Study shows B.C.'s at-risk LGBTQ adolescent girls safer in progressive communities

Research led by the UBC school of nursing has determined that progressive political attitudes and supportive communities resulted in lower reported rates of self-harm and suicidal ideation by bisexual and lesbian girls in B.C. communities.

The analysis took in data from the 2013 British Columbia Adolescent Health Survey—in which suicide attempts, self-harm behaviors, and suicidal thoughts were reported by sexual-minority students, among other facts—and from community-level supportive environments and the results of the 2013 B.C. provincial elections.

Survey responses from 2,678 self-identified LGB and heterosexual students (69 percent of which were girls) from 274 schools represented (in weighted models) an estimared 24,624 sexual-minority students in B.C. schools.

UBC nursing professor Elizabeth Saewyc, who is also diector of UBC's Stigma and Resilience Among Vulnerable Youth Centre, is lead researcher for the study, published recently in the journal Preventive Medicine. Both the Canadian Institutes of Health Research and the U.S. National Institutes of Health contributed funding for the analysis, and UBC postdoctoral research fellow Gu Li and researchers from the University of Minnesota, the University of Connecticut, and San Diegio State University were involved.

In the study's introduction, the authors noted that World Health Organization research places the annual worldwide death toll by suicide at about 800,000. They also stated that suicide is one of the leading causes of death (24 percent) among youth aged 15 to 24 in Canada. Because of this, "it is important to study its immediate precursors among adolescents, collectively known as suicidal behavior (e.g., suicidal ideation, nonfatal suicidal attempts, and nonsuicidal self-harm behaviors). To develop effective prevention and intervention programmes, it is also important to identify individual differences in suicidal behavior, as well as risk and protective factors."

Community supports for LGBTQ youth considered in the study included LGBTQ drop-ins, meetings for families, allies, and friends of LGBTQ youth, supportive health services, anti-bullying initiatives, and Pride parades.

According to the published study abstract, disparities between community attutudes toward heterosexual and LGBTQ youth promped the research: "Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada."

Overall, the researchers found that the more community supports in an area—including groups, events, and services—the fewer the reports of self-harm or suicidal thoughts or attempts when compared to communities with fewer such assistances, especially among bisexual and lesbian girls. They also discovered that the same girls reported fewer incidents of self-harm or suicidal thoughts in communities where more people voted NDP in the 2013 provincial election.

“The impact of stigma and discrimination continues to put the health of LGBTQ youth at risk, but this risk isn’t equal everywhere in B.C.,”  UBC's Saewyc said in a July 28 university release. “Our research found that where lesbian, gay and bisexual youth live—their community environment, and the kind of LGBTQ-inclusive supports that are or aren’t there—appears to play a role in their odds of suicidality and self-harm.”

Adolescent girls who self-identified as bisexual or lesbian appeared to benefit the most from the models used in the data analysis, according to the paper. "Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation...and suicidal attempts...and significantly lower self-harm behaviors....Further, progressive political climates predicted marginally significant lower suicidal ideation...and significantly lower self-harm behaviors....For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys."

The researchers had this to say about why their analysis showed that community LGBTQ supports and progressive political climates seemed to help girls more than boys: 

"It is unclear why sexual minority girls appear to have benefited more from supportive environments than boys in our data, but we offer a few possibilities: First, sexual minority girls had a higher incidence of suicide behavior than did sexual minority boys, so there is a larger room for improvement among sexual minority girls. Second, sexual minority girls may be more disadvantaged within social climates than sexual minority boys, dealing with the intersections of structural sexism as well as homophobia or biphobia (Meyer et al., 2011; Daley et al., 2007). Subsequently, when a community is supportive, sexual minority girls may respond more strongly to the difference. Further research is needed to identify environments that also support sexual minority boys."

Finally, the paper's authors concluded that politicians, policymakers, and youth workers should get behind more LGBTQ-friendly resources for youth.

"Our findings suggest progressive policies and community attitudes, as well as greater numbers of safe and supportive community spaces, are associated with lower levels of risk for suicide and self-harm among a population that has disproportionately high risks of such mental health challenges. The findings further support the case for stigma and discrimination as a key driver of the disparities experienced by sexual minority youth health. Clinicians, policymakers, and those who work with youth should advocate for more LGBTQ friendly clinical and social resources, and support events such as Pride celebrations or Transgender Day of Remembrance events, in order to provide a safer, more supportive social climate for LGBTQ young people, to more clearly affirm they are welcome and wanted in each community."