Excess suicide rate among same-sex married is decreasing in the Nordic countries

A newly published study shows that people who enter a same-sex marriage have higher suicide rates than people entering opposite-sex marriages. But the study also found that across the years since same-sex marriage was legalized, the suicide rate has been decreasing more rapidly among people in same-sex marriages than among those in opposite-sex marriages.

While it has been well-established that people belonging to sexual minority groups have elevated risk of suicide attempts, there has been limited and conflicting evidence of elevated risk for death by suicide. By combining civil register data from two countries that were among the first to legalize same-sex marriages, Denmark and Sweden, researchers have addressed this question in a study published this week in the Journal of Epidemiology and Community Health.

In this study, the largest of its kind to date, more than 28,500 individuals who entered a same-sex marriage were followed for an average of over 11 years. Overall, this group was found to be 2.3 times more likely to die by suicide compared to individuals who entered an opposite-sex marriage during the same period.

Suicide rates decreased more rapidly among those in same-sex marriages

Among those in same-sex marriages, the excess rate of suicide mortality was highest among young people, with same-sex-married persons aged 18-34 years having a suicide rate 2.7 times higher than opposite-sex-married persons of comparable age. The protective effect of marriage otherwise was found to hold for opposite-sex and same-sex married spouses alike: those divorced or widowed from any type of marriage had considerably higher suicide risk than those still married.

Of note, the study found that across the years since same-sex marriage was legalized, the suicide rate has been decreasing more rapidly among people in same-sex marriages than among those in opposite-sex marriages. Comparing suicide rates in the earlier years of same-sex marriage (1989-2002) to rates in later years (2003-2016), the researchers found a 46% decrease among same-sex-married persons and a 28% decrease among opposite-sex married individuals.

”Our findings suggest that persons in same-sex marriages may be experiencing declining levels of stigma, although it is troubling that our study confirms an excess of suicide deaths in same-sex-married persons.” said lead author Dr. Annette Erlangsen, an adjunct associate professor at Department of Mental Health, Johns Hopkins Bloomberg School of Public Health and working at Danish Research Institute for Suicide Prevention. She continued: ”One could consider our findings from Denmark and Sweden, which are among the leading countries in same-sex rights, as the ’best case’-scenario. It is possible that excess mortality by suicide is even higher in sexual minority people in other countries.”

“We are pleased to note an improvement in the suicide rate of people in same-sex marriages, which could be related to the increased awareness of LGBT-rights and protective measures from the legislative side” says Dr. Gunnar Andersson, professor in Demography at Stockholm University, Sweden.

Another study author, Dr Ann Haas, Professor Emerita in at the Department of Health Sciences at Lehman College of the City University of New York and a leading researcher on LGBT suicide , noted that, “The fact that while decreasing, suicide rates in same-sex married people remains higher than for opposite-sex married people suggests that legal marriage erases some but not all forms of sexual orientation-based stigma and discrimination that have been credibly linked to suicidal behavior in sexual minority people.”

Erlangsen, Annette, Sven Drefahl, Ann Haas, Charlotte Björkenstam, Merete Nordentoft, Gunnar Andersson, "Suicide among persons who entered same-sex and opposite-sex marriage in Denmark and Sweden, 1989-2016: a binational, register-based cohort study", Journal of Epidemiology and Community Health, DOI: http://dx.doi.org/10.1136/jech-2019-213009

Annette Erlangsen, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health & Danish Research Institute for Suicide Prevention

Phone: +61 402 165 059 / +45 4026 3918

Ann Haas, Department of Health Sciences, Lehman College, City University of New York, USA

Gunnar Andersson, Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden