L’association des dimensions de l’orientation sexuelle, du harcèlement et du suicide : quelles minorités sexuelles sont les plus à risque ? The association of bullying with suicide ideation, plan, and attempt among adolescents with GLB or unsure sexual identity, heterosexual identity with same-sex attraction or behavior, or heterosexual identity without same-sex attraction or behavior

Résumé

Le but de cette étude était de comparer l’association de l’intimidation avec l’idée suicidaire, la planification et la tentative de suicide, chez les élèves hétérosexuels sans attirance ou comportement envers le même sexe, les élèves hétérosexuels avec attirance ou comportement envers le même sexe et les élèves non hétérosexuels. Un total de 1852 élèves âgés de 14 à 18 ans, de 14 écoles publiques et privées de Montréal ont été interrogés anonymement. Les éléments du sondage ont évalué les dimensions de l’orientation sexuelle, les comportements à risque pour la santé, le harcèlement et les paramètres de suicide. En analyse multivariée, le groupe de référence était les élèves hétérosexuels sans attirance ou comportement envers le même sexe et n’ayant subi aucune intimidation. Lorsque les élèves avaient été victimes d’intimidation, ils étaient plus susceptibles d’avoir des idées suicidaires (rapport des chances [RC] = 2,11, intervalle de confiance [IC] 95 % = 1,52 à 2,92), mais pas plus susceptibles d’avoir eu des tentatives de suicide. Les élèves non hétérosexuels étaient deux fois plus susceptibles d’avoir des idées suicidaires lorsque non victimes d’intimidation (RC = 2,35, IC 95 % = 1,24 à 4,48) et quatre fois plus susceptibles lorsque qu’il y avait eu intimidation (RC = 4,44, IC 95 % = 2,26 à 8,72). De même pour les tentatives de suicide, elles n’étaient pas à risque accru sans intimidation, mais elles étaient presque trois fois plus nombreuses lorsqu’il y avait intimidation (RC = 2,87, IC 95 % = 1,43 à 5,78). La principale conclusion de cette étude est que la différence de risque suicidaire entre les élèves victimes et non victimes d’intimidation était de loin la plus grande chez les élèves ayant une identité non hétérosexuelle.

Mots-clés :

• intimidation,
• harcèlement,
• suicide,
• adolescents,
• orientation sexuelle,
• gay,
• lesbienne,
• bisexuel,
• homosexuel

Abstract

Context Bullying is a known risk factor for suicidality, and suicide is the second leading cause of death for adolescents. Both are increased in sexual minority youth (SMY). As SMY are comprised of youth who self-identify as gay, lesbian, bisexual (GLB) or who have same-sex attractions or behaviors, our previous finding that different subgroups have different risks for suicidality is understandable. Given that the difference was along sexual identity lines (GLB vs heterosexual SMY), the analysis of bullying data in the same subgroups was felt to be important.

Objective To compare the association of bullying and suicide among heterosexual students without same-sex attractions or behaviors, heterosexual students with same-sex attractions and behaviors, and students with gay, lesbian or bisexual (GLB) or unsure sexual identities.

Design The 2004 Quebec Youth Risk Behavior Survey (QYRBS) questionnaire was based on the 2001 Center for Disease Control Youth Risk Behavior Survey, and included items assessing the three dimensions of sexual orientation (identity, attraction and behavior), health risk behaviors, experiences of harassment, and suicidal ideation, plans and attempts.

Methods A total of 1852 students 14-18 years of age from 14 public and private high schools in Montréal Québec were surveyed anonymously during the 2004-2005 academic year.

Main outcome measure Self reports of suicidal ideation, suicidal plan and suicide attempts in the last 12 months.

Results In all, 117 students (6.3%) had a non-heterosexual identity (GLB or unsure) and 115 students (6.3%) had a heterosexual identity with same-sex attraction or behavior. Bullying occurred in 24% of heterosexual students without same-sex attraction or behavior, 32% of heterosexual students with same-sex attraction or behavior, and 48% of non-heterosexually identified students. In multivariable analysis, the common risk factors of age, gender, depressed mood, drug use, fighting, physical and sexual abuse, and age of initial sexual contact were controlled. The reference group was heterosexual students without same-sex attraction or behavior and no bullying. When these students were bullied, they were more likely to have suicidal ideation (odds ratio [OR] = 2.11, 95% confidence interval [CI] = 1.52-2.92) but not suicide attempts. Non-heterosexual students with no bullying were twice as likely to have suicidal ideation (OR = 2.35, 95% CI = 1.24-4.48) and four times as likely when bullied (OR = 4.44, 95% CI = 2.26–8.72). Similarly for suicide attempts, they were not at increased risk when not bullied, but they were almost three times as likely when bullied (OR = 2.87, 95% CI = 1.43-5.78). Heterosexual students with same-sex attraction or behavior were never more likely on any of the suicide measures compared to the reference group, even when bullied.

Conclusion This study was the first to show that adolescent students with a non-heterosexual identity will have a disproportionate increase in their suicide parameters when subject to harassment, but that heterosexually identified students with same-sex attraction or behavior did not have an increased risk over heterosexually identified students without same-sex attraction. This suggests that same-sex attraction and behavior on their own are not contributory to suicide risk, and that the efforts of future research as well as public health efforts may be better served by examining the interface between sexual identity and the school, family, and larger culture that surrounds the sexual minority youth. Longitudinal studies looking at the interplay between all these factors are needed.

Keywords:

• bullying,
• suicide,
• homosexual,
• gay,
• lesbian,
• bisexual,
• youth,
• adolescents,
• suicide ideation,
• suicide plan,
• suicide attempts