While suicide rates have traditionally been significantly higher among men than women, rates are even higher for queer men. And yet, it's an issue that remains largely unaddressed.
Postdoctoral research fellow Dr. Olivier Ferlatte of UBC's Men's Health Research program is one of several local researchers who are leading the way toward broaching the silence around suicide in Canada, particularly when it comes to LGBT issues.
"This is a population highly impacted by this issue," Ferlatte said by phone. "Gay and bisexual men are four times more likely to attempt suicide than straight men but it's very ignored and it's a very difficult topic to talk about so we're giving voice to people who were affected by suicide."
In the 2014-15 Sex Now survey conducted by the Community Based Research Centre, suicide ideation and attempts were higher among younger queer men than older ones. Almost one-third of respondents who were 25 years or younger had considered suicide and seven percent had attempted suicide. In contrast, only 11 percent of those 60 years or older had ever considered suicide, with only two percent having made a suicide attempt. (The researchers pointed out that the issue may be much larger, due to those who have committed suicide being absent from the data.)
Further delving into the data, Ferlatte headed a study published in February in AIDS Care that analyzed suicide issues among HIV–positive gay and bisexual men. This group faces stigma not only based on their sexual orientation but also due to their HIV status.
The data was taken from 673 HIV–positive men who completed the Sex Now survey.
Due to their HIV status, these men experienced being socially excluded (57 percent), rejected as a sexual partner (22 percent), verbally abused (17 percent), or physically abused (three percent).
Within this group, 22 percent reported suicide ideation and five percent reported suicide attempts within the past year.
Compared with HIV–negative respondents, HIV–positive men were 1.29 times higher to experience suicide ideation while their suicide attempt rate was found to be 1.55 times higher. Those who experienced multiple forms of stigma (two or more types) were at higher risk for suicide than those who didn't. In particular, verbal abuse was found to be a significant factor for suicide ideation, and social exclusion and physical violence as significant factors for suicide attempts.
The rate of recent suicide attempts by HIV–positive MSM in this study was over 12 times higher than the overall rate for Canadian men.
The researchers noted that a 2015 study found that HIV–positive men (for all sexual identities) were three times more likely to die from suicide than the general population.
To help address the lack of dialogue about such issues, Ferlatte also curated a visual art exhibition of works by men who have sex with men (MSM) and LGBT community members.
Men's Health Initiative's Man-Up Against Suicide previously organized a photo exhibit about suicide that primarily featured heterosexual men as well as women who lost their male partners. The participation of a few queer men in that exhibit inspired the researchers to launch an LGBT–specific photo project.
Ferlatte explained that the exhibit is intended to raise public awareness, to destigmatize issues about mental health, and to generate conversation about the need for LGBT–specific suicide prevention.
"There is no targeted program anywhere in Canada for this population despite the health inequity," he said.
The Still Here exhibition, featuring 17 photographs plus one painting, launched on March 3 and will be on display for four months at Health Initiative for Men's newly relocatedand expanded health centre (416–1033 Davie Street).
The works were made by 29 gay, bisexual, and other MSM, who either thought about or attempted suicide or lost someone to suicide. They were each given a camera to depict and express their experiences or tell their story.
Although the participants aren't professional artists, Men's Health Research founder John Oliffe previously explained to the Straight that photos can help men to talk about suicide in an indirect way, allowing them to talk about sensitive issues in the third person ("he" or "him" rather than "I").
Ferlatte said he asked participants which of the photos from the 350 submissions they received would be ones that they would want to see in an exhibit.
Five participants were also teamed up with visual artist Foster Eastman, who collaborated with them to create an art installation.
A previous version of the exhibit was on display at Gallery Gachet in the autumn. However, Ferlatte explained that because the HIM clinic is not an art gallery and people would be entering space without knowing about the photos in advance, they were more careful about which photos they chose.
"Some of the images could be quite raw so we didn't want to have that necessarily in the space," he said.
A recurring theme in the photographs is how hidden the issue remains.
"Often what we find is that some of the people who participated felt that when they were experiencing thoughts of suicide, they thought they were the only person who experienced that," Ferlatte said.
He said many participants expressed feelings of loneliness, feeling alone because of silence about mental-health issues, experiencing difficulties in accessing mental health services, and feeling socially isolation because of their sexuality or other identities. Those who lost someone close to suicide often expressed feelings of guilt.
What also became apparent to Ferlatte was the resiliency and strength of the people who participated in study.
"A lot of them experienced a high level of homophobic violence, trauma, or sexual abuse but they are still here and a lot of them find their creative way to cope with suicide ideation, whether it's connecting to the community...or finding strength within and participating in different parts of gay culture," he said.
The photographs have been compiled into a book which can be ordered through the Men's Health Research website. Ferlatte explained that the book can be used to intiate conversations about suicide.
In the future, Ferlatte said that they hope to extend their photo project to include queer women as well as HIV–positive gay and bisexual men.
While Ferlatte said they also want to take the exhibit across the province and the country, they are still searching for funding to do so and are accepting donations at their website to support their efforts.