Skerrett et al, 2014

A recent study (Skerrett et al, 2014) found that LGBT suicides are more likely to be associated with relationship problems rather than familial conflict when compared to non-LGBT cases. Some commentators have interpreted this as evidence that worse health outcomes among LGBT people are caused by problems inherent to the nature of LGBT relationships, rather than by societal discrimination. Such presumption is untenable. Confounders in this finding include selection bias and reporting bias.

The study identified 35 LGBT cases among 5966 suicides recorded in the Queensland Suicide Register (QSR). Previous studies have found that 2.6% of men and 2.3% of women in Australia identify as homosexual or bisexual (Smith et al, 2003), and that people in same-sex relationships are greatly overrepresented among suicide cases (Mathy et al, 2011). Based on these figures, one would expect well in excess of 137 LGBT cases in the QSR. The methodology used in the Skerrett study grossly under-identifies LGBT cases while disproportionately selecting for LGBT people who live away from their biological families. People may be expected to experience less familial conflict if they live away from their families.

The QSR data is generated chiefly from police interviews with next of kin. While a domestic partner normally takes precedence, this rule may not have been followed in LGBT cases because Queensland law did not consistently recognise same-sex partners as next of kin during most of the study period. This introduces further potential bias in the attribution of factors associated with the LGBT suicides.

A basic principle of scientific evidence is that observations can only be interpreted within the context of the observer. Findings in variables where confounders are not controlled for do not constitute valid evidence, but at most can only raise further questions that require further appropriately designed study to explore.

References:

1. Mathy RM, Cochran SD, Olsen J, Mays VM. The association between relationship markers of sexual orientation and suicide: Denmark, 1990-2001. Soc Psychiatry Psychiatr Epidemiol 2011.

2. Skerrett DM, Kõlves K, De Leo D. Suicides among lesbian, gay, bisexual, and transgender populations in Australia: An analysis of the Queensland Suicide Register. Asia Pac Psychiatry 2014.

3. Smith AM, Rissel CE, Richters J, Grulich AE, de Visser RO. Sex in Australia: sexual identity, sexual attraction and sexual experience among a representative sample of adults. Aust N Z J Public Health 2003.