Sexual Orientation Differences in Lethal Methods Used in Suicide: Findings From the National Violent Death Reporting System

Abstract

We examined sexual orientation and sex differences in seven methods of suicide among adult suicides reported in the United States National Violent Death Reporting System (2012–2015; N = 59,075). Overall, most sexual minorities (i.e., lesbians, gay men, bisexuals) identified in the dataset used hanging (38%) followed by firearm (30%) and drug or poison ingestion (20%). Sexual minorities were more likely than heterosexuals to be younger, female, and Black/African American. Multivariate sex-stratified analyses in the overall sample showed that strong sexual orientation differences in lethal methods existed among men but not among women. However, when we compared sex differences in lethal methods among sexual minorities only, we found that lesbian/bisexual women, as compared to gay/bisexual men, were more likely to use a firearm or drug or poison ingestion than hanging. Findings suggest that the higher rate of suicide mortality among sexual minorities is likely driven by hanging, a method of suicide that is not particularly amenable to lethal method restricted-access prevention approaches. Future research directions, clinical training recommendations, and intervention opportunities are discussed.

Keywords:

• Death records
• firearm
• hanging
• mortality
• overdose

Additional information

Funding

This study was partially supported by the UCLA School of Public Health Gun Violence Prevention Pilot Grant (K.A. Clark) and the National Institute of Mental Health [S.D. Cochran; R21MH115344] and the National Institute of Minority Health and Health Disparities [V.M. Mays P60 MD006923].

Notes on contributors

Kirsty A. Clark

Kirsty A. Clark, Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

Vickie M. Mays

Vickie M. Mays, Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA, Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA, BRITE Center for Science, Research, and Policy, University of California, Los Angeles, Los Angeles, CA, USA.

Onyebuchi A. Arah

Onyebuchi A. Arah and Leeka I. Kheifets, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

Leeka I. Kheifets

Onyebuchi A. Arah and Leeka I. Kheifets, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

Susan D. Cochran

Susan D. Cochran, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA; BRITE Center for Science, Research, and Policy, University of California, Los Angeles, Los Angeles, CA, USA.