TY - JOUR

T1 - Suicide among persons who entered same-sex and opposite-sex marriage in Denmark and Sweden, 1989-2016

T2 - a binational, register-based cohort study

AU - Erlangsen, Annette

AU - Drefahl, Sven

AU - Haas, Ann

AU - Bjorkenstam, Charlotte

AU - Nordentoft, Merete

AU - Andersson, Gunnar

PY - 2020/1

Y1 - 2020/1

N2 - Background People belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using unique national data from two countries, we investigated whether individuals entering a same-sex marriage (SSM), a proxy group of sexual minority individuals, had higher suicide rates than those entering opposite-sex marriage (OSM). Methods A cohort study of all males and females who entered an SSM (n=28 649) or OSM (n=3 918 617) in Denmark and Sweden during 1989-2016 was conducted. Incidence rate ratios (IRRs) for suicide were calculated using adjusted Poisson regression models. Results In total, 97 suicides occurred among individuals who had entered an SSM compared with 6074 among those who entered an OSM, corresponding to an adjusted IRR of 2.3 (95% CI 1.9 to 2.8). For people who entered SSM, a 46% decline was noted over time from an IRR of 2.8 (95% CI 1.9 to 4.0) during 1989-2002 to 1.5 (95% CI 1.2 to 1.9) during 2003-2016. The excess suicide mortality was present in all age groups but most pronounced among younger individuals aged 18-34 years of age (IRR 2.7, 95% CI 1.5 to 4.8) and females (IRR 2.7, 95% CI 1.8 to 3.9). Conclusion This large register-based study found higher suicide rates among individuals who entered an SSM, compared with those who entered an OSM. A lower suicide rate was noted for individuals in SSMs in recent years. More research is needed to identify the unique suicide risk and protective factors for sexual minority people.

AB - Background People belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using unique national data from two countries, we investigated whether individuals entering a same-sex marriage (SSM), a proxy group of sexual minority individuals, had higher suicide rates than those entering opposite-sex marriage (OSM). Methods A cohort study of all males and females who entered an SSM (n=28 649) or OSM (n=3 918 617) in Denmark and Sweden during 1989-2016 was conducted. Incidence rate ratios (IRRs) for suicide were calculated using adjusted Poisson regression models. Results In total, 97 suicides occurred among individuals who had entered an SSM compared with 6074 among those who entered an OSM, corresponding to an adjusted IRR of 2.3 (95% CI 1.9 to 2.8). For people who entered SSM, a 46% decline was noted over time from an IRR of 2.8 (95% CI 1.9 to 4.0) during 1989-2002 to 1.5 (95% CI 1.2 to 1.9) during 2003-2016. The excess suicide mortality was present in all age groups but most pronounced among younger individuals aged 18-34 years of age (IRR 2.7, 95% CI 1.5 to 4.8) and females (IRR 2.7, 95% CI 1.8 to 3.9). Conclusion This large register-based study found higher suicide rates among individuals who entered an SSM, compared with those who entered an OSM. A lower suicide rate was noted for individuals in SSMs in recent years. More research is needed to identify the unique suicide risk and protective factors for sexual minority people.

KW - Denmark

KW - register data

KW - sexual minorities

KW - suicidal behaviour

KW - suicide

KW - Sweden, same-sex marriage

U2 - 10.1136/jech-2019-213009

DO - 10.1136/jech-2019-213009

M3 - Journal article

C2 - 31722984

AN - SCOPUS:85075119649

VL - 74

SP - 78

EP - 83

JO - Journal of Epidemiology & Community Health

JF - Journal of Epidemiology & Community Health

SN - 0143-005X

IS - 1

ER -