Bisexual women 3 times more likely to attempt suicide compared to straight women: Canadian study

WARNING: This story includes discussion of suicide.

In the first study of its kind to tie survey data to health records, researchers found that bisexual women were three times more likely to attempt suicide compared to heterosexual women.

Gay men and lesbians were also twice as likely as straight people to attempt or die by suicide, according to the study.

The data provides a more comprehensive look at the mental health challenges facing the LGBTQ2S+ community in Canada, and which demographics may be most in need of support, researchers say.

“We wanted to better characterize the disparity in suicide-related behaviors across sexual orientations and gender,” Antony Chum, a Faculty of Health assistant professor and Canada Research Chair in Population Health Data Science at York University, said in a press release. “Prior research on suicide attempts has mostly relied on self-reported data from surveys, which means we don’t have information on people who are too sick to participate or have died by suicide.”

In order to get a broader picture beyond self-reported data, researchers looked at health records for more than 123,000 individuals in Ontario, which were linked to the Canadian Community Health Survey, which provided data on demographics such as sexuality and neighbourhood.

The health records included details such as emergency room visits or hospitalizations for non-fatal self-harm, as well as fatal suicide events between 2002 and 2019.

Researchers included suicide attempts and fatal suicide events together as suicide-related behaviour (SRB) to measure which groups were struggling with suicidality at the highest rates.

After researchers adjusted for age, they found that there were 163 fatal or non-fatal suicide attempts among bisexuals for every 100,000 people, according to a video accompanying the study. There were also 75 instances of SRB among gay men and lesbians for every 100,000 people, compared to 39 instances of SRB among heterosexuals for every 100,000 people.

The study, published Wednesday in the American Journal of Psychiatry, showed that when the sample was split by gender, the results became more pronounced.

“Depending on gender, bisexuals had between two to 3.4 times greater risk of SRB compared to heterosexuals, while gay and lesbian individuals had between 2.1 to 2.2 times greater risk,” Gabriel John Dusing, a post doctoral fellow at York University and one of the co-authors, said in the video.

This study comes not only at the beginning of Pride month, which is dedicated to celebrating LGBTQ2S+ lives, but also amid what lawmakers have called a “rising tide of targeted hate and violence” against the LGBTQ2S+ community. The latest Statistics Canada figures show a 64 per cent increase in hate crimes targeting sexual orientation, and the federal government has said it will increase funding for Pride events this month in order to help cover increased safety and security costs.

Those in the LGBTQ2S+ community face higher degrees of depression, anxiety and suicidality than the general population, and previous research has found that this is often tied to feelings of not being accepted by the larger society, as well as the strain of dealing with homophobia or transphobia aimed at them by society.

Researchers in this new study cited a 2018 survey on safety in Canada found that gay, lesbian and bisexual Canadian were twice as likely as heterosexual Canadians to have reported facing harassment in public, online, or at work.

The higher risk of suicidality found by this study among bisexual women could be due to a combination of factors, Chum said.

“(It) could be attributed to greater discrimination that bisexual people face within the LGBTQ+ community, as well as higher rates of violence, trauma, and caregiving burden that bisexual women may experience in opposite-sex relationships.”

Previous research by the same team had found that living in an under-resourced neighbourhood and being part of a sexual minority were two separate risk factors for increased SRB.

The study, which received funding from a Canadian Institutes of Health Research project grant, is limited by the fact that it only looked at sexual orientation, and only included data on gay, lesbian and bisexual individuals, meaning that non-binary, transgender, asexual and other members of the LGBTQ2S+ community were not included. It also assumes that the sexualities of participants remained stable across the follow-up period, which means that some participants may have been falsely labelled as heterosexual due to not coming out earlier in life. 

But the fact that this study pairs survey data with actual health and death records marks a step forward in research on LGBTQ2S+ mental health struggles, researchers say.

A big hurdle in trying to quantify how much a group struggles with suicidal behaviour is survivorship bias: when the data is compiled only through self-reported surveys, it leaves out a huge swathe of people who have died by suicide and aren’t around anymore to talk about their experiences.

“The study shows a clear need for better funding, policy and programming to address LGBTQ+ suicide risk,” says Chum. “We also need increased training for healthcare workers to address LGBTQ+ suicide risk. Further, we want to encourage hospitals and clinics to collect sexual orientation data as part of routine patient care.”

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If you or someone you know is in crisis, here are some resources that are available.

Canada Suicide Prevention Helpline (1-833-456-4566)

Centre for Addiction and Mental Health (1 800 463-2338)

Crisis Services Canada (1-833-456-4566 or text 45645)

Hope for Wellness Helpline (English, French, Cree, Ojibway and Inuktitut): 1-855-242-3310

Embrace Life Council hotline: [phone]

Kids Help Phone [phone])

If you need immediate assistance call 911 or go to the nearest hospital.