Suicide among LGBT youth

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Researchers have found that attempted suicide rates and suicidal ideation among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQQ) youth is comparatively higher than among the general population.[1][2][3][4][5][6] LGBT teens and young adults have one of the highest rates of suicide attempts.[7][8] According to some groups, this is linked to heterocentric cultures and institutionalised homophobia in some cases, including the use of rights and protections for LGBT people as a political wedge issue like in the contemporary efforts to halt legalising same-sex marriages.[9][10][11] Depression and drug use among LGBT people have both been shown to increase significantly after new laws that discriminate against gay people are passed.[12]

Bullying of LGBT youth has been shown to be a contributing factor in many suicides, even if not all of the attacks have been specifically addressing sexuality or gender.[13] Since a series of suicides in the early 2000s, more attention has been focused on the issues and underlying causes in an effort to reduce suicides among LGBTQ youth. The Family Acceptance Project's research has demonstrated that "parental acceptance, and even neutrality, with regard to a child's sexual orientation" can bring down the attempted suicide rate.[7] Suicidal ideation and attempts seem to be roughly the same for heterosexual youth as for youth counterparts who have same-sex attractions and behavior but do not identify as being LGBTQ.[14] This correlates with the findings of a large survey of US adults that found higher rates of "mood and anxiety disorders, key risk factors for suicidal behavior," are linked to people who identify as gay, lesbian, and bisexual, rather than sexual behaviors, especially for men.[15]

The National Action Alliance for Suicide Prevention notes there are no national data (for the U.S.) regarding suicidal ideation or suicide rates among the LGBT population as a whole or in part, for LGBT youth or LGBT seniors, for example.[16] In part because there is no agreed percentage of the national population that is LGBTQ, or even identifies as LGBTQ, also death certificates do not include sexuality information.[9] A 1986 study noted that previous large scale studies of completed suicides did not "consider sexual orientation in their data analyses."[17]

Reports and studies[edit]

Clinical social worker Caitlin Ryan's Family Acceptance Project (California State University, San Francisco) conducted the first study of the effect of family acceptance and rejection on the health, mental health and well-being of LGBT youth, including suicide, HIV/AIDS and homelessness.[18] Their research shows that LGBT youths "who experience high levels of rejection from their families during adolescence (when compared with those young people who experienced little or no rejection from parents and caregivers) were more than eight times likely to have attempted suicide, more than six times likely to report high levels of depression, more than three times likely to use illegal drugs and more than three times likely to be at high risk for HIV or other STDs" by the time they reach their early 20s.[18]

Numerous studies have shown that lesbian, gay, and bisexual youth have a higher rate of suicide attempts than do heterosexual youth. The Suicide Prevention Resource Center synthesized these studies and estimated that between 30 and 40% of LGBT youth, depending on age and sex groups, have attempted suicide.[19] A U.S. government study, titled Report of the Secretary's Task Force on Youth Suicide, published in 1989, found that LGBT youth are four times more likely to attempt suicide than other young people.[20] This higher prevalence of suicidal ideation and overall mental health problems among gay teenagers compared to their heterosexual peers has been attributed to minority stress.[21][22] "More than 34,000 people die by suicide each year," making it "the third leading cause of death among 15 to 24 year olds with lesbian, gay, and bisexual youth attempting suicide up to four times more than their heterosexual peers."[23]

It is impossible to know the exact suicide rate of LGBT youth because sexuality and gender minorities are often hidden and even unknown, particularly in this age group. Further research is currently being done to explain the prevalence of suicide among LGBT youths.[24][25][26]

In terms of school climate, "approximately 25 percent of lesbian, gay and bisexual students and university employees have been harassed due to their sexual orientation, as well as a third of those who identify as transgender, according to the study and reported by the Chronicle of Higher Education."[27] Research has found the presence of gay-straight alliances (GSAs) in schools is associated with decreased suicide attempts; in a study of LGBTQ youth, ages 13–22, 16.9% of youth who attended schools with GSAs attempted suicide versus 33.1% of students who attended schools without GSAs.[28]

"LGBT students are three times as likely as non-LGBT students to say that they do not feel safe at school (22% vs. 7%) and 90% of LGBT students (vs. 62% of non-LGBT teens) have been harassed or assaulted during the past year."[29] In addition, "LGBQ students were more likely than heterosexual students to have seriously considered leaving their institution as a result of harassment and discrimination."[30] Susan Rankin, a contributing author to the report in Miami, found that “Unequivocally, The 2010 State of Higher Education for LGBT People demonstrates that LGBTQ students, faculty and staff experience a ‘chilly’ campus climate of harassment and far less than welcoming campus communities."[30]

According to a study in Taiwan, 1 in 5 or 20% of Taiwanese gay people have attempted suicide.[31]

Developmental psychology perspectives[edit]

The diathesis-stress model suggests that biological vulnerabilities predispose individuals to different conditions such as cancer, heart disease, and mental health conditions like major depression, a risk factor for suicide. Varying amounts of environmental stress increase the probability that these individuals will develop that condition. Minority stress theory suggests that minority status leads to increased discrimination from the social environment which leads to greater stress and health problems. In the presence of poor emotion regulation skills this can lead to poor mental health. Also, the differential susceptibility hypothesis suggests that for some individuals their physical and mental development is highly dependent on their environment in a “for-better-and-for-worse” fashion. That is, individuals who are highly susceptible will have better than average health in highly supportive environments and significantly worse than average health in hostile, violent environments. The model can help explain the unique health problems affecting LGBT populations including increased suicide attempts. For adolescents, the most relevant environments are the family, neighborhood, and school. Adolescent bullying - which is highly prevalent among sexual minority youths - is a chronic stressor that can increase risk for suicide via the diathesis-stress model. In a study of American lesbian, gay, and bisexual adolescents, Mark Hatzenbuehler examined the effect of the county-level social environment.[32] This was indexed by the proportion of same-sex couples and Democrats living in the counties. Also included were the proportions of schools with gay-straight alliances as well as anti-bullying and antidiscrimination policies that include sexual orientation. He found that a more conservative social environment elevated risk in suicidal behavior among all youth and that this effect was stronger for LGB youth. Furthermore, he found that the social environment partially mediated the relation between LGB status and suicidal behaviour. Hatzenbuehler found that even after such social as well as individual factors were controlled for, however, that "LGB status remained a significant predictor of suicide attempts."

Institutionalized and internalized homophobia[edit]

Institutionalized and internalized homophobia may also lead LGBT youth to not accept themselves and have deep internal conflicts about their sexual orientation.[33] Parents may force children out of home after the child's coming out.[34]

Homophobia arrived at by any means can be a gateway to bullying which can take many forms. Physical bullying is kicking, punching, while emotional bullying is name calling, spreading rumors and other verbal abuse. Cyber bullying involves abusive text messages or messages of the same nature on Facebook, Twitter, and other social media networks. Sexual bullying is inappropriate touching, lewd gestures or jokes.[35]

Bullying may be considered a "rite of passage",[36] but studies have shown it has negative physical and psychological effects. "Sexual minority youth, or teens that identify themselves as gay, lesbian or bisexual, are bullied two to three times more than heterosexuals", and "almost all transgender students have been verbally harassed (e.g., called names or threatened in the past year at school because of their sexual orientation (89%) and gender expression (89%)") according to GLSEN's Harsh Realities, The Experiences of Transgender Youth In Our Nation’s Schools.[23]

This issue has been a hot topic for media outlets over the past few years, and even more so in the months of September and October 2010. President Barack Obama has posted an "It Gets Better" video on The White House website as part of the It Gets Better Project. First lady Michelle Obama attributes such behaviors to the examples parents set as, in most cases, children follow their lead.[37]

The Trevor Project[edit]

"The Trevor Project was founded by writer James Lecesne, director/producer Peggy Rajski and producer Randy Stone, creators of the 1994 Academy Award-winning Young Adult Fiction short film, Trevor , a Young Adult Fiction/comedy/drama about a gay 13-year-old boy who, when rejected by friends because of his sexuality, makes an attempt to take his life."[38] They are an American non-profit organization that operates the only nationwide, offering around-the-clock crisis and suicide prevention helpline for LGBTQ youth, the project "is determined to end suicide among LGBTQ youth by providing life-saving and life-affirming resources including our nationwide, 24/7 crisis intervention lifeline, digital community and advocacy/educational programs that create a safe, supportive and positive environment for everyone."[38]

It Gets Better Project[edit]

It Gets Better Project is an Internet-based project founded in the US by Dan Savage and his husband Terry Miller in September 2010,[39][40] in response to the suicides of teenagers who were bullied because they were gay or because their peers suspected that they were gay. Its goal is to prevent suicide among LGBT youth by having gay adults convey the message through social media videos that these teens' lives will improve.[41] The project has grown rapidly: over 200 videos were uploaded in the first week,[42] and the project's YouTube channel reached the 650 video limit in the next week.[43] The project is now organized on its own website, the It Gets Better Project,[43] and includes more than 30,000 entries, with more than 40 million views, from people of all sexual orientations, including many celebrities.[44] A book of essays from the project, It Gets Better: Coming Out, Overcoming Bullying, and Creating a Life Worth Living, was released in March 2011.[45]

Developmental psychologist Ritch Savin-Williams argues that the It Gets Better Project "promotes a false 'suffering suicidal script'" and that the rates of serious suicide attempts are in proportion to that of non-LGBT counterparts, (when the non-lifethreatining attempts are left out).[46][47][48] He presents as evidence the past surveys have bias built in and do not accurately portray that presently there has "never been a better time to be young and gay."[47] He argues that we should not be sending the message that “it gets better” but that “life can be good now,” saying 'things get better' sends the message that suicide and poor mental health are normal processes for queer/non-heterosexual teens.[49] Associate professor of psychology and gender studies at the University of Utah, Lisa Diamond studied adolescents in Salt Lake City and found that although LGBTQ youth were more likely to make friends with non-white and differently able children, there lead ‘ordinary lives’ and are just as well-adjusted as their straight counterparts.[50] Savin-Williams notes that the suicide and bullying are more easily attributed to gender nonconformity than sexuality itself, "straight youth who are gender-atypical suffer as much as gay kids."[50] Independently, sexuality was found have an effect, as a national study of 15,000 middle and high-school students found that LGBTQ teenagers were "more likely to be harshly punished by schools and courts than their straight peers."[50]

Policy responses[edit]

A number of policy options have been repeatedly proposed to address this issue. Some advocate intervention at the stage in which youth are already suicidal (such as crisis hotlines), while others advocate programs directed at increasing LGBT youth access to factors found to be “protective” against suicide (such as social support networks or mentors).

One proposed option is to provide LGBT-sensitivity and anti-bullying training to current middle and high school counselors and teachers. Citing a study by Jordan et al., school psychologist Anastasia Hansen notes that hearing teachers make homophobic remarks or fail to intervene when students make such remarks are both positively correlated with negative feelings about an LGBT identity[51] Conversely, a number of researchers have found the presence of LGBT-supportive school staff to be related to “positive outcomes for GLBT youth.”[51] Citing a 2006 Psychology in the Schools report, The Trevor Project notes that “lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth who believe they have just one school staff member with whom they can talk about problems are only 1/3 as likely as those without that support to… report making multiple suicide attempts in the past year.”[52]

Another frequently proposed policy option involves providing grant incentives for schools to create and/or support Gay-Straight Alliances, student groups dedicated to providing a social support network for LGBT students. Kosciw and Diaz, researchers for the Gay, Lesbian and Straight Education Network, found in a nationwide survey that “students in schools with a GSA were less likely to feel unsafe, less likely to miss school, and more likely to feel that they belonged at their school than students in schools with no such clubs.”[53] Studies have shown that social isolation and marginalization at school are psychologically damaging to LGBT students, and that GSAs and other similar peer-support group can be effective providers of this “psychosocial support.”[51]

See also[edit]

Notes[edit]

  1. ^ J Homosex. 2011 January; 58(1): 10–51. Published online 2011 January 4. doi: 10.1080/00918369.2011.534038; PMCID: PMC3662085; NIHMSID: NIHMS312131; Ann P. Haas, Mickey Eliason, Vickie M. Mays, Robin M. Mathy, Susan D. Cochran, Anthony R. D'Augelli, Morton M. Silverman, Prudence W. Fisher, Tonda Hughes, Margaret Rosario, Stephen T. Russell, Effie Malley, Jerry Reed, David A. Litts, Ellen Haller, Randall L. Sell, Gary Remafedi, Judith Bradford, Annette L. Beautrais, Gregory K. Brown, Gary M. Diamond, Mark S. Friedman, Robert Garofalo, Mason S. Turner, Amber Hollibaugh, and Paula J. Clayton
  2. ^ Risk Factors for Suicide among Gay, Lesbian, and Bisexual Youths, Curtis D. Proctor and Victor K. Groze, Social Work (1994) 39 (5): 504-513. doi: 10.1093/sw/39.5.504
  3. ^ Risk Factors for Attempted Suicide in Gay and Bisexual Youth Gary Remafedi, James A. Farrow, Robert W. Deisher, PEDIATRICS - American Academy of Pediatrics, Vol. 87 No. 6 June 1, 1991 pp. 869 -875
  4. ^ Stephen T. Russell and Kara Joyner. Adolescent Sexual Orientation and Suicide Risk: Evidence From a National Study. American Journal of Public Health: August 2001, Vol. 91, No. 8, pp. 1276-1281. doi: 10.2105/AJPH.91.8.1276
  5. ^ Gay and Lesbian Youth, Tracie L. Hammelman, Journal of Gay & Lesbian Psychotherapy Vol. 2, Iss. 1, 1993, DOI:10.1300/J236v02n01_06, pages 77-89
  6. ^ Johnson, R. B., Oxendine, S., Taub, D. J. and Robertson, J. (2013), Suicide Prevention for LGBT Students . New Directions for Student Services, 2013: 55–69. doi: 10.1002/ss.20040
  7. ^ a b Study: Tolerance Can Lower Gay Kids' Suicide Risk, Joseph Shapiro, All Things Considered, National Public Radio, December 29, 2008. [1]
  8. ^ Elevated rates of suicidal behavior in gay, lesbian, and bisexual youth. Bagley, Christopher; Tremblay, Pierre, Crisis: The Journal of Crisis Intervention and Suicide Prevention, Vol 21(3), 2000, 111-117. doi: 10.1027//0227-5910.21.3.111
  9. ^ a b National Action Alliance for Suicide Prevention Tackles LGBT Suicide, April 26, 2012, Kellan Baker and Josh Garcia. [2]
  10. ^ Addressing the Needs of Older Lesbian, Gay, Bisexual, and Transgender Adults, Posted: 2/18/2011 Volume 19 - Number 2 - February 2011, Mark J. Simone, MD, and Jonathan S. Appelbaum, MD, Clinical Geriatrics 2011;19(2):38-45.
  11. ^ Research exposes negative effects of anti-gay legislation - The Michigan Daily
  12. ^ "The Impact of Institutional Discrimination on Psychiatric Disorders in Lesbian, Gay, and Bisexual Populations: A Prospective Study by Mark L. Hatzenbuehler, MS, MPhil, Katie A. McLaughlin, PhD, Katherine M. Keyes, MPH and Deborah S. Hasin, PhD". Ajph.aphapublications.org. 2010-01-14. doi:10.2105/AJPH.2009.168815. Retrieved 2011-08-21. 
  13. ^ Verbal and physical abuse as stressors in the lives of lesbian, gay male, and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Savin-Williams, Ritch C. Journal of Consulting and Clinical Psychology, Vol 62(2), Apr 1994, 261-269. doi: 10.1037/0022-006X.62.2.261
  14. ^ Zhao Y., Montoro R., Igartua K., Thombs B. D. Suicidal ideation and attempt among adolescents reporting “unsure” sexual identity or heterosexual identity plus same-sex attraction or behavior: Forgotten groups?Journal of the American Academy of Child and Adolescent Psychiatry. 2010;49(2):104–113.
  15. ^ Bostwick W. B., Boyd C. J., Hughes T. L., McCabe S. E. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States.American Journal of Public Health.2010;100(3):468–475.
  16. ^ National Action Alliance for Suicide Prevention Tackles LGBT Suicide, April 26, 2012, Kellan Baker and Josh Garcia. National Action Alliance for Suicide Prevention
  17. ^ Rich, C. L., Fowler, R. C., Young, D. and Blenkush, M. (1986), San Diego Suicide Study: Comparison of Gay to Straight Males. Suicide and Life-Threat Behavi, 16: 448–457. doi: 10.1111/j.1943-278X.1986.tb00730.x
  18. ^ a b Helping LGBT youth, others learn to cope, April 27, 2012, Visalia Times-Delta. [3]
  19. ^ "Preventing Suicide among Gay, Lesbian, Bisexual, Transgendered, and Questioning Youth and Young Adults" (PDF). Retrieved 2011-08-21. 
  20. ^ "Report of the Secretary's Task Force on Youth Suicide". Eric.ed.gov. Retrieved 2011-08-21. 
  21. ^ August 21, 2011 (1999-10-27). "Definition of Bisexual suicide risk". Medterms.com. Retrieved 2011-08-21. 
  22. ^ Meyer IH (September 2003). "Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence". Psychological Bulletin 129 (5): 674–97. doi:10.1037/0033-2909.129.5.674. PMC 2072932. PMID 12956539. 
  23. ^ a b "Additional Facts about Lesbian, Gay, Bisexual, and Transgender Youth". Thetrevorproject.org. Retrieved 2011-08-21. 
  24. ^ "Sexual Orientation and Youth Suicide" by Dr. Gary Remafedi, October 6, 1999, retrieved 2 May 2006.
  25. ^ "Youth suicide risk and sexual orientation - Statistical Data Included" by Rutter, Philip A & Soucar, Emil, Summer 2002, retrieved 2 May 2006.
  26. ^ Articles Relating to Suicide by GLB Youth, retrieved 3 May 2006.
  27. ^ Wienerbronner, Danielle (2010-09-15). "LGBT Students Harassed At Colleges Nationwide, New Report Says". Huffington Post. 
  28. ^ Walls, N. Eugene; Wisneski, Hope; Kane, Sarah (March 2013). "School climate, individual support, or both? Gay straight alliances and the mental health of sexual minority youth". School Social Work Journal 37 (2): 88–111. 
  29. ^ "Additional Facts About Lesbian, Gay, Bisexual, and Transgender Youth". Thetrevorproject.org. Retrieved 2011-08-21. 
  30. ^ a b Rothaus, Steve (2010-09-15). "Steve Rothaus' Gay South Florida". Miamiherald.typepad.com. Retrieved 2011-08-21. 
  31. ^ Lloyd, Peter. "Nearly 20 per cent of Taiwan's gay population have attempted suicide, report claims". Pink Paper. Archived from the original on 14 July 2012. 
  32. ^ "The Social Environment and Suicide Attempts inLesbian, Gay, and Bisexual Youth", Pediatrics. 127 (5), 2011: 896–903 
  33. ^ Gibson, P. (1989), “Gay and Lesbian Youth Suicide”, in Fenleib, Marcia R. (ed.), Report of the Secretary's Task Force on Youth Suicide, United States Government Printing Office, ISBN 0-16-002508-7
  34. ^ Adler, Margot (November 20, 2011). "Young, Gay And Homeless: Fighting For Resources". NPR. 
  35. ^ By Janice L. Habuda (2010-10-29). "Students learn about bullying". Buffalonews.com. Retrieved 2011-08-21. 
  36. ^ Levinson, David. Encyclopedia of Crime and Punishment, Volumes 1-4. p. 137. ISBN 9780761922582. 
  37. ^ "Michelle Obama On Bullying: Adults Need To Set Example". Huffingtonpost.com. 2010-10-28. Retrieved 2011-08-21. 
  38. ^ a b About Trevor[dead link]
  39. ^ Wyatt Buchanan (October 21, 2005). "Marriage can be right for us all, says Dan Savage. But let's not get carried away with monogamy". San Francisco Chronicle. Retrieved April 30, 2011. 
  40. ^ "Video: Authors @Google: Dan Savage and Terry Miller on the It Gets Better Project | It Gets Better Project". Itgetsbetter.org. Retrieved 2011-08-21. 
  41. ^ Parker-Pope, Tara (September 22, 2010). "Showing Gay Teens a Happy Future". The New York Times. 
  42. ^ Savage, Dan. "Welcome to the It Gets Better Project". Retrieved 2010-10-12. 
  43. ^ a b Hartlaub, Peter (2010-10-08). "Dan Savage overwhelmed by gay outreach's response". San Francisco Chronicle. Retrieved 2010-10-09. 
  44. ^ Noreen Fagan (8 February 2011). "Dan Savage talks teens, straight people and It Gets Better". Xtra!. Retrieved 15 February 2011. 
  45. ^ Furlan, Julia (March 22, 2011). "The 'It Gets Better Project' Turns the Spotlight on Anti-Gay Bullying". WNYC. Retrieved March 30, 2011. 
  46. ^ New data on lesbian, gay and bisexual mental health
  47. ^ a b The Gay Kids Are All Right, November 11, 2010, Ritch Savin-Williams.
  48. ^ A Look At The Lives Of Gay Teens Robert Siegel interview of Ritch Savin-Williams, October 21, 2010, National Public Radio.
  49. ^ The Gay Kids Are All Right
  50. ^ a b c Gay or Straight, Youths Aren’t So Different
  51. ^ a b c "Hansen, Anastasia. "School-Based Support for GLBT Students: A Review of Three Levels of Research." ‘‘Psychology in the Schools.’’ 44.8(2007). 839-848". Eric.ed.gov:80. Retrieved 2011-08-21. 
  52. ^ http://www.thetrevorproject.org/sites/default/files/educatorresourceguide.pdf
  53. ^ "2005 NSCS Final v6.pdf" (PDF). Retrieved 2011-08-21. 

Further reading[edit]

  • Diamond, L. (2003). Was it a phase? Young women’s relinquishment of lesbian/bisexual identities over a 5-year period. Journal of Personality and Social Psychology, 84(2), 352-364.
  • Diamond, L. (2008). Female Bisexuality From Adolescence to Adulthood: Results From a 10-Year Longitudinal Study. Developmental Psychology, 44(1), 5-14.
  • Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., Silverman, M. M., et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of Homosexuality, 58(1), 10-51.
  • Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135(5), 707-730.
  • Helling, S., Levy, D. S., & Herbst, D. (2010, October). Tormented to Death? People Magazine, 56. New York, NY.
  • Kann, L., Olsen, E. O., McManus, T., Kinchen, S., Chyen, D., Harris, W. A., & Wechsler, H. (2011). Sexual identity, sex of sexual contacts, and health-risk behaviors among students in grades 9--12 --- youth risk behavior surveillance, selected sites, United States, 2001–2009. * MMWR Surveillance summaries Morbidity and mortality weekly report Surveillance summaries CDC, 60(7), 1-133.
  • Marshal, M. P., Dietz, L. J., Friedman, M. S., Stall, R., Smith, H. A., McGinley, J., Thoma, B. C., et al. (2011). Suicidality and Depression Disparities Between Sexual Minority and Heterosexual Youth: A Meta-Analytic Review. The Journal of Adolescent Health, 49(2), 115-23.
  • Mayock, P.; Bryan, A.; Carr, N. & Kitching, K. (2009) "Supporting LGBT Lives: A Study of the Mental Health and Well-Being of Lesbian, Gay, Bisexual and Transgender People" Dublin: BeLonG To Youth Services
  • O’Donnell, S., Meyer, I. H., & Schwartz, S. (2011). Increased risk of suicide attempts among Black and Latino lesbians, gay men, and bisexuals. American Journal of Public Pealth, 101(6), 1055-9.
  • Russell, S. T., Clarke, T. J., & Clary, J. (2009). Are Teens “‘Post-Gay’”? Contemporary Adolescents’ Sexual Identity Labels. Journal of Youth and Adolescence, 38, 884-90.
  • Savin-Williams, R. (2005). The New Gay Teenager. Cambridge, Massachusetts: Harvard University Press.
  • Savin-Williams, R. C. (2008). Then and Now: Recruitment, Definition, Diversity, and Positive Attributes of Same-Sex Populations. Developmental Psychology, 44(1), 135-138.
  • Savin-Williams, R. C., & Ream, G. L. (2003). Suicide attempts among sexual-minority male youth. Journal of Clinical Child and Adolescent Psychology, 32(4), 509-522.
  • Savin-Williams, R. C., & Ream, G. L. (2007). Prevalence and stability of sexual orientation components during adolescence and young adulthood. Archives of Sexual Behavior, 36(3), 385-94.
  • Savin-williams, R. C. (2006). Who’ s Gay ? Does It Matter ? Psychological Science, 15(1), 40-45.
  • Savin-williams, R. C., Cohen, K. M., & Youth, G. (2005). Development of Same-Sex Attracted Youth. Development, 1979(2004).
  • Schwartz, S., & Meyer, I. H. (2010). Mental health disparities research: the impact of within and between group analyses on tests of social stress hypotheses. Social science & medicine (1982), 70(8), 1111-8. Elsevier Ltd. doi:10.1016/j.socscimed.2009.11.032
  • Selby, E. A., Anestis, M. D., Bender, T. W., Ribeiro, J. D., Nock, M. K., Rudd, M. D., Bryan, C. J., et al. (2010). Clinical Psychology Review Overcoming the fear of lethal injury : Evaluating suicidal behavior in the military through the lens of the Interpersonal – Psychological Theory of Suicide. Clinical Psychology Review, 30(3), 298-307.
  • Van Orden, K. a, Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. a, & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575-600.
  • Young, R. M., & Meyer, I. H. (2005). The trouble with “MSM” and “WSW”: erasure of the sexual-minority person in public health discourse. American Journal of Public Health, 95(7), 1144-9.

External links[edit]