The disparity in lifetime suicide attempts between sexual minority and heterosexual adults is significantly higher than the previously estimated rate of 20% when accounting for information bias, according to research published in the American Journal of Epidemiology.

Although previous studies have demonstrated disparities in suicide risk between lesbian, gay, and bisexual (LGB) populations and heterosexual populations, both exposure and outcome may have been affected by biases associated with both self-reporting and interviewers.

Researchers conducted a systematic literature search to identify studies of lifetime suicide attempts in sexual minority and heterosexual adults and used a meta-analysis to generate unadjusted estimates of relative risk. To adjust for possible information biases, they applied a Bayesian misclassification correction model accounting for prior information about sensitivity and specificity of exposure and outcome measures.

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Study results showed that when accounting for information bias in the context of socially stigmatized exposure and outcome, the estimated lifetime prevalence of suicide attempts among heterosexuals is reduced and is increased among sexual minorities. The relative risk is 4.67, which is significantly higher than previous estimates.

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The study was limited by focusing the analysis on 1 type of bias and a possible bias resulting from population losses from those who die from suicide. In addition, it remains unknown how suicide risk influences likelihood of participation in studies.

The validity of research estimating the sexual minority suicide disparity has been long debated. These results add to the evidence that there is an elated risk for lifetime suicide attempts among sexual minority populations. Researchers stated, “we urge the immediate development of public health strategies to reduce the 5-fold higher rate of lifetime suicide attempts among lesbian, gay, and bisexual populations.”


Salway T, Plöderl M, Liu J, et al. Effects of multiple forms of information bias on estimated prevalence of suicide attempts by sexual orientation: an application of a Bayesian misclassification correction method to data from a systematic review [published online September 5, 2018]. Am J Epidemiol. doi:10.1093/aje/kwy200