The Other Epidemic

Last week I was woken by a phone call that put the fate of a longtime friend into my hands. His voice fading, his speech slurred, he pleaded, "You have to let me go."

Everyone says people who really want to commit suicide just do it. If they call someone, it's a cry for help. That made sense the first time I heard it, but I'm no longer so sure. I've had three long-term relationships, and I remained close to each partner for years after the respective break-ups. One by one, all three of them committed suicide. My first lover slit his wrists in a bathtub; the second downed a bottle of pills with a bottle of champagne; the third jumped off the balcony of his penthouse.

Sitting in my bed that recent morning, about to bear witness to a fourth, it struck me: How do I instill the will to live in someone else when my own life has led me to respect and understand the will to die? When you've lost a lot of people you've loved to suicide, does it make you more numb, more understanding, or just blinded by the blight?

John is one of my last surviving gay male friends from the 70s. He'd made a previous suicide attempt last May. While swallowing 10 pills with a vodka and tonic is lame by most standards, it was enough to land him in a psychiatric ward where getting out was a lot harder than getting in. As he explained it, you're basically a prisoner until the staff feels you're safe to leave.

The age of AIDS claimed my best longtime friends. These weren't bar buddies or tricks or fair-weather friends, but soulful bonds I nurtured over years. In a numbing span of fourteen months during 1993-94, four deaths decimated my circle of friends. To quote an old Elton John song, I learned what it was like "to have a graveyard as a friend," leaving me with a morbid fantasy: If I could dig up one friend and bring him back, whom would I pick? Suddenly it was as if one of them had come back. Released from the psychiatric ward last year, John reached out to me.

But then I received that chilling middle-of-the-night call earlier this month. John's second suicide attempt had nothing lame about it. I decided it was time to get the facts about gay men and suicide.

I began my search for national statistics withÊthe government and discovered theÊNational Center for Injury Prevention and Control (NCIPC), an arm of the Centers for Disease Control (CDC). According to NCIPC, suicide took the lives of 30,622 people in 2001. (Keep in mind a lag time of several years in finalizing annual suicide rates.) In 2002, 132,353 individuals were hospitalized following suicide attempts; 116,639 were treated in emergency departments and released. Most suicides are committed with a firearm (55-60 percent). Suicide is the eighth-leading cause of death for all U.S. men; males are four times more likely to die from suicide than females—even though women report attempting suicide during their lifetimes about three times as often as men. Suicide rates are highest among whites, increase with age, and are very high among those 65 years and older.

NCIPC states that the highest risk factors for suicide are previous suicide attempts, a history of mental disorders, particularly depression, a history of alcohol or substance abuse and a family history of suicide.

But amidst this wealth of information, NCIPC offers no stats about gay suicide on their website, which contains extensive findings about suicide among virtually every group of Americans. While they do fund and sponsor groups around the country working on suicide prevention amongÊgay or GLBT Americans, they don't offer gay-specific statistics by themselves. Those who hold that our government is only interested in "gay diseases" and "gay drug addicts" appear to be supported by this glaring oversight by the one government agency that made a name for itself leading the charge on AIDS.

With a national picture drawn, oneÊin which GLBT Americans can't lie down and be counted, we are left with various state, local and international organizations to get a sense of gay suicide rates. Several problems immediately present themselves. Do we accept the boilerplate assertion that 10 percent of Americans are gay? How do we factor in bisexuals, people who come out late in life or remain celibate or simply don't identify as part of either team? This may be what statisticians live for, but I found myself amused and amazed by the efforts over the years that have gone into neatly sortingÊthe messy business ofÊpeople into categories of sexual orientation. While most of the studies and statistics came with as many qualifications and caveats as findings, here's the best of what I found.

Studies on the impact of HIV and AIDS in gay male suicides are reported from around the world, each one comparing age differences that change with each study. One studied 17- to 29-year-olds, another 18- to 25-year-olds, but no two studies can be compared by the findings within the same age range. It appears, however, in most studies at home and abroadÊthat there is a higher incidence of suicide among those who are HIV positive and have AIDS.

Aside from those suffering from HIV and AIDS, another group with high suicide rates is lesbian, gay, bisexual, transgendered and "questioning" young people (GLBTQ). According to New York City's Hetrick-Martin Institute, an advocacy group and home of the Harvey Milk High School for GLBTQ youth, they areÊthree times more likely to attempt suicide than other youth, and 40 percent of GLBT youth attempted suicide compared to their heterosexual peers.

The Trevor Project—which bills itself as "a non-profit organization established to promote acceptance among gay and questioning teenagers, and to aid in suicide prevention among that group"—asserts, "teenage suicide has risen by more than 200 percent since 1960. For every kid who takes his or her own life, there are 20 kids who try, and gay youth in grades 7-12 are twice as likely to make plans to commit suicide than are their straight counterparts." The Trevor Helpline is the only National toll-free, 24-hour, 365-day-a-year, confidential suicide hotline for gay and questioning teens (1-866-4U-TREVOR). Their website offers information on how to recognize signsÊof suicidal tendencies, how to help someone who exhibits them, and a resource directory to services and counseling.

Kevin Caruso of PreventSuicideNow.com makes an important point about the reliability of suicide statistics in GLBT youth: "It is difficult to research gay, lesbian, bisexual, and transgendered youth suicide because many young gays, lesbians, bisexuals, and transgendereds have not 'come out.' But it has been estimated that as many as 30 percent of all youth suicides are completed by gays, lesbians, bisexuals and transgendereds."

While the best information we have available suggests that gay suicide is highest among the young, the aging and those directly impacted by AIDS, gay-positive organizations are quick to point out that the numbers are still too low, as suicide among adolescent gays is always under-reported because sexual orientation may not be disclosed or even investigated. On the other side of the debate, anti-gay organizations such as TheGayYouthSuicideMyth.com argue heartily that statistics about GLBTQ youth suicide are over-inflated to promote the agendas of gay organizations.

For gays, straights and in-betweens, suicide is a far greater problem than many realize. And I had no idea when John's fateful call came that there was a remedy for him. He'd been running to doctors all year; most of them pill-throwers who kept telling him, "Try this. Try these." But it wasn't until he swallowed enough pills to possibly kill him that the help he needed was found.

After calling 911, the local police broke down his door. An ambulance took him to an emergency room to pump his stomach. Then he was moved to a psychiatric ward that evaluated his specific needs and sent him to a specialized, 24-hour, live-in facility with a staff of doctors that covered multiple, overlapping disciplines. Able to monitor the effects of the regimen of multiple antidepressants they were trying on him, they could watch him around the clock, and adjust and readjust the levels of his medications until he was finally relieved of his depression and his despair. Or until his insurance ran out.

Given that John's coverage was indeed coming to a halt, this week his doctor asked if he would attempt suicide again were he released.

"What did you tell him?" I asked.

"You know me, I only tell the truth," he replied. "I told him, 'Maybe.'"