LGBT topics

Bringing youth voices out of the closet: Are you asking the right questions to help prevent suicide?

By Rosemary Hardwick. Reprinted with permission.

Definitions

For the purposes of this article, youth are defined as individuals between the ages of 14 and 25, the age range for youth defined by the World Health Organization (WHO). Lesbian, gay, bisexual, transgender, transsexual, intersex, two-spirited and questioning youth are referred to, collectively, as members of a sexual minority.

Lesbian refers to women whose primary emotional, physical, spiritual and sexual attraction is to other women.

Gay refers to men whose primary emotional, physical, spiritual and sexual attraction is to other men.

Bisexual refers to people who have emotional, physical, spiritual and sexual attractions to members of both genders.

Transgender refers to people who feel that their gender identity is different than their biological sex. Some transgender persons wish to change their anatomy to be more congruent with their self-perception while others do not have such a desire. Transgender persons can be heterosexual, gay, lesbian or bisexual (University of Minnesota, 1993). Transgender is also an umbrella term that some people use not only to include but also to unite politically all people who cross the lines of the sex and/or gender they were assigned at birth. It is not necessarily appropriate to include transsexuals in this category who, on a variety of levels, identify with the opposite gender from their biological sex (Ross, 1997).

Transsexual refers to people who cross the lines of the sex they were assigned at birth by altering their bodies (Ross, 1997). Such individuals are biologically of one sex but psychologically feel that they are of the other sex. As a result, they feel "trapped in the wrong kind of body." Transsexuals who are preparing for sex-change surgery may be conspicuous as they accustom themselves to wearing the clothing of the opposite sex and attempt to develop the appropriate mannerisms. Transsexuality is not a sexual preference, meaning that it is not a matter of sexual attraction to another person. Instead, transsexuality is a matter of self-identity or gender identity (University of Oregon, 1990).

Intersex refers to people who, without voluntary medical interventions, possess bodies that doctors cannot neatly classify as male or female. Such people may have chromosomal sex other than XX (female) or XY (male) or they may have primary or secondary sex characteristics that defy the medical definitions of male and female.

Two-spirited refers to Aboriginal people who follow First Nations traditions of homosexuality, bisexuality and/or transgenderism. The two-spirit tradition has a rich history and was widely accepted and often celebrated among almost all tribes in North America before European colonization. To many modern gays, lesbians, bisexuals and trans people, this acceptance provided a symbol of hope and a goal to strive for, while offering two-spirits a proud, vibrant history (Rainbow Youth Talk, 2004).

Questioning refers to people who have yet to fully discover the nature of their sexuality and who may eventually realize that they are straight, gay, lesbian, bisexual or transgender. This questioning period may be very short or last an extended period of time, and it may occur one or more times during a person's life (Rainbow Youth Talk, 2004).

Suicide

Suicide is not far away and abstract but up close and personal. It devastates. If we can help prevent just one needless death, we have gained a tremendous victory, particularly among the young, who still have so much to offer and to experience. It's precisely because of this youth and inexperience that many suicidal youth are not fully aware of how permanent this choice is. They fail to understand that they won’t be around to see the reaction of their friends when they hear the news; that their deaths can't be reversed; that there is no re-wind button for their actions. They don't appreciate how the feelings of loss and anguish will reverberate through the lives of their loved ones for as long as they live.

Late one afternoon last June, a 17-year-old boy jumped from his bedroom window on the thirtieth floor of a Toronto apartment building while his father, my friend, was in another room. Shortly after, my friend went to find his son, looked out the open window, and saw his son’s lifeless body below. He rushed to his side and cradled his son’s broken body until the police arrived. He then left me a frantic telephone message. I joined him soon after. I truly believe that, had this young man seen the anguish his father experienced that night, he would never have killed himself. My friend was beside himself with grief. Many policeman combed through the apartment questioning him for hours. The boy had been slightly depressed, and my friend had begun to suspect that his son was unable to tell him that he was gay. Otherwise, the boy had given no indication that he was suicidal. Once the police left, and as my friend prepared to leave, we passed by his son’s bedroom. The window was still open, and my friend asked for it to be closed. He never stayed in that apartment again and fell into a deep depression that prevented him from working. Last December, he moved out of the apartment that he had lived in since the incident. He didn't leave a forwarding address, and I haven't heard from him since.

It's extremely difficult for many sexual minority youth to "come out" to their parents, often because they don’t want to disappoint them or because they’re afraid of them. A joint 2001 report from the University of Quebec in Montreal and McGill University concluded that the suicide ideation rate for sexual minority youth in the 12 months before coming out is 75 per cent. This stress can be compounded when sexual minority youth are also members of racial, cultural, or religious minorities.

Canada has a vastly diverse population. Although people from all regions of the world and from all cultural, ethnic and religious backgrounds have made Canada their home, this has not always been the case. Canada was originally settled by Aboriginal people. In the past three centuries, the country has increasingly been under the control of white Europeans, mostly of Anglo and Franco descent, whose traditions and religious faiths, mainly Protestant and Catholic Christianity, dominated and shaped the region. These traditions and faiths, as well as those of many 20th century immigrants to Canada from other cultures, did not accept sexual minorities.

In recent decades, Canadian society has gradually become more accepting of sexual minorities:

• In 1969, the Government of Canada decriminalized consenting homosexual acts.
• In 1978, the Canadian psychiatric profession declassified homosexuality as a mental illness.
• In 1982, the Canadian Charter of Rights and Freedoms recognized the rights of minority groups.
• In 1985, sexual orientation was read into the Charter as a protected ground of discrimination.
• In 1986, the Ontario government passed Bill 7, which extended the protection of the Human Rights Code to lesbians and gays.
• Currently, the human rights statutes of all provinces and territories and the Canadian Human Rights Act have protections written into them for sexual minorities in areas of housing, employment and access to services.
• In 2003, Ontario became the first province to legally recognize same-sex marriages.
• In 2005, the Liberal government's same-sex legislation passed third reading in the House of Commons, thereby officially recognizing same-sex marriage.

Despite this progress, discrimination against sexual minorities is still widespread in Canada. As a result, members of sexual minorities are subject to hostility, bullying and violence. Heterosexual youth usually have safe places they can go, including home, church, or school, but for sexual minority youth, this is often not the case. As well, there is a lack of sexual minority role models, and sexual minority youth are inundated daily with heterosexual media images. Furthermore, sexual minority media images are often negative. The Hays Office, established in Hollywood in the 1920s, required film makers to depict members of sexual minorities as either mentally ill or criminal, a policy that remained in place until 1964. Sexual minorities are given the impression tha they are not safe with themselves, that they are somehow bad, false people, who are living a lie. Because of cognitive, emotional, and social absences, they become isolated, lack social support and have few peers.

A recent survey in London, Ontario, revealed that 98 per cent of gay high school students had suffered verbal harassment. In 1996, the Triangle Program, part of Oasis Alternative Secondary School, was established in Toronto as Canada’s only classroom for lesbian, gay, bisexual and transgendered youth who could not participate in other schools because they were harassed. In 2003, a young man had to sue his Toronto-area school board for the right to take his same-sex date to the prom, an action that garnered national media attention. In April 2004, the organization Creating Awareness of Teenage Suicide (CATS) urged Toronto's city council to review a bylaw that the City of Edmonton had adopted making bullying illegal and imposing a fine on the tormentors. The Edmonton bylaw has proven a powerful deterrent, and the number of reported incidents of harassment has dropped substantially. Although this is a positive initiative, many people still feel compelled to hide their sexual and gender orientation, a situation that leads to feelings of fear, guilt and shame, and, all too often, to suicide.

The impact of discrimination on sexual minority youth is especially devastating. Pierre Tremblay, coauthor of the 1996 Alberta report The Gay, Lesbian & Bisexual Factor in the Youth Suicide Problem, said that it’s not surprising young gays attempt suicide: "They’re in a world where the message is just hatred—and kids are really sensitive to that—of knowing that if anyone knew what they are, they’re toast." Tremblay also found that "accurate statistics of gay, lesbian and bisexual youth deaths from suicide are unavailable, mostly because these youngsters often tell no one their problems, and the ones who survive suicide attempts often deny their homosexual orientation to mental health professionals."

Neither the government nor any other social service or health organization in Canada keeps statistics on the rate of suicide among sexual minority youth in Canada. Although these statistics might be difficult to attain, the attempt should certainly be made. Accurate and relevant statistics would be invaluable in determining the magnitude of the problem and the number of resources that should be directed at combatting the devastating reality of suicide among sexual minority youth. As well, the omission of these particular statistics raises the possibility that systemic discrimination and homo/bi/trans-phobia exists throughout social services and government agencies.

In 2002, Anton A. Leenaars, national representative of the International Association for Suicide Prevention (IASP), made the following observation:

In many countries, suicide ranks among the top ten causes of death—this is true in Canada. The World Health Organization (WHO) stated that by the year 2020, 1.5 million people will kill themselves annually worldwide. The WHO has, in fact, made suicide prevention, along with public prevention of malaria and tobacco-related diseases, the top priorities for the first decade of this millennium. The WHO started the WHO initiative on Suicide Prevention. … A hallmark of these efforts is the development of national strategies. Many countries have started such initiatives … Canada, however, has none. It is regrettable because its suicide rate is even higher than its neighbor, the USA — in young males, it is 50 to 60 per cent higher. … Despite the Canadian government's inertia, public advocacy continues. … Preventionists in Canada are determined. … The taboo continues—maybe it is not okay to ask the bureaucrats in Ottawa, "How many young people are we going to allow to die needlessly?"

Leenaars continues: "Many others could tell more important stories; our native people could, for example, tell how they were relegated as a topic to an appendix of the 1994 edition of Suicide in Canada." Ironically, the Centre for Suicide Prevention in Calgary dedicates only two paragraphs in the appendix of its otherwise excellent resource Aboriginal Youth: A Manual of Promising Suicide Prevention Strategies to the topic of sexual orientation or two-spirited issues. The Aboriginal community has inadvertently done to sexual minorities in its 2003 report what the government had done to the Aboriginal community in its 1994 report. Nevertheless, this report contains relevant information, strategies and contact data specific to the Canadian Aboriginal community:

Today the suicide rate among Aboriginal people is approximately three times higher than the rate for the general Canadian population. In fact, suicide now represents the greatest single cause of death in this population. … It is estimated that suicide accounts for more than a third of all deaths among young Aboriginal people. Young Aboriginal girls are 7.5 times more likely to die by suicide than the average Canadian adolescent girl, while Aboriginal male adolescents are five times more likely to die by suicide than their average counterparts. Young Aboriginal males between the ages of 15 and 29 are most at risk for suicide, with the highest rates of suicide of any group in Canada. … Traditionally, two-spirited persons were valued in many Aboriginal communities as they were considered to have a great gift of vision that went beyond most people’s abilities. Two-spirited people were not only considered normal but a crucial and much-needed part of the natural world and the community as a whole. Like the non-Aboriginal community, First Nations, Inuit, and Métis communities have grown to fear and reject members who are sexually different. As a result, most two-spirited and transgender Aboriginal young people live with high levels of discrimination and intolerance that often prompt them to leave their community and move to a larger urban setting where they experience loneliness, isolation and are vulnerable to victimization. We know that gay, lesbian and bisexual youth are at greater risk for suicide problems than their heterosexual counterparts. Recent studies in Canada and the United States suggest that homosexuality issues are involved in up to one-third of young men under 24 who die by suicide. Relevant data also suggest that Aboriginal gay youth are often subjected to high levels of homophobia and have serious suicidal problems.

In 1997, Project Affirmation of the Coalition for Lesbian and Gay Rights in Ontario released Systems Failure: A Report on the Experiences of Sexual Minorities in Ontario’s Health-Care and Social-Services Systems. The report reached the following conclusion:

It is crucial that recommendations be implemented to improve the access to service of lesbian, gay and bisexual youth. A December 1989 study from the Village Clinic in Winnipeg found that 25 per cent of lesbian and gay youth had attempted suicide, most for reasons related to their being gay. This echoed the slightly earlier finding of the US government's Department of Health and Human Resources, which estimated that lesbian and gay youth accounted for more than 30 per cent of all US suicides….The work of Project Affirmation confirms what the lesbian, gay, bisexual, transgender, and transsexual communities have known for a long time: they do not get the service for which they pay and to which they have a right. They are expected to contribute to society but not to benefit from it. This report calls for much-needed changes. It is time for healthcare and social services systems to begin to respect the principles of fair and just treatment—for everyone.

Factors influencing the risk of suicide

Stage-setting factors

These are factors, such as a family history of suicide, that make a person more vulnerable to suicide.

Contributing factors

These are factors such as physical, emotional, and/or sexual abuse and being a member of a sexual minority, that heighten the existing risk.

Trigger factors

These are factors such as feelings of disconnection, abandonment or rejection that can trigger predisposed persons to attempt suicide. Other triggers than can prompt youth belonging to a sexuality minority to attempt suicide include these:

• questioning but being unable to articulate
• feeling different from the accepted heterosexual norm
• experiencing the ending of a relationship
• being shocked at having a crush on someone of the same sex
• feeling like the wrong gender trapped inside a body
• being bullied at school for being a butch dyke, tom boy, nancy boy, fairy, poof, fag, or queer
• being the butt of jokes, graffiti, and hate crimes
• experiencing the death or suicide of someone close or of an idol or role model
• not having a voice
• having an argument at home
• getting into trouble at home or at school or being apprehended by the police
• being physically, sexually or emotionally abused
• being confused over sexuality and having no role models
• being rejected due to one’s sexual orientation or gender identity
• using drugs and/or alcohol as a coping mechanism to deal with the stigma of belonging to a sexual minority
• feeling shame, guilt or self-loathing about one’s sexual identity or gender identity

Protective factors

These factors, such as the availability of at least one significant adult who can provide warmth, care and understanding, are conditions that lessen the risk of suicide. Other factors that may protect youth against suicide are these:

• feeling connected to family and school.
• having good problem-solving skills and the ability to cope with or overcome difficulties.
• being in good physical and mental health.
• having a strong religious faith or believing that life has a meaning or purpose.
• feeling part of a community and participating socially.
• having a close friend, preferably an adult.

What individuals can do to help suicidal youth

The following advice for helping suicidal youth who belong to a sexual minority is adapted from information published by the Ottawa chapter of Parents and Friends of Lesbians and Gays (PFLAG).

In some ways, we as a society have been slowly killing children from a sexual minority over a period of years. Their suicides merely finish the job that we started. We as family members, school and youth-agency personnel, institutional policy makes, governmental agents, and religious lay people and leaders can change this destructive atmosphere. Educating ourselves about lesbian and gay youth suicide is an important beginning. Here are some things that we can do:

• Encourage individual and institutions such as schools, scouts, 4-H clubs and churches to show respect to all youth including lesbian and gay youth.
• Make clear that abusive language and actions will not be tolerated.
• Inform ourselves and our youth about the wide ranges of sexual experience.

Make it safe for gay and lesbian adults, including teachers and others who work with youth, to be open about their own sexual orientation without fear of discrimination or loss of employment.

Visible displays of acceptance of sexual minority youth are also important. Don’t make youth ask if you're accepting because too many of them won't. For example, you could display a "safe zone" or "positive space" sticker to indicate to sexual minority youth that they can feel safe and accepted in a compassionate environment. Some of these stickers feature pink triangles or rainbows, both well-known symbols in the sexual minority community. This visibility can have immediate and positive consequences.

Ryan McCaffrey, a heterosexual athlete who started a Safe Zone program at his high school in Brookfield, Connecticut, stated: "People speak first and think later. All prejudice stems from ignorance. When we got this topic out in the open and people heard about it, they opened their minds, listened and got educated." During the national media attention garnered by the Safe Zone program at Brookfield High School, McCaffrey received a phone call from a parent whose son committed suicide because he was gay. The father told McCaffrey that, if a Safe Zone program had existed in his son’s high school, he believed that his son might still be alive. Afterward McCaffrey reflected, "Until then, I never realized the effect this could have."

Because sexual orientation is not a visible identity, the true impact of Safe Zone programs may never be truly measured.

What schools can do to help suicidal youth

• Address sexual orientation and gender identity issues from kindergarten on.
• Evaluate how accepting they are to youth from a sexual minority.
• Create a checklist for assessing whether they foster phobias about being homosexual, bisexual or transgendered.
• Develop inclusive policy statements.
• Provide sexual minority educational resources in school libraries.
• Highlight positive sexual minority role models.
• Include the study of sexual minorities in the curriculum in such subjects as English, History or Family Studies.

Future responses will need to flexible and creative. Reframing the inevitable social and political changes will enable us to see them as opportunities rather than as crises.

Additional resources

• Canadian Institutes of Health Research
• International Association for Suicide Prevention
• Centre for Suicide Prevention (Calgary)
• EGALE Canada (Ottawa)
• Toronto Suicide Information Alliance (tsia@rogers.com)
• Creating Awareness of Teenage Suicide