King et al (Reference King, McKeown and Warner2003) have published a valuable contribution to the literature regarding the mental health of lesbians and gay men. However, they erred in asserting that, ‘No study has examined whether gay and lesbian people have elevated rates of completed suicide....’ (p. 557). This is important because studies of sexual orientation and attempted v. completed suicide have yielded different results. Nearly all studies of sexual orientation and attempted suicide have found that gay men and lesbians have higher rates of self-harm than heterosexuals. Conversely, all studies of sexual orientation and completed suicide have concluded that gay men and lesbians do not die by suicide at a higher rate than heterosexuals.
Spencer (Reference Spencer1959) followed 100 Oxford undergraduates referred by their general practitioners. Relative to 35% of controls (n=100), a significantly greater proportion of patients (51%) had homosexual behaviour, fantasies or desires. ‘No patient was lost by suicide’ but 9 of 10 who attempted suicide were ‘persistently homosexual’ (pp. 402–403). Cohen (Reference Cohen1961) found only one same-sex couple (1.7%) among 58 completed suicide pacts. O’Hara (Reference O'Hara1963) found only 4% lesbians and gay men in a 1-year incidence study of double suicides in Japan. Rich et al (Reference Rich, Fowler and Young1986) reported that 13 (11%) of 119 males aged 21–42 who died by suicide in Los Angeles had disclosed a homosexual identity prior to death. In New York City, Shaffer et al (Reference Shaffer, Fisher and Hicks1995) found that in 3 (2.5%) of 120 completed youth (aged ≤20 years) suicide cases the individual was gay. However, they found no gay or lesbian young people among 147 living controls matched for age, gender and ethnicity.
Thus, contrary to King et al's assertion, at least five peer-reviewed studies of sexual orientation and completed suicide have been published.
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