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Disparities in suicide-related behaviors across sexual orientations by gender: a retrospective cohort study using linked health administrative data


Objective — The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals.

Methods — Data from a population-based survey (N=123,995) were linked to health administrative data (2002–2019), and differences in time to suicide-related behavior events across sexual orientations were examined using Cox proportional hazards regression.

Results — The crude incidence rates of suicide-related behavior events per 100,000 person-years were 224.7 for heterosexuals, 664.7 for gay/lesbian individuals, and 5,911.9 for bisexual individuals. In fully adjusted (gender-combined) models, bisexual individuals were 2.98 times (95% CI=2.08–4.27) more likely to have an event, and gay men and lesbians 2.10 times (95% CI=1.18–3.71) more likely, compared with heterosexual individuals.

Conclusions — In a large population-based sample of Ontario residents, using clinically relevant outcomes, the study found gay/lesbian and bisexual individuals to be at elevated risk of suicide-related behavior events. Increased education among psychiatric professionals is needed to improve awareness of and sensitivity to the elevated risk of suicide-related behavior among sexual minority individuals, and further research on interventions is needed to reduce such behaviors.



Chum A, Kim C, Nielsen A, Dusing GJ, O’Campo P, Matheson FI, Barker L, Vigod S, Ling V, Fung K, Kennedy H, Kennedy S. Am J Psychiatry. 2023; Jun 7 [Epub ahead of print].

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