It is exciting when you can see the positive impact of public policy on health outcomes of our children. A study recently published by JAMA Pediatrics provides cause to hope that we can decrease the rates of suicide attempts among adolescents. It examined the effects of same-sex marriage legalization and adolescent suicide attempts and found that in states that implemented same-sex marriage policies, the proportion of high school students attempting suicide among sexual minorities fell by 7 percent compared to states that did not have same-sex marriage legalization.
Sadly, there is an established correlation between suicide attempts and youth identifying as lesbian, gay, bisexual, transgender, or questioning (LGBTQ). Data from the 2015 Youth Risk Behavior Surveillance System reveal that 29 percent of students who identified as sexual minorities (LGBTQ) reported suicide attempts within the past 12 months compared to 6 percent of heterosexual high school students.
There are a number of risk factors that contribute to suicide and suicide attempts among adolescents, including depression, substance use, and family history. In this study, the investigators highlight one of the likely reasons why sexual minorities are among the most vulnerable for suicide: stigma.
Stigma involves disapproval of personal characteristics or beliefs that are against cultural norms. Policies that prevent same-sex marriage are a form of structural stigma that label sexual minorities as different and deny them the rights and benefits associated with marriage. The legalization of same-sex marriage is a step to reduce the stigma that sexual minorities face. Throughout the legalization process, significant media attention and increased visibility of sexual minorities helps to create a social support network.
But could the increased visibility negatively affect the mental health of sexual minorities? The investigators cite possible hostile family environments and political and social backlash as potential harmful downstream effects. Thankfully, the reduction in suicide attempts among sexual minorities was sustained two years after legalization, suggesting that this backlash doesn’t worsen mental health outcomes. In fact, the authors of the study estimate that same-sex policies would be associated with more than 134,000 fewer adolescents attempting suicide each year.
Fighting to reduce stigma is a key concept for the mental health of all youth, regardless of sexual orientation. There are too many who suffer in silence. This study shows that legislative policies can result in real life-or-death consequences. Let's use this study to keep the momentum going towards advocating for their rights and mental health resources for all our teens.