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      Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

      , PhD 1 , , PhD 2 , , PhD, MSPH 3 , , MA, MSW, MSt, MSc 4 , , PhD, MS 5 , , PhD 6 , , MD 7 , , PhD 8 , , PhD, RN, FAAN 9 , , PhD 10 , , PhD 11 , , MPA 12 , , PhD, MSW 13 , , OD 14 , , MD 15 , , ScD 16 , , MD, MPH 17 , , PhD 18 , , PhD 19 , , PhD 20 , , PhD 21 , , PhD, MSW, MPA 22 , , MD, MPH 23 , , MD 24 , 25 , , MD 1

      Journal of Homosexuality

      Taylor & Francis

      LGBT, risk factors, suicide, suicide attempts, suicide prevention

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          Abstract

          Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice.

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          Most cited references 159

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          Diagnostic and statistical manual of mental disorders.

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            Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

             Ilan Meyer (2003)
            In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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              Minority stress and mental health in gay men.

               Ilan Meyer (1995)
              This study describes stress as derived from minority status and explores its effect on psychological distress in gay men. The concept of minority stress is based on the premise that gay people in a heterosexist society are subjected to chronic stress related to their stigmatization. Minority stressors were conceptualized as: internalized homophobia, which relates to gay men's direction of societal negative attitudes toward the self; stigma, which relates to expectations of rejection and discrimination; and actual experiences of discrimination and violence. The mental health effects of the three minority stressors were tested in a community sample of 741 New York City gay men. The results supported minority stress hypotheses: each of the stressors had a significant independent association with a variety of mental health measures. Odds ratios suggested that men who had high levels of minority stress were twice to three times as likely to suffer also from high levels of distress.
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                Author and article information

                Journal
                J Homosex
                J Homosex
                wjhm
                Journal of Homosexuality
                Taylor & Francis
                0091-8369
                1540-3602
                4 January 2011
                January 2011
                : 58
                : 1
                : 10-51
                Affiliations
                [1 ] American Foundation for Suicide Prevention, New York, New York, USA
                [2 ] Department of Health Education, San Francisco State University, San Francisco, California, USA
                [3 ] Departments of Psychology and Health Services, University of California, Los Angeles, Los Angeles, California, USA
                [4 ] LifeWise Consulting, Bend, Oregon, USA
                [5 ] Department of Epidemiology, UCLA School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
                [6 ] College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania, USA
                [7 ] Department of Psychiatry, The University of Colorado at Denver, Denver, Colorado, USA
                [8 ] College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, Columbia University–New York State Psychiatric Institute, Division of Child and Adolescent Psychiatry, New York, New York, USA
                [9 ] Health Systems Science, and UIC National Center of Excellence in Women's Health, University of Illinois at Chicago, College of Nursing, Chicago, Illinois, USA
                [10 ] Department of Psychology, The City University of New York–The City College and Graduate Center, New York, New York, USA
                [11 ] Department of Family Studies and Human Development, University of Arizona, Tucson, Arizona, USA
                [12 ] National Center for the Study and Prevention of Youth Suicide, American Association of Suicidology, Washington, DC, USA
                [13 ] Suicide Prevention Resource Center, Education Development Center, Inc., Washington, DC, USA
                [14 ] Suicide Prevention Resource Center, Education Development Center, Inc., Newton, Massachusetts, USA
                [15 ] Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA
                [16 ] Department of Community Health and Prevention, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
                [17 ] Youth and AIDS Projects, and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
                [18 ] Center for Population Research in LGBT Health, and The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
                [19 ] Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
                [20 ] Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
                [21 ] Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
                [22 ] Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
                [23 ] Adolescent HIV Services, Howard Brown Health Center and Children's Memorial Hospital, Chicago, Illinois, USA
                [24 ] Regional Mental Health Services, The Permanente Medical Group, Inc., and Department of Psychiatry, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA
                [25 ] Queers for Economic Justice, New York, New York, USA
                Author notes

                This work has been supported by grants to the American Foundation for Suicide Prevention from the Lilly Foundation and the Johnson Family Foundation.

                The authors gratefully acknowledge the contribution of the following individuals to the 2007 Conference on LGBT Suicide and Suicide Risk: Jane Pearson, PhD, National Institute of Mental Health; Keri Lubell, PhD, Centers for Disease Control and Prevention; Maria Dinger, Substance Abuse and Mental Health Services Agency; Joel Ginsberg, JD, former Executive Director of the Gay and Lesbian Medical Association; Edward Dunne, PhD, former chair of the AFSP Survivor Council; and Edmond Yomtoob, PsyD, Janice Hurtado and Kimberly Gleason who represented the AFSP Chapters. We also thank Charles F. Reynolds, MD, President of the AFSP Board of Directors; Christian York and Lisa Riley, representatives of the AFSP Chapter Advisory Committee on LGBTQ Issues; and Dave Reynolds, MPH, Senior Public Policy and Research Manager at The Trevor Project, who reviewed and critiqued an earlier draft of the manuscript. Leanne Spaulding at AFSP deserves our special thanks for her assistance with the referencing of the paper. Finally, we deeply grateful to Robert Gebbia, AFSP Executive Director, and Andrew Lane, Executive Director of the Johnson Family Foundation, for their support and commitment to this project.

                Address correspondence to Ann P. Haas, Director of Prevention Projects, American Foundation for Suicide Prevention, 120 Wall Street, 22nd Floor, New York, NY 10005, USA. E-mail: ahaas@ 123456afsp.org
                Article
                10.1080/00918369.2011.534038
                3662085
                21213174
                Copyright © Taylor & Francis Group, LLC

                This is an open access article distributed under the Supplemental Terms and Conditions for iOpenAccess articles published in Taylor & Francis journals , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research Article

                Sexual medicine

                risk factors, suicide, suicide attempts, lgbt, suicide prevention

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