Concealment of Sexual Minority Identities in Interviewer-Administered Government Surveys and Its Impact on Estimates of Suicide Ideation Among Bisexual and Gay Men

ABSTRACT

Bisexual and gay men are at increased risk of suicide ideation. Characterizing this risk requires self-disclosure of sexual identities; however, many will conceal their identity when interviewed. The authors investigated the impact of the resulting information bias within the Canadian Community Health Survey (CCHS). Expected probabilities of disclosure were derived from a community-based survey of bisexual and gay men, stratified by sexual identity and other social characteristics. Forty percent of bisexual men and 86% of gay men were willing to disclose to CCHS interviewers. The odds of suicide ideation were higher for bisexual (odds ratio [OR] = 4.91) and gay (OR = 3.63) men compared to heterosexual men. After bias analysis these disparities remained significant but were attenuated, with greater attenuation for bisexual (adjusted OR = 3.53) than for gay (adjusted OR = 3.52) men. The authors recommend that researchers continue exploring bias in estimated sexual minority health disparities, and that population surveys be more inclusive of bisexual-identified individuals.

KEYWORDS:

• LGB
• men
• sexual identity
• disclosure
• research methods
• sampling

Funding

The Sex Now survey is funded by the Vancouver Foundation. This research was supported by funds to the Canadian Research Data Centre Network (CRDCN) from the Social Sciences and Humanities Research Council (SSHRC), the Canadian Institute for Health Research (CIHR), the Canadian Foundation for Innovation (CFI), and Statistics Canada. Although the research and analysis are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada. Travis S. Hottes is supported by a Vanier Canada Graduate Scholarship. David J. Brennan is partially funded by an Ontario HIV Treatment Network Applied HIV Research Chair.

Additional information

Notes on contributors

Travis Salway Hottes

Travis Salway Hottes, MSc, is a doctoral student in epidemiology at the Dalla Lana School of Public Health, University of Toronto. His research interests include social epidemiology, community-based research, and the health of gay, lesbian, bisexual, and transgender people.

Dionne Gesink

Dionne Gesink, PhD, is an associate professor in the Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto. Her research focuses on the social epidemiology of sexual health and is grounded in relational and community based participatory research principles.

Olivier Ferlatte

Olivier Ferlatte, PhD, is a postdoctoral fellow in the School of Nursing at the University of British Columbia in Vancouver, Canada. His research is focused on gay and bisexual men's social and health inequities.

David J. Brennan

David J. Brennan, MSW, PhD, is an associate professor at the Factor-Inwentash Faculty of Social Work, University of Toronto. He holds an Ontario HIV Treatment Network Applied HIV Research Chair in gay and bisexual men's health and is the director of the CRUISElab, a social science lab focused on gay and bisexual men's health. Dr. Brennan's research focuses on issues related to the health and wellness of gay and bisexual men, particularly as it relates to data collection methods and the use of online spaces and tools.

Anne E. Rhodes

Anne E. Rhodes, PhD, is an associate professor in the Division of Epidemiology, Dalla Lana School of Public Health, and the Department of Psychiatry, at the University of Toronto. She is also affiliated with the Institute for Clinical Evaluative Sciences in Toronto, the Department of Psychiatry and Behavioural Neurosciences at McMaster University in Hamilton, and the Offord Centre for Child Studies in Hamilton. Dr. Rhodes's program of research is focused on better understanding the causal pathways to suicidal behaviours in youth to aid prevention efforts.

Rick Marchand

Rick Marchand, PhD, is managing director of the Community-Based Research Centre for Gay Men's Health in Vancouver.

Terry Trussler

Terry Trussler, EdD, is research director at the Community-Based Research Centre for Gay Men's Health and Principal Investigator of the Sex Now periodic survey.