No One Knows How Many L.G.B.T.Q. Americans Die by Suicide

Corey Russo, the chief death investigator in Utah, is used to asking strangers questions about the most harrowing moments of their lives. When she appears at the scene of a homicide, a homicide or any other type of unexpected death, her job is to interview complainants about how the deceased lived.

how old were they? What was his caste? did he have a job? Was he ever hospitalized for psychiatric issues? How were they feeling that morning?

Over the years, she’s added new questions to the list: What was his sexual orientation? What was his gender identity?

M / s. Russo, who works at the medical examiner’s office in Salt Lake City, is one of relatively few death investigators nationwide who are routinely collecting such data, regardless of the sexuality or gender identity surrounding a person’s death. may be relevant to the circumstances of ,

She recalled the recent suicide of a young man who died in an older adults home. During her interviews, Ms. Rousseau learned that the man had been living with them for a year, ever since his family had thrown him out of their home because he was gay. He was battling emotional turmoil and drug addiction.

“It was heartbreaking to hear,” said Ms. Russo, a homosexual who has lost loved ones to suicide. “In that case, it was very relevant to understand that piece,

Studies of LGBTQ people show that they have higher rates of suicidal thoughts and suicide attempts, factors that greatly increase the risk of suicide.

But because most death investigators don’t collect data on sexuality or gender identity, no one knows how many gay and transgender people commit suicide each year in the United States. The information vacuum makes it difficult to adapt suicide prevention efforts to meet the needs of those most at risk and to measure how well the programs work, the researchers said.

The absence of data now is especially unfortunate, he said, when assumptions about suicide rates among LGBTQ groups often feature in high-stakes political debates. Some LGBTQ advocates have warned that banning gender-affirming care for transgender minors would lead to more suicides, while some Republican lawmakers have claimed that suicide deaths are rare.

Utah, which like many mountain states high rate of suicide mortalityhas been at the forefront of efforts to collect such data since 2017, when its state legislature passed a law Compulsory detailed investigation of suicides.

“Lawmakers were asked to respond to the suicide crisis in our state,” said Michael Staley, a sociologist assigned to lead the data-collection effort in the Utah medical examiner’s office. “It’s a five-alarm fire.”

In the months that followed, investigators like Ms. Russo appears in a death scene, Dr. Staley’s six-person team conducts “psychological autopsies,” contacting family members of everyone who has died of suicide or drug overdose in the state to obtain detailed information about the deceased’s life.

Such data – which includes sexual relationships and gender as well as housing, mental health, drug problems and social media use – can be used to help understand the complex array of factors that influence people’s lives. Contribute to the decisions to end the life of Dr. Staley said. He plans to release a report later this year, describing interviews with the families of people who have died by suicide in Utah in the past. five years.

For children and adolescents who die by suicide, the team interviews not only the parents and guardians, but also a number of close friends. In some cases, Dr. Staley recalled, friends knew about the deceased’s sexuality, gender or drug use struggles that the parents did not.

These conversations can be extremely difficult. John Blonich, head of a research initiative called the LGBT Mortality Project at the University of Southern California, has roped in to observe and train death investigators on the importance of collecting data on gender and sexuality. Their training helps investigators overcome distress or stigma surrounding questions from friends and relatives of the deceased.

“They’re talking with families who are in shock, who are angry, who are sometimes catatonic because of their loss,” Dr. Blasnich said.

So far, Dr. Blonich has trained investigators in Utah, Nevada, Colorado, New York, and California, where a 2021 state law Launched a pilot program to collect data on sexual orientation and gender identity. recently Study Of 114 investigators in three states, Dr. blonich informed of that only about 41 percent had asked directly about the deceased person’s sexual orientation prior to the training, and just 25 percent had asked about gender identity.

Medical examiners send reports of homicides and suicides to the Centers for Disease Control and Prevention, which maintains a database Violent deaths tally with comprehensive demographic, medical and social information, including toxicology tests, mental health diagnoses and even stories of financial and family hardships. but a study of more than 10,000 suicides Found among young adults reported to the CDC database, only 20 percent included information about the decedent’s sexuality or gender identity.

Another agency in the Department of Health, the Office of the National Coordinator for Health Information Technology, is trying to set new standards that would require any hospital that chooses to ask its patients about their sexuality and gender identity. Receives federal funds for.

Death investigators “are limited by the fact that they can’t ask the person questions,” Dr. John Auerbach, who worked on standardizing questions about sexuality and gender at the CDC from 2021 to 2022. If doctors were regularly talking to their patients about sexuality and gender identity, that information could also help answer other public health questions, such as the relative risk of cancer or diabetes in the LGBTQ community concerned. Doctor. Orbach said.

But that approach has its limits. Patients may not feel comfortable disclosing that information to their doctors. And people who don’t interact with the health care system may be at particularly high risk of suicide.

LGBTQ advocates said that obtaining the data had become more urgent over the past few years, as states across the country have placed restrictions on many aspects of life for gay and transgender people.

“With the lack of data, it’s very easy to dismiss us,” said Casey Pick, director of law and policy at The Trevor Project, a nonprofit focused on suicide prevention among LGBTQ youth that has lobbied at the state and federal level. Start collecting data.

“I’ve heard it many times: Lawmakers and public witnesses at hearings suggest that the LGBTQ community is crying wolf over suicide because we don’t have the data to indicate that,” Ms. Pick said.

It’s also important to accept the unknown, Dr. Staley said. Although studies have reported higher rates of suicidal thoughts and suicide attempts among gay, lesbian, and transgender people, this does not necessarily mean higher rates of suicide. They noted that although women have a higher rate of suicide attempts than men, men have a much higher rate of death by suicide, partly because they have more access to guns.

And Dr. Staley, who is gay, cautioned against political narratives that “normalize suicide as part of the gay experience.”

“I would argue that if anything, this life experience prepares us to be resilient,” he said. “Our fate is not sealed. Our story is not written.

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline or visit speakingofsuicide.com/resources for a list of additional resources.

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