from Clinical/Therapeutic Issues
by Dr. Richard Fitzgibbons
October 17, 2005 - Recent claims by Time magazine gay journalist John Cloud about positive mental health among gay teens is contradicted by studies on emotional and relational instability among gays in several studies.
Suicide in America, 1995
Herbert Hendin, M.D.
Executive Director American Suicide Foundation
New York, Professor of Psychiatry
New York Medical College
"The extreme vulnerability to rejection of suicidal homosexuals may have an important social component as well. With all its sexual and social activity, the "gay life" provides no more than an alienated and isolated existence for many homosexuals. Continuity of relationships between two homosexuals is rare, although many homosexuals spend a lifetime seeking it. For those who do seek it, any relationship that offers that possibility is apt to be intensely over invested rather quickly. Since such relationships usually lack social or family support, rejection or disappointment signifies not merely abandonment but despair over the inability to escape emotional isolation." Page 146
Sexual Organization of the City Laumann, E, et al., U. of Chicago, 2004.
In this major study of homosexual dating patterns, Laumann discovered that most of those with same sex attractions spend their lives in "transactional" relationships (short term commitments that last than six months on average).
Professor Laumann's research provides additional evidence that males with SSA, in particular, experience pervasive loneliness and many short-lived relationships.
AIDS 17,7:1029-1038, 2003. Dr. Maria Xiridou with the Amsterdam Municipal Health Service found that consensual infidelity was the norm. The average relationship lasted 1.5 years. Those in casual relationships averaged between 16 -28 sexual partners per year. Also, 86% of the new HIV infections in Amsterdam occurred among those in steady relationships.
Lifetime prevalence of DSM- III- R Psychiatric Disorders
|One or more diagnoses||56.1%||41.4%|
|Two or more||37.8%||14.4%|
Stanford et al. (2001) Arch Gen Psychiatry, Vol. 58.
Study from the Netherlands of 5, 898 adults of which 2.1% self-identified as homosexual.
Arch Gen Psychiatry 1999 Oct; 56(10):876-80
Is sexual orientation related to mental health problems and suicidality in young people?
Fergusson DM, Horwood LJ, Beautrais AL. Christchurch Health and Development Study, Christchurch School of Medicine, New Zealand.
BACKGROUND: This study examines the extent to which gay, lesbian, and bisexual young people are at increased risk of psychiatric disorder and suicidal behaviors using data gathered on a New Zealand birth cohort studied to age 21 years.
METHODS: Data were gathered during the course of the Christchurch Health and Development Study, a 21-year longitudinal study of a birth cohort of 1265 children born in Christchurch, New Zealand. At 21 years of age, 1007 sample members were questioned about their sexual orientation and relationships with same-sex partners since the age of 16 years. Twenty-eight subjects (2.8%) were classified as being of gay, lesbian, or bisexual sexual orientation. Over the period from age 14 to 21 years, data were gathered on a range of psychiatric disorders that included major depression, generalized anxiety disorder, conduct disorder, and substance use disorders. Data were also gathered on suicidal ideation and suicide attempts.
RESULTS: Gay, lesbian, and bisexual young people were at increased risks of major depression (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.8-9.3), generalized anxiety disorder (OR, 2.8; 95% CI, 1.2-6.5), conduct disorder (OR, 3.8; 95% CI, 1.7-8.7), nicotine dependence (OR, 5.0; 95%, CI, 2.3-10.9), other substance abuse and/or dependence (OR, 1.9; 95% CI, 0.9-4.2), multiple disorders (OR, 5.9; 95% CI, 2.4-14.8), suicidal ideation (OR, 5.4; 95% CI, 2.4-12.2), and suicide attempts (OR, 6.2; 95% CI, 2.7-14.3).
CONCLUSIONS: Findings support recent evidence suggesting that gay, lesbian, and bisexual young people are at increased risk of mental health problems, with these associations being particularly evident for measures of suicidal behavior and multiple disorder.
Sexual Orientation and Suicidality -- A Co-twin Control Study in Adult Men
Richard Herrell, MS; Jack Goldberg, PhD; William R. True, PhD, MPH; Visvanathan Ramakrishnan, PhD; Michael Lyons, PhD; Seth Eisen, MD; Ming T. Tsuang, MD, DSc, PhD, Arch Gen Psychiatry. 1999; 56:867-874.
BACKGROUND: Several recent studies have found a higher lifetime prevalence of suicide attempts in homosexual males compared with heterosexual control subjects or population rates. These studies used either convenience samples, most without controls, or population-based samples in which confounding factors such as depression and substance abuse were not measured.
METHODS: This study used twins from the population-based Vietnam Era Twin Registry, Hines, Ill. An analytic sample of 103 middle-aged male-male twin pairs from the registry was identified in which one member of the pair reported male sex partners after age 18 years while the other did not. Four lifetime symptoms of suicidality as measured by the Diagnostic Interview Schedule were analyzed: thoughts about death, wanting to die, thoughts about committing suicide, and attempted suicide. A composite measure of reporting at least one suicidality symptom was also assessed.
RESULTS: Same-gender sexual orientation is significantly associated with each of the suicidality measures. Unadjusted matched-pair odds ratios follow: 2.4 (95% confidence interval [CI], 1.2-4.6) for thoughts about death; 4.4 (95% CI, 1.7-11.6) for wanted to die; 4.1 (95% CI, 2.1-8.2) for suicidal ideation; 6.5 (95% CI, 1.5-28.8) for attempted suicide; and 5.1 (95% CI, 2.4-10.9) for any of the suicidal symptoms. After adjustment for substance abuse and depressive symptoms (other than suicidality), all of the suicidality measures remain significantly associated with same-gender sexual orientation except for wanting to die (odds ratio, 2.5 [95% CI, 0.7-8.8]).
CONCLUSIONS: The substantially increased lifetime risk of suicidal behaviors in homosexual men is unlikely to be due solely to substance abuse or other psychiatric comorbidity. While the underlying causes of the suicidal behaviors remain unclear, future research needs to address the inadequacies in the measurement of both sexual orientation and suicidality in population-based samples.
From the Division of Epidemiology-Biostatistics, School of Public Health, University of Illinois at Chicago (Mr Herrell and Drs Goldberg and Ramakrishnan); the Vietnam Era Twin Registry, Health Services Research and Development Program, Department of Veterans Affairs Hospital, Hines, Ill (Drs Goldberg and Ramakrishnan); the School of Public Health, St Louis University (Dr True), the Research Service, St Louis VAMC (Drs True and Eisen), the Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine (Dr Eisen), St Louis, Mo; the Department of Psychology, Boston University (Dr Lyons), the Harvard Institute of Psychiatric Epidemiology and Genetics (Drs Lyons and Tsuang), the Harvard Medical School, Department of Psychiatry at Massachusetts Mental Health Center (Drs Lyons and Tsuang), Boston, Mass.
Am J Public Health 2000 Apr; 90(4):573-8 Related Articles, Links
Lifetime prevalence of suicide symptoms and affective disorders among men reporting same-sex sexual partners: results from NHANES III.
Cochran SD, Mays VM.
Department of Epidemiology, UCLA School of Public Health 90095-1772, USA. firstname.lastname@example.org
OBJECTIVES: This study examined lifetime prevalence of suicide symptoms and affective disorders among men reporting a history of same-sex sexual partners.
METHODS: In the third National Health and Nutrition Examination Survey, men aged 17 to 39 years were assessed for lifetime history of affective disorders and sexual behavior patterns. The study classified this subset of men into 3 groups: those reporting same-sex sexual partners, those reporting only female sexual partners, and those reporting no sexual partners. Groups were compared for histories of suicide symptoms and affective disorders.
RESULTS: A total of 2.2% (95% confidence interval [CI] = 1.3%, 3.1%) of men reported same-sex sexual partners. These men evidenced greater lifetime prevalence rates of suicide symptoms than men reporting only female partners. However, homosexually/bisexually experienced men were no more likely than exclusively heterosexual men to meet criteria for lifetime diagnosis of other affective disorders.
CONCLUSIONS: These data provide further evidence of an increased risk for suicide symptoms among homosexually experienced men. Results also hint at a small, increased risk of recurrent depression among gay men, with symptom onset occurring, on average, during early adolescence.
Am J Psychiatry. 2003 Mar; 160(3):541-6. Related Articles, Links
Sexual orientation and self-harm in men and women.
Skegg K, Nada-Raja S, Dickson N, Paul C, Williams S.
Department of Psychological Medicine, University of Otago Medical School, Dunedin, New Zealand. email@example.com
OBJECTIVE: Recent studies of homosexual people have found higher rates of nonfatal suicidal behavior than among heterosexuals. The purpose of this study was to determine associations between self-harm and sexual orientation for men and women separately, defining sexual orientation by sexual attraction rather than by behavior.
METHOD: In a birth cohort of 1,019 New Zealand young adults eligible to be interviewed at age 26 years, 946 participated in assessments of both sexual attraction and self-harm.
RESULTS: Both women and men who had experienced same-sex attraction had higher risks of self-harm. The odds ratios for suicidal ideation in the past year were 3.1 for men and 2.9 for women. Odds ratios for ever having deliberately self-harmed were 5.5 for men and 1.9 for women. Men with same-sex attraction were also significantly more likely to report having attempted suicide. In both sexes, a greater degree of same-sex attraction predicted increasing likelihood of self-harm, with over one-third of men and women with persistent major same-sex attraction reporting this. Men with even a minor degree of same-sex attraction had high rates of self-harm and resulting physical injury. One-quarter of deliberate self-harm among men and one-sixth among women was potentially attributable to same-sex attraction.
CONCLUSIONS: This study provides evidence of a link between increasing degrees of same-sex attraction and self-harm in both men and women, with the possibility of some difference between the sexes that needs to be explored further.
American Journal of Public Health December 2002.
RESEARCH AND PRACTICE
Battering Victimization Among a Probability-Based Sample of Men Who Have Sex With Men
Gregory L. Greenwood, PhD, MPH, Michael V. Relf, PhD, RN, Bu Huang, PhD, Lance M. Pollack, PhD, Jesse A. Canchola, MS and Joseph A. Catania, PhD Gregory L. Greenwood, Lance M. Pollack, Jesse A. Canchola, and Joseph A. Catania are with the Center for AIDS Prevention Studies, University of California, San Francisco. At the time of this study, Michael V. Relf was with Whitman-Walker Clinic, Washington, DC. Bu Huang is with the Prevention Research Center, School of Social Work, University of Washington, Seattle.
Correspondence: Requests for reprints should be sent to Gregory L. Greenwood, PhD, UCSF-CAPS, 74 New Montgomery St, Suite 600, San Francisco, CA 94105 (e-mail: firstname.lastname@example.org).
ABSTRACT OBJECTIVES. This study measured the prevalence of battering victimization (i.e., experience of psychological/symbolic, physical, and sexual battering) among men who have sex with men (MSM) and identified characteristics of these men.
METHODS. A probability-based sample of 2881 MSM living in 4 cities completed telephone interviews between 1996 and 1998.
RESULTS. Prevalence estimates were 34% for psychological/symbolic battering, 22% for physical battering, and 5% for sexual battering. The strongest demographic correlate independently associated with all forms of battering was age 40 or younger, whereas education and HIV serostatus were associated with physical and psychological/symbolic violence.
CONCLUSIONS. Rates of battering victimization among urban MSM are substantially higher than among heterosexual men and possibly heterosexual women. Public health efforts directed toward addressing intimate partner battering among these men are needed. This finding looks at the relationship between sexual orientation and relationship violence.
FINDING. Relationship violence was found to be a significant problem for homosexuals. Forty-four (44) percent of the gay men reported having experienced violence in their relationships; 13 percent reported sexual violence and 83 percent reported emotional abuse. Levels of abuse ran even higher among lesbians: 55 percent reported physical violence in their relationships, 14 percent reported sexual abuse, and 84 percent reported emotional abuse.
Sample or Data Description
499 ethnically diverse homosexual, bisexual, and transgendered teenagers and adults
Susan C. Turrell
"A Descriptive Analysis of Same-Sex Relationship Violence for a Diverse Sample"
Journal of Family Violence.
Vol. 13, 2000. Page(s) 281-293.
Associated Keywords: Homosexuality, Spouse/Partner abuse, Violence, Sexual abuse
Finding ID: 3334
This finding looks at the relationship between homosexuality and relationship violence.
FINDING: Almost one-third (29.7 percent) of gays and nearly one-half (47.5 percent) of lesbians reported being or having been the victim of relationship violence. In addition, 22 percent of gays and 38 percent of lesbians admitted using violence against their partners.
Sample or Data Description
283 gays and lesbians
Lisa Walder-Haugrad, Linda Vaden Gratch, and Brian Magruder
"Victimization and Perpetration Rates of Violence in Gay and Lesbian Relationships: Gender Issues Explored"
Violence and Victims. Vol. 12, 1997. Page(s) 173-184.
Associated Keywords: Homosexuality, Spouse/Partner abuse, Violence, FindingID: 2690
Self-harm in homosexuals
946 young adults aged 26 in New Zealand
Homosexual men -- 3.1 times more likely to have suicidal ideation
Homosexual women -- 2.9 times more likely to have suicidal ideation
Homosexual men -- 5.5 times more likely to self-harm
Homosexual women -- 1.9 times more likely to self-harm
Skegg K. Am J Psychiatry. 2003 Mar; 160(3):541-6.