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American Adolescents Rejecting Their Sexual Orientation Have a 70% Higher Risk of Suicide

(Blogmensgo, gay blog March 26, 2018) A study by the American CDC (Centers for Disease Control and Prevention of Atlanta (Georgia), under the direction of Francis B. Annor and recently published in the American Journal of Preventive Medicine, shows that American adolescents who do not live their sexual orientation have a suicide risk of 46.3% – compared to 22.4% for those who live in harmony with their sexual orientation. According to statistical weighting and adaptation, these young people with a “sexual orientation discordance” have a 70% higher probability of suicidal thoughts or attempts than their peers who live their sexual orientation.

A unique study

Scope of the study

Francis Annor and his team had developed a 99-element questionnaire that was completed by 15,624 students from public and private schools in grades 9 to 12 in all 50 states plus Washington, DC. They then selected a sample of 6,790 gay or heterosexual students who had already had at least one sexual encounter.

The Atlanta researchers believe that this study is the first to focus on the risk of suicide among young Americans. Similar studies had so far focused on the general population (especially adults). In a sense, it is the first study to statistically refine the methodological definition of sexual orientation and to investigate the relationship between discordant sexual orientation and the risk of suicide among American teenagers (see below for details).

The questionnaire contained two questions on sexuality and three on suicide.
Respondents first had to define their own sexual identity (gay, straight or bisexual) and then the sexual identity of their current or former partners (always of the same sex, always of the opposite sex or of both sexes). The term “discordant sexual orientation” refers to sexual behavior that does not correspond to sexual identity, i.e. when gays or lesbians have sex with a person of the opposite sex or with persons of both sexes, or when a heterosexual has sex with persons of the same or both sexes.
Suicide risk refers only to the 12 months prior to completion of the questionnaire (2017) and ranges from a simple thought of suicide to the preparation of suicide and attempted suicide.

Key findings

The researchers assumed that there were three factors in sexual orientation: Sexual identity (homo/hetero/bi), sexual behavior and sexual attraction. Discordant sexual orientation describes the contradiction between two factors, with the Atlanta team focusing on the discrepancy between sexual identity and “sexual contacts”.

Of the 6,790 students in the sample, a total of 3.9% had discordant sexual orientation. Among the 2.2% of gay or lesbian students, however, the rate is 31.9%, whereas in the 97.8% of heterosexual students, it is only 3.3%.

The most notable difference is the high suicide risk factor, which affects girls (29.5% of the female panel) more than boys (18.4% of the male panel). The risk among homosexual adolescents is twice as high as among heterosexuals (45.9% versus 22.8%). The breakdown by sexual orientation makes the difference even clearer, as the high risk affects 46.3% of people with discordant sexual orientation and only 22.4% of those with concordant sexual orientation.

Two factors seem to increase the risk of suicide: First, bullying at school (risk of suicide among bullying victims 42.2%, compared with 22.4%). Secondly, physical violence, i.e. forced sexual intercourse. The risk of suicide among rape victims is 51.4% (one in two!), compared to only 20.3% among those who were not forced (or raped).

Alarming but valuable insights

The authors of the study believe that their statistics are comparable to similar studies on the adult population. Certain variables (depression, alcoholism, drug use) are more common among people with discordant sexual orientation and suicidal tendencies, both adolescents and adults. But the Atlanta researchers merely show the simultaneous occurrence of these three variables without suggesting any real causality.

On the other hand, Francis B. Annor’s team suggests that students with discordant sexual orientation suffer from social discrimination, stigmatization, up to complete rejection and risk to internalize them. It is therefore necessary to create a safer environment and a more inclusive school environment for sexual minorities. Ideally, sexual diversity should be promoted and better accepted, and there should be less discrimination.

Some methodological weaknesses

The authors of the study admit that they did not consider the criterion of sexual attraction and therefore considered only two of the three components of sexual orientation (sexual identity, sex of partners).

They also recognize that their 2017 statistics are based on a 2015 methodology and demography (YRBS data), which is not ideal. Since this database only covers students, it does not cover the entire youth population in the United States and may not include a fairly large extracurricular LGB subgroup.

Another unanswered question is how to exactly define “sexual contact”…

The authors also acknowledge that they may have reduced the LGB rate by simply eliminating all “Don’t know” answers to sexual orientation questions. Since young people are not always sure what their sexual identity is, this is a distortion, as is the fact that they have voluntarily excluded the questionnaires of students who identify themselves as bisexual.

Finally, Francis Annor and his team recognize that it is not uncommon for teenagers at puberty to have different sexual experiences: It is part of natural exploration and self-observation that is very common at this age, but does not automatically lead to depression or discomfort.

More mistakes…

The selection of the sample also represents certain sources of error.

The study is not based on age groups but only on the class level, so that students who have skipped or doubled a class are not correctly classified. However, a year more or less can make a significant difference in a teenager's life.

The main shortcomings of this study are statistical: the researchers did not carry out a statistical classification, so that the final sample shows an over-representation of blacks and Hispanics, according to which the results should actually be adjusted.

Nor has such an adjustment been made with regard to gender distribution, so that the data shows a strong gender imbalance (56% of boys and 44% girls).

The final sample includes only 194 students who consider themselves gay or lesbian and 311 students with discordant sexual orientation. In view of the fact that the study covers all 50 states and the District of Columbia, the statistical value and, above all, the representativeness of the results appear too weak. We hope that similar studies for each state or region will soon provide more accurate and reliable results.

Finally, it should be noted that only living persons replied to the questionnaire. This is obvious, but it means that students whose suicide attempt was “successful” are not included in the study results. The actual risk of suicide is therefore higher than the figures available here. Furthermore, only suicidal thoughts, plans and attempts of the last twelve months were taken into account.


The study by the Atlanta researchers shows that despite the shortcomings mentioned above, education and prevention policies must be improved to better include gays, lesbians and bisexuals.

Building on this study, methods and strategies should now be developed for the fight against homophobia, especially since many of these cases are actually a matter of life and death.

The study shows how important it is to listen, understand and protect the suffering young people in order to avoid serious to fatal consequences. Equally important are the coming-out and reaction of family, friends and the school environment. Here, too, there is room for improvement – for everyone, even outside the school system.

More details about this study: Sexual Orientation Discordance and Nonfatal Suicidal Behaviors in U.S. High School Students. Annor, Francis B. et al. American Journal of Preventive Medicine, Vol. 54, Issue 4, pages 530-538.

Love, Simon, by Greg Berlanti

Since a good and healthy coming-out is extremely important, young people can be positively informed by the mass media, such as the cinema.

These days Greg Berlanti has released a film in the USA called Love, Simon (above: official trailer in English), which shows teenager Simon’s (Nick Robinson) difficulties with his coming-out as well as his first homoerotic feelings.

Here is a second trailer, also in English:

Filmmaker Xavier Dolan from Quebec underlines Berlanti's positive approach to the topic of coming out of the closet.

Speak no Evil, by Uzodinma Iweala

The authors of the Atlanta study may well avoid any reference to religion and only speak of “social norm” and “social pressure” as stressors, especially among young people with discordant sexual orientation.

In his novel Speak no Evil, American writer Uzodinma Iweala tells the story of Niru, the son of Nigerian immigrants, who makes his parents very proud as long as he does not come out of the closet. Of course: the high school student is young, handsome, sporty, cultivated and is heading for a degree at Harvard. Like the book character, the author is the son of Nigerian immigrants and studied at Harvard.

Speak no Evil (cover)

Speak no Evil, by Uzodinma Iweala, published by HarperCollins.

Everything would be fine without the extreme piety of his parents, who are driven by a homophobia bordering on madness. Being gay is to them like the embodiment of absolute evil. When they learn of their son’s homosexuality, father and mother bombard him with religious phrases and arguments comparable to a senseless and cruel conversion therapy.

This is a great and informative book for everyone interested in this topic.

Frank-S / MensGo

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