Suicide in LGBTI (Lesbian, Gay, Bisexual, Transgender, Intersex) Individuals

Yıl 2025, Cilt: 17 Sayı: 1, 1 - 11, 31.03.2025

Elçin Alaçam , Mualla Yılmaz

https://doi.org/10.18863/pgy.1402625

Öz

Although lesbian, gay, bisexual, transgender, and intersex (LGBTI) people have become more visible in recent years, in many countries, people with different sexual orientations continue to face discrimination, exclusion, labeling, violence, fines, and death penalties. Individuals with different sexual orientations are subjected to homophobic attitudes that are considered not only by society but also by their closest social environment, such as family. Homophobia within the family can lead to a loss of self-confidence, self-esteem and negative situations such as migration and homelessness. In addition to the difficulties they experience, their inability to benefit from health services negatively affects their mental health. Studies show that the rates of suicide among LGBTI people are higher than among heterosexuals due to difficulties and mental problems. In order to reduce the suicide risk of individuals with different sexual orientations, the lack of knowledge of society and healthcare professionals should be eliminated. LGBTI individuals should be supported in the coming out process, and school-family-health worker cooperation should be ensured due to the higher risk of suicide during adolescence. Preventive interventions should be prioritized, and the cultural competencies of healthcare professionals should be gained in order to determine whether individuals who commit suicide were previously receiving psychological support in some of the studies conducted. Training should be organized for health professionals to gain cultural competencies, courses for those with different sexual orientations should be added to the curriculum, and care guidelines should be created. This review aims to address the factors in suicidal behaviors of those with different sexual orientations and the strategies that can be implemented to address these factors. It is thought that this review can be used as a resource for creating training and care guidelines, which are essential factors in gaining future cultural competencies of healthcare professionals.

Anahtar Kelimeler

Suicide, Cultural Compotencies, Different Sexual Orientations, Homophia

LGBTİ (Lezbiyen, Gey, Biseksüel, Transseksüel, İnterseks) Bireylerde İntihar

Öz

Lezbiyen, gey, biseksüel, transseksüel ve interseksler (LGBTİ) son yıllarda daha fazla görünür olmalarına rağmen pek çok ülkede farklı cinsel yönelimleri olanlara ayrımcılık, dışlanma, etiketlenme, şiddet, para cezası ve ölüm cezaları gibi yaptırımlar devam etmektedir. Farklı cinsel yönelimi olan bireyler toplumdan olduğu kadar aile gibi en yakın sosyal çevrelerinden de homofobik tutumlara maruz kalmaktadır. Aile içinde homofobi bireylerde özgüven, özsaygı kaybına ve göç etme, evsiz kalma gibi olumsuz durumları yaşamalarına neden olabilmektedir. Yaşadıkları güçlüklere ek olarak sağlık hizmetlerinden yararlanamamaları LGBTİ’lerin ruh sağlıklarını olumsuz etkilemektedir. Yapılan çalışmalarda LGBTİ’lerin yaşadıkları güçlükler ve ruhsal problemlere bağlı intihar oranlarının heteroseksüellere oranla daha fazla olduğu görülmektedir. LGBTİ’lerde intihar risklerini azaltabilmek adına toplumun ve sağlık çalışanlarının bilgi eksiklikleri giderilmelidir. Ergenlik döneminde intihar riskinin daha yüksek olmasına bağlı LGBTİ’lerin açılma sürecinde destek verilmeli, okul-aile-sağlık çalışanı işbirliği sağlanmalıdır. Yapılan çalışmalardan bazılarında intihar eden bireyin daha öncesinde psikolojik destek alıyor olmasının saptanmasına yönelik önleyici müdahalelere öncelik verilmeli ve sağlık çalışanlarının kültürel yetkinlikleri kazandırılmalıdır. Sağlık çalışanlarının kültürel yetkinliklerinin kazandırılması adına eğitimler düzenlenmeli, müfredata bu bireylere yönelik dersler eklenmeli ve bakım kılavuzları oluşturulmalıdır. Bu derleme ile farklı cinsel yönelimi olanların intihar davranışlarındaki etmenlerin ve bu etmenlere yönelik olarak uygulanabilecek stratejilerin ele alınması amaçlanmıştır. Derlemenin ileriye yönelik olarak sağlık çalışanların kültürel yetkinliklerinin kazandırılmasında önemli bir etmen olan eğitimlere ve oluşturulacak olan bakım kılavuzlarına kaynak olarak kullanılabileceği düşünülmektedir.

Anahtar Kelimeler

İntihar, Kültürel Yetkinlik, Farklı cinsel yönelim, Homofobi

Kaynakça

• Adam R (2016) Meeting the unique health-care needs of LGBTQ people. Lancet, 387:95.
• Akçay S, Taşkın M (2019) İntihar ve toplumsal cinsiyet: sosyal hizmet perspektifinden bir değerlendirme. Uluslararası Toplum Araştırmaları Dergisi, 20:2280-2299.
• Albuquerque GA, de Lima Garcia C, da Silva Quirino G, Alves MJH, Belém JM, dos Santos Figueiredo FW et al. (2016) Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. BMC Int Health Hum Rights, 16:2.
• Alessi EJ, Kahn S, Chatterj, S (2016) ‘The darkest times of my life’: recollections of child abuse among forced migrants persecuted because of their sexual orientation and gender identity. Child Abuse Negl, 51:93-105.
• Barrett C, Crameri P, Lambourne S, Latham J, Whyte C (2015) Understanding the experienvces and needs of lesbian, gay, bisexual and trans australians living with dementia and their partners. Australas J Ageing, 34:34-38.
• Beycan Ekitli G, Çam MO (2017) Bakım sürecinde zorlandığımız alan: LGBTİ’ye yönelik bir gözden geçirme. Psikiyatri Hemşireliği Dergisi, 8:179-187.
• Biçmen Z, Bekiroğulları Z (2014) Social problems of lgbt people in Turkey. Procedia Soc Behav Sci, 113:204-233.
• Bogart LM, Revenson TA, Whitfield KE, France CR (2014) Introduction to the special section on lesbian, gay, bisexual, and transgender (LGBT) health disparities: where we are and where we’re going. Ann Behav Med, 47:1-4.
• Boyacıoğlu NE, Dinç H, Özcan NK (2018) Lezbiyen, gey, biseksüel, transseksüel ve interseks adolesanlar. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 9:13-16.
• Caroll A, Mendos LR (2017) State-Sponsored Homophobia: A World Survey of Sexual Orientation Laws: Criminalisation, Protection and Recognition, 12th ed. Geneva, International Lesbian, Gay, Bisexual, Trans and Intersex Association(ILGA).
• Çavdar D, Çok F (2016) Türkiye’de LGBT’lerin okul yaşantıları. Kaos GL, 151:54-58.
• Earnshaw VA, Chaudoir SR (2009) From conceptualizing to measuring hiv stigma: a review of hiv stigma mechanism measures. AIDS Behav, 13:1160-1177.
• De Lange J, Baams L, van Bergen DD, Bos HM, Bosker RJ (2022) Minority stress and suicidal ideation and suicide attempts among lgbt adolescents and young adults: a meta-analysis. LGBT Health, 9:222-237.
• Demir B, Gönüllü HJ, Altun H, Kartal SZ (2021) Heteroseksüel sistem içerisinde cinsel yönelim ve cinsiyet kimliği temelli sosyal dışlanmaya maruz kalan lgbti+ bireylerin psikososyal yaşamları. Sosyal Hizmet, 2021(1):50-69.
• Erdoğan B, Köten E (2015) “As kendini de hepimiz kurtulalım artık!”: Sosyal dışlanmadan intihara LGBT gençler. Alternatif Politika, 7:143-167.
• Feigelman W, Plöderl M, Rosen Z, Cerel J (2020) Research note on whether sexual minority individuals are over-represented among suicide’s casualties. Crisis, 41:229-232.
• Figueiredo AR, Abreu T (2015) Suicide among LGBT individuals. Eur Psychiatry, 30(Suppl 1):1815.
• GLMA (2006) Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender Patients. Washington DC, Gay and Lesbian Medical Association.
• Haas A, Drescher J (2014) Impact of sexual orientation and gender identity on suicide risk:implications for assessment and treatment. Psychiatr Times, 30:24-25.
• Haas AP, Eliason M, Mays VM, Mathy RM, Cochran SD, D’Augelli AR et al. (2011) Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. J Homosex, 58:10-51.
• Hadland SE, Yehia BR, Makadon HJ (2016) Caring for LGBTQ youth in inclusive and affirmative environments. Pediatr Clin North Am, 63:955-969.
• Hafeez H, Zeshan M, Tahir MA, Jahan N, Naveed S (2017) Health care disparities among lesbian, gay, bisexual, and transgender youth: a literature review. Cureus, 9:e1184.
• Hanımoğlu E (2019) Stigmatization and suicide vulnerability in LGBT students: ınquiry and recommendations. J Educ ELearn Res, 6:45-51.
• Henry RS, Hoetger C, Rabinovitch AE, Aguaye Arelis A, Rabago Barajas BV, Perrin PB (2021) Discrimination, mental health, and suicidal ideation among sexual minority adults in Latin America: considering the roles of social support and religiosity. Trauma Care, 1:143-161.
• HHS (2016) Advancing LGBT Health and Well-being. Washington DC, U.S. Department of Health and Human Service..
• Hottes T, Ferlatte O, Dulai J (2016) Preventing Suicide among Gay and Bisexual Man: New Research & Perspectives. Vancouver, Canada, CBRC (Community-Based Research Centre for Gay Men’s Health).
• Joint Commission (2011) Advancing Effective Communication, Cultural Compotence, and Patient and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community: A Field Guide. Oakbrook Terrace, IL, The Joint Commission.
• Kirchner S, Till B, Plöderl M, Niederkrotenthaler T (2022) Effects of ‘’it gets better’’ suicide prevention videos on youth identifying as lesbian, gay, bisexual, transgender, queer, or other sexual or gender minorities: a randomized controlled trial. LGBT Health, 9:436-446.
• Korkmaz M, Aydın Avcı İ (2018) Halk sağlığı hemşirelerinin LGBT bireylerin sağlıklı yaşam sürdürmelerindeki rolü. SETSCI-Conference Proceedings, 3:460-466.
• Kosciw JG, Greytak EA, Bartkiewicz MJ, Boesen MJ, Palmer NA (2012) The 2011 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual and Transgender Youth in Our Nation’s Schools. New York, GLSEN.
• Landry J (2017) Delivering culturally sensitive care to lgbtqi patients. J Nurse Pract, 13:342-347.
• Levi-Belz Y, Peleg D, Ifrah K (2022) An integrative psychological model of risk factors for suicidal ideation and behavior among Israeli lgbt individuals. Omega (Westport), doi: 10.1177/00302228221087504..
• Liu RT, Sheehan AE, Walsh RFL, Sanzari CM, Cheek SM, Hernandez EM (2019) Prevelance and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: a. systematic review and metaanalysis. Clin Psychol Rev, 74:101783.
• Logie CH, Alschech J, Guta A, Ghabrial MA, Mothopeng T, Ranotsi A et al. (2019) Experiences and perceptions of social constraints and social change among lesbian, gay, bisecual, and transgender persons in Lesotho. Cult Health Sex, 21:559-574.
• Logie CH, James L, Tharao W, Louthfy MR (2011) Hiv, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by hiv-positive women in Ontario, Canada. PLoS Med, 8:e1001124.
• Lunn MR, Cui W, Zack MM, Thompson WW, Blank MB, Yehia BR (2017) Sociodemographic characteristics and health outcomes among lesbian, gay and bisexual US adults using healthy people 2020 leading health indicators. LGBT Health, 4:283-294.
• Madireddy S, Madireddy S (2022) Supportive model for the improvement of mental health and prevention on suicide among LGBTQ+ youth. Int J Adolesc Youth, 27:85-101.
• McGarry A (2016) Pride parades and prejudise: visibility of Roma and LGBTQ communities inpost socialist Europe. Communist Post-Communist Stud, 49:269-277.
• McNair RP, Hegarty K (2010) Guidelines for the primary care of lesbian, gay, and bisexual people: a systematic review. Ann Fam Med, 8:533-541
• Medina-Martinez J, Saus-Ortega C, Sanchez-Lorente MM, Sosa-Palanca EM, Garcia-Martinez P, Marmol-Lopez MI (2021) Health inequities in lgbt people and nursing interventions to reduce them: a systematic review. Int J Environ Res Public Health, 18:11801.
• Mereish EH, O’Cleirigh C, Bradford JB (2014) Interrelationships between lgbt-based victimization, suicide, and substance use problems in a diverse sapmle of sexual and gender minorities. Psychol Health Med, 19:1-13.
• Ozcan A, Ozdil K, Bulucu Buyuksoy GD, Kucuk Ozturk G (2021) The attitudes of nursing students toward gay and lesbian individuals in Turkey: stigmatization. Int J Caring Sci, 14:1160-1169.
• Özeren E (2014) Sexual orientation discrimination in the workplace: a systematic review of literature. Procedia Soc Behav Sci, 109:1203-1215.
• PAHO (2013) Addressing the Causes of Disparities in Health Service Access and Utilization for Lesbian, Gay, Bisexual and Trans (LGBT) Persons. Washington DC, Pan American Health Organization World Health Organization.
• Poteat TC, Logie CH, Adams D, Mothopeng T, Lebona J, Letsie P et al. (2015) Stigma, sexual health, and human rights among women who have sex with women in Lesotho. Reprod Health Matters, 23:107-116.
• Ream GL (2019) What’s unique about lesbian, gay, bisexual, and transgender (lgbt) youth and young adult suicides? findings from the national violent destah reporting system. J Adolesc Health, 64:602-607.
• Rivers I, Gonzalez C, Nodin N, Peel E, Tyler A (2018) LGBT people and suicidality in youth: a qualitative study of perceptions of risk and protective circumstances. Soc Sci Med, 212:1-8.
• Rodriguez NS (2016) Communicating global inequalities: How lgbt asylium-spesific NGOs use social media as public relations. Public Relat Rev, 42:322-332.
• Russell ST, Horn S, Kosciw J, Saewyc E (2010) Safe school policy for LGBTQ students and commentaries. Soc Policy Rep, 24:1-25.
• Ryan C, Russell S, Huebier D, Diaz R, Sanchez J (2010) Family acceptence in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs, 205-213.
• Singh AA (2013) Transgender youth of color and resilience: negotiating oppression and findings support. Sex Roles, 68:690-702.
• Skerrett DM, Kolves K, de Leo D (2015) Are lgbt populations at a higher risk for suicidal behaviors in Australia? Research findings and implications. J Homosex, 62:883-901.
• Soner G (2019) Yaşlı LGBT bireylerin sağlık sorunları ve hemşirenin rolü. SETSCI-Conference Proceedings, 12:34-36.
• Spairosu L (2014) Gay pride through the Serbian daily press. Procedia Soc Behav Sci, 163:26-35.
• TODAP (2017) Psikologlar İçin LGBTİ’lerle (Lezbiyen, Gey, Biseksüel, Trans, İnterseks) Çalışma Kılavuzu. İstanbul, Toplumsal Dayanışma İçin Psikologlar Derneği.
• Trevor Project (2021) National Survey on LGBTQ Youth Mental Health. West Holywood,CA, The Trevor Project.
• Virupaksha HG, Muralidhar D, Ramakrishna J (2016) Suicide and suicidal behavior among transgender persons. Indian J Psychol Med, 38:505-509.
• Wang YC, Chang SR, Miao NF (2022) Suicide attempts among Taiwanese lesbian, gay, bisexual, and transgender adults during the 2018 Taiwan referendum on same-sex issues. J Nurs Scholarsh, 54:388-395
• Whitaker K, Shapiro VB, Shields JP (2016) School based protective factors related to suicide for lesbian, gay, and bisexual adolescent. J Adolesc Health, 58:63-68.
• Wolford-Clevenger C, Frantell K, Smith PN, Flores LY, Stuart GL (2018) Correlates of suicide ideation and behaviors among transgender people: a systematic review guided by ideation-to action theory. Clin Psychol Rev, 63:93-105.
• WHO (2020) World Health Organization Global Health Observatory (GHO) data. https://www.who.int/gho/mental.health/en/ (Accessed 07.06.2020).
• Yalçınoğlu N, Önal AE (2014) Eşcinsel ve biseksüel erkeklerin içselleştirilmiş homofobi düzeyi ve sağlık üzerine etkileri. Turkish Journal of Public Health, 12:100-112.
• Yarns BC, Abrams JM, Meeks TW, Sewell DD (2016) The mental health of older LGBT adults. Curr Psychiatry Rep, 18:1-11.
• Yıldız E (2018) Suicide in sexual minority populations: a systematic review of evidence based studies. Arch Psychiatr Nurs, 32:650-659.
• Yolaç E, Meriç M (2020) Internalized homophobia and depression levels in LGBT individuals. Perspect Psychiatr Care, 57:304-310.