature". Journal of Men's Health 5 (1): 23–35. doi:10.1016/j.jomh.2007.11.002.
- Möller-Leimkühler, Anne Maria. "The gender gap in suicide and premature death or: why are men so vulnerable?". European Archives of Psychiatry and Clinical Neuroscience 253 (1): 1–8. doi:10.1007/s00406-003-0397-6.
- Stack, Steven. "New Micro-Level Data on the Impact of Divorce on Suicide, 1959-1980: A Test of Two Theories". Journal of Marriage and the Family 52 (1): 119–127. doi:10.2307/352844.
- Girard, Chris. "Age, Gender, and Suicide: A Cross-National Analysis". American Sociological Review 58 (4): 553–574. doi:10.2307/2096076.
- Rudmin, Lloyd Webster. "Questions of Culture, Age, and Gender in the Epidemiology of Suicide". Scandinavian Journal of Psychology 44: 373–381 url=http://onlinelibrary.wiley.com/doi/10.1111/1467–9450.00357/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false.
- Schrijvers, Didier. "The gender paradox in suicidal behavior and its impact on the suicidal process". Journal of Affective Disorders 138 (2): 19–26. doi:10.1016/j.jad.2011.03.050.
- Varnik, A, et al. "Suicide methods in Europe: a gender-specific analysis of countries participating in the ‘‘European Alliance Against Depression’’". Journal of Epidemiology and Public Health 62 (6): 545–551. doi:10.1136/jech.2007.065391.
- Thompson, Martie, et al. "Examining Gender Differences in Risk Factors for Suicide Attempts Made 1 and 7 Years Later in a Nationally Representative Sample". Journal of Adolescent Health 48: 391–397. doi:10.1016/j.jadohealth.2010.07.018.
- "Teen Suicide Statistics". Adolescent Teenage Suicide Prevention. FamilyFirstAid.org. 2001. Retrieved 2006-04-11.
- Murphy, George E. "Why Women are Less Likely Than Men to Commit Suicide". Comprehensive Psychiatry 39 (4): 165–175. doi:10.1016/S0010-440X(98)90057-8.
- Kung, Hsiang-Ching, et al. "Risk factors for male and female suicide decedents ages 15–64 in the United States". Social Psychiatry and Psychiatric Epidemiology 38 (8): 419–426. doi:10.1007/s00127-003-0656-x.
- Goldston, David B.; Sherry Davis Molock; Leslie B. Whitbeck; Jessica L. Murakami; Luis H. Zayas; Gordon C. Nagayama Hall. "Cultural Considerations in Adolescent Suicide Prevention and Psychosocial Treatment". American Psychologist 63 (1): 14–31. doi:10.1037/0003-066x.63.1.14. Retrieved 22 April 2013.
- Landburg, Jonas. "Alcohol and Suicide in eastern Europe". Centre for Social Research on Alcohol and Drugs 27: 361–373. doi:10.1080/09595230802093778.
- "'A crisis of masculinity': men are struggling to cope with life". The Daily Telegraph. 19 Nov 2014. Retrieved 2014-11-20.
- Lester, Patterns, Table 3.3, pp. 31-33
- Barraclough BM (1987). "Sex ratio of juvenile suicide". J Am Acad Child Adolescent Psychiatry 26 (3): 434–5. doi:10.1097/00004583-198705000-00027. PMID 3496328.
- Barlow, D. H., and V. M. Durand. Abnormal psychology, an integrative approach. Wadsworth Pub Co, 2011. Print.
- Zhang, J., Jiang, Chao., Jia, S., Wieckorek, W.F., Arch Suicide Res. 2002; 6(2): 167–184.