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To the Editor: In their Grand Rounds article about suicide in teenagers, Dr Zametkin and colleagues¹ did not discuss sexual orientation as a risk factor. I find that many homosexual patients have told me that awareness of their own sexual orientation began in their childhoods, and as teenagers they were confused, frightened, embarrassed, and thought of suicide.

The medical literature strongly supports such an association between sexual orientation and suicidality. Remafedi et al,² in a study of junior and senior public high school students, found suicide attempts reported by 28.1% of bisexual/homosexual males compared with 4.2% of heterosexual males (odds ratio, 7.10; 95% confidence interval, 3.05-16.53). A recent review article³ cited 10 studies that found consistently high rates of suicide attempts (20%-42%) among homosexual teenagers. Bagley and Tremblay⁴ found that rates of serious suicide attempts were 4 times higher in homosexual youth. Finally, in examining data from the National Longitudinal . . . [Full Text of this Article]

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Suicide in Teenagers: Assessment, Management, and Prevention
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Sexual Orientation and Youth Suicide
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