Are gay teens suicide prone? New study's weaknesses show that the answer isn't as easy to come by

May 10, 1998|By Delia M. Rios

In a study just published in the journal Pediatrics and repeated in daily newspapers, gay teen-agers were "more than three times as likely" to have reported a suicide attempt than heterosexual peers - but the study, as even its lead author admits, has weaknesses that are prompting others to cast doubt on this finding.

Researchers have tried before to link suicide and sexual orientation but flawed methods led to flawed conclusions. Nevertheless, those flaws did not prevent dubious statistics from making their way into public consciousness and public policy. The primary weakness of this new study is that there is no general agreement on what constitutes a suicide attempt. In the study, it was left to the teens surveyed to define what it meant. The study also relies on self-reporting, so there was no independent verification that suicide attempts occurred. And the "validity and reliability" of the question on sexual orientation is unclear, as the authors admit, so that the population studied may not accurately reflect the true population of gay, lesbian and bisexual students in the survey.

Pediatrician Rob Garofalo, the study's lead author, argues that previous studies have been consistent with what his study shows and he stands by his work.

"I don't agree that (the weaknesses) invalidate the study," he says.

But Garofalo, who works with troubled youth, both heterosexual and homosexual, adds this: "I would like to get people to stop talking about statistical risks. My studies and previous studies show issues that have been long suspected by clinicians. We know that these kids are at increased risk.

"The question is, what are we going to do about it?"

That has been the rallying cry of advocates for gay teens for years - bolstered by disputed statistics. They've used the numbers to further their campaigns to provide gay teens with social services and school programs designed to counter ills from physical attacks by schoolmates to depression - all factors, they and some researchers have argued, that might ultimately lead a gay teen to a suicide attempt. Actress Ellen DeGeneres, in a TV interview, claimed that her "coming out" in her situation comedy was, in part, to bolster the psyches of gay teens who might be driven to suicide.

But does the fact that there are some gay teens who are troubled necessarily mean that they are more likely to be troubled than heterosexual teens? Or that those difficulties necessarily imply a risk for suicide?

As suicide risk statistics are quoted, they obscure the fact that the majority of homosexual teens - and heterosexual teens - do not kill themselves. There are, overall, 5,000 adolescent suicides in the United States every year.

"Most gay kids grow up healthy, that's something I want to stress," says Garofalo of Children's Hospital in Boston, which is affiliated with Harvard Medical School.

But he is equally sure that there is a "subset" of gay teens who are at risk for problems. Garofalo determined to embark upon his own study when he realized that there was no consensus on this.

The discussions revolving around gay teens and suicide have been so contentious within the research community that a conference was convened four years ago to address the alleged link between suicide and sexual orientation. Representatives of the national Centers for Disease Control and Prevention, the National Institute of Mental Health, the American Psychological Association, the American Association of Suicidology, and gay and lesbian advocacy and service groups dispelled any notion that there was a link.

Peter Muehrer, chief of the youth mental health program of the National Institute of Mental Health, evaluated studies for the conference. He says nothing in what he has read in this new study - despite the authors' assertions that it breaks new ground - convinces him that a link between gay teens and suicide has been shown.

Quantifying how many gay teens may be so troubled that they would consider killing themselves - and then comparing them to the general population - is a daunting and, as the editor of Pediatrics acknowledges, perhaps impossible project. The defense voiced time and again when these studies come into question gives pause - for science and for public policy.

"In common sense, do you think this group of children does not have an increase in suicide attempts?" asks Dr. Jerold Lucey, the editor of Pediatrics. "Anyone who knows anything about children and adolescents knows this is a troubled group."

But the critical question remains:

How do we know?

Are personal observations good enough to qualify as science? Are they enough to determine public policy?

The scientific obstacles in proving the assertion that gay teens are more at risk for suicide attempts, Muehrer argues, have yet to be overcome.

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