Purpose

This study describes changes in proportions of lesbian, gay, bisexual, transgender, and other gender/sexual minorities (LGBTQ+) among total deaths by suicide in American 11–29 year olds between 2014 and 2019.

Methods

Data came from the Centers for Disease Control and Prevention's (CDC) National Violent Death Reporting System (NVDRS). All cases classified as deaths by suicide since 2014 that had valid data for sexual orientation or transgender identity were included from states that started participating in NVDRS before 2016. The latest year of data available was 2019. Valid n = 4,086, including 673 LGBTQ+ cases. Analyses used “reverse regression” with gender/sexual orientation as the dependent variable, essentially estimating contributions of timing of fatal self-injury and other variables to relative risk of a case being LGBTQ+.

Results

The proportion of decedents who were LGBTQ+ increased between 2014 and 2019. Post-hoc analyses suggested an inflection point or break in the trend at November 9, 2016. The proportion of decedents who were LGBTQ+ increased from 13% before to 20% after that date, driven largely by increases from 2.0% to 6.5% among transgender youth and from 0.5% to 1.7% among those described in medical examiner and law enforcement reports as “struggling” or questioning. Asian bisexual females and gay males were especially overrepresented.

Conclusions

Previous research found that the policy environment affects LGBTQ+ youths' mental health; this study generalizes those findings to actual deaths by suicide. LGBTQ+ youth at risk should be assessed for anxiety, trauma, and perceived physical threat from the political and rhetorical environment.

中文翻译：

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2014-2019 年女同性恋、男同性恋、双性恋、跨性别、酷儿、质疑和其他性别/性少数 (LGBTQ+) 青年中的自杀死亡趋势

目的

本研究描述了 2014 年至 2019 年间美国 11-29 岁自杀死亡总人数中女同性恋、男同性恋、双性恋、跨性别和其他性别/性少数群体 (LGBTQ+) 比例的变化。

方法

数据来自疾病控制和预防中心 (CDC) 的国家暴力死亡报告系统 (NVDRS)。自 2014 年以来，所有具有有效性取向或变性身份数据的自杀死亡病例均来自 2016 年之前开始参与 NVDRS 的州。可用数据的最新年份是 2019 年。有效n  = 4,086，包括 673 例 LGBTQ+ 病例。分析使用以性别/性取向为因变量的“反向回归”，主要估计致命自伤的时间和其他变量对病例为 LGBTQ+ 的相对风险的贡献。

结果

LGBTQ+ 死者的比例在 2014 年至 2019 年期间有所增加。事后分析表明，2016 年 11 月 9 日是趋势的拐点或突破点。LGBTQ+ 死者的比例从之前的 13% 增加到之后的 20% ，主要是由于跨性别青年从 2.0% 增加到 6.5%，在体检医师和执法报告中描述为“挣扎”或质疑的人从 0.5% 增加到 1.7%。亚洲双性恋女性和男同性恋者的比例特别高。

结论

以往研究发现，政策环境影响LGBTQ+青少年的心理健康；这项研究将这些发现推广到实际的自杀死亡。应评估处于风险中的 LGBTQ+ 青年是否存在焦虑、创伤以及来自政治和修辞环境的身体威胁。