Last fall, several teens were tragically lost to suicide and their untimely deaths spurred an unprecedented debate. The debate took place in schools, in the media, among researchers and parents, because the teens who ended their lives had self-identified as sexual minorities and also because they were all victims of bullying. The local and national media produced intense coverage of these suicide deaths with attention grabbing headlines that underscored how intensely these teens had been tormented prior to their deaths. As a result of the media coverage and the debate surrounding these specific suicide deaths, it became clear that there are several key issues that need to drive future suicide prevention and intervention efforts, in order to produce better resolutions for vulnerable youth. Among the most salient questions are what resources are available to better understand and address suicides among gay teens?; what is done about bullying, an important risk factor for suicide among gay teens; and finally, how will social change, possibly already underway, change norms and social support for gay teens?

While suicide is the third leading cause of death among youth in the U.S., the rate of suicide is likely much higher among sexually minorities. However, death certificates do not specify sexual orientation so the actual numbers of any type of death specifically for sexual minorities are not known. Regardless of the specific numbers of deaths, it is clear that suicide prevention efforts to date are underfunded, with relatively limited reach for vulnerable youth. However, as an example, the Trevor Project (1-800-4-U-Trevor) is a national 24 hour per day operated suicide hotline that is available and targeted specifically for gay and questioning youth that can address the potentially unique issues that they may face and to help avert crises. This project provides a unique and targeted service, however given the scope of this public health problem, additional efforts are needed to better handle the underlying circumstances that contribute to stigma, social alienation, victimization, and self-medication among vulnerable youth that may have been caused or exacerbated by bullying.

Bullying has emerged as a key risk factor for suicides among gay teens. Unfortunately, bullying is reported by nearly a third of U.S. middle and high school students making it a very common occurrence across campuses. The good news is that school dis- tricts across the country are implementing or amending policies and laws to better handle bullying. As an example, in 2010, the Georgia General Assembly modified the existing bullying law by expanding the definition of bullying and also requiring local school districts to notify parents when their child bullies or is a victim of bullying. Moreover, the law was also modified to require school districts to adopt policies that prohibit bullying and to have age appropriate consequences and interventions available at all schools. While these new laws are too recent to have been evaluated with regards to their impact, they serve as possible additional protection for youth, especially gay teens that may have been marginalized in school. The more pressing question however, is what protection these laws may or may not provide related to cyber bullying that crosses the boundaries between school and home, as well as other settings. The profound impact of the nearly instantaneous transmissions of hurtful messages through texting, emails, and posting on social networking sites make prevention and enforcement efforts infinitely more complex. It is with this context in mind that positive social changes are also needed to better support those youth in need of support and protection.

While efforts are made to better understand suicides among gay teens and policies have been put in place to better address risk factors such as bullying, most impact may be seen due to other social movements that give gays and other sexual minorities a stronger voice and equality. In particular, the “NOH8” campaign, which serves to visually symbolize the impact of silencing the voices of those in favor of same-sex marriages in California and elsewhere as a response of the repeal of the Proposition 8 that was voted on in 2008, maintains momentum more than two years after the significant vote. Moreover, the “It gets better project” encour- ages all of us to sign a pledge to spread a message of hope and to commit to speak up against hate and intolerance so that those who are impacted by bullying know that it will get better. These prosocial and positive initiatives are key to driving social change especially by urging all of us to intervene and to act. However, these initiatives are profoundly strengthened by recent changes in national policy such as the recent repeal by President Obama in December 2010 of the “Don’t ask, don’t tell” policy which has restricted the U.S. military from identifying or revealing sexual minorities who have not disclosed their sexual orientation while in the service while actively barring those who are openly gay, lesbian or bisexual from serving. The policy, with a previous and complex history, was put in place in 1993 and has been vigorously debated ever since. While it is difficult to assess the impact this policy has had and the future impact the repeal will have, it clearly sends a strong message at the national level about integration and positive social change as key priorities. These initiatives taken as a whole will likely bring positive change to our next generation of youth who will hopefully grow up in a new social environment. We have to recognize that the teens of today have grown up immersed in a social environment where silence around sexual orientation was expected. Therefore, we can no longer be taken by surprise that our vul- nerable youth decide to take their own lives in response to the marginalization and victimization they have experienced. Instead it falls on all of us to contribute in large or small ways to make life better for our youth, because our future depends on them and their well-being.

Monica Swahn, PhD. is an Associate Professor of Public Health and the Associate Dean for Research in the College of Health and Human Sciences at Georgia State University. Dr. Swahn has written extensively about suicide, adolescent violence and teen alcohol consumption