United States Surgeon General Regina Benjamin and the National Action Alliance for Suicide Prevention released the “2012 National Strategy for Suicide Prevention: Goals and Objectives for Action” on Sept. 10. The report includes extensive discussion of suicide in the LGBT community.

The report describes the National Alliance for Suicide Prevention as an “innovative public-private partnership [that] represents a new approach to enlisting all Americans in the fight to prevent suicide.”

The report “highlights four immediate priorities to reduce the number of suicides,” according to a Sept. 10 release from the Substance Abuse and Mental Health Services Administration, an agency of the federal Department of Health and Human Services. These priorities are “integrating suicide prevention into health care policies; encouraging the transformation of health care systems to prevent suicide; changing the way the public talks about suicide and suicide prevention; and improving the quality of data on suicidal behaviors to develop increasingly effective prevention efforts.”

The report identifies certain groups at greater-than-average risk for suicide, including veterans and LGBT people.

The actual suicide rate in the LGBT community is technically unknown, the report says, “because death certificates do not indicate sexual orientation and gender identity.” Circumstantial evidence, however, strongly suggests that the number is higher than the average across all population groups.

“A meta-analysis of 25 international population-based studies found the lifetime prevalence of suicide attempts in gay and bisexual male adolescents and adults was four times that of comparable heterosexual males,” the report says. “Lifetime suicide attempt rates among lesbian and bisexual females were almost twice those of heterosexual females.” “Across studies, 12 to 19 percent of LGB adults report making a suicide attempt, compared with less than five percent of all U.S. adults.”

Consistent with last fall’s rash of gay youth suicides, the report states, “A later meta-analysis of adolescent studies concluded that LGB youth were three times more likely to report a lifetime suicide attempt than heterosexual youth, and four times as likely to make a medically serious attempt.” “[A]t least 30 percent of LGB adolescents report attempts, compared with eight to 10 percent of all adolescents.”

The evidence regarding transgender people is scanty, but nonetheless alarming. “To date, population-based studies have not identified transgender participants,” the report states, “but numerous nonrandom surveys show high rates of suicidal behavior in that population, with 41 percent of adult respondents to the 2009 National Transgender Discrimination Survey reporting lifetime suicide attempts.”

The facts of homosexuality or transgender identity in themselves are not the causes of increased rates of attempted suicide and suicidal ideation, the report states. Instead, “[s]uicidal behaviors in LGBT populations appear to be related to ‘minority stress,’ which stems from the cultural and social prejudice attached to minority sexual orientation and gender identity,” and includes such things as “family rejection, harassment, bullying, violence and victimization.”

“Institutional discrimination” resulting from “laws and public policies that create inequities or omit LGBT people from benefits and protections afforded others” is “increasingly recognized as an aspect of minority stress,” the report says.

The report also identifies as a factor “suicide contagion,” a sense that killing oneself is a normal, rational response to bullying or discrimination stemming from media coverage of LGBT suicides.

Not surprisingly, the report identifies “factors that foster and promote resilience in LGBT people” to include “family acceptance, connection to caring others and a sense of safety, positive sexual/gender identity and the availability of quality, culturally appropriate mental health treatment.”

The report goes on to identify numerous “strategies for preventing suicidal behaviors in LGBT populations,” including “reducing sexual orientation and gender-related prejudice and associated stressors; improving identification of depression, anxiety, substance abuse and other mental disorders; increasing availability and access to LGBT-affirming treatments and mental health services; reducing bullying and other forms of victimization that contribute to vulnerability within families, schools and workplaces; enhancing factors that promote resilience, including family acceptance and school safety; changing discriminatory laws and public policies; and reducing suicide contagion.”

Facebook, a private sector partner in the National Action Alliance, will be offering a service that allows users to report friends’ suicidal comments to Facebook, which will then immediately send an email encouraging the person to call the National Suicide Prevention Lifeline at 1-800-273 TALK (8255), or to click a link to begin a chat session with a crisis worker.

The government issued a national suicide strategy in 2001, but the 2012 report is more detailed and has been well-received.

“The 2012 NSSP represents a significant step forward in our ongoing efforts to highlight the unique health needs of the LGBT community and to ensure government responsiveness,” said Andrew Lane, a gay member of the National Action Alliance for Suicide Prevention.

“We applaud the National Strategy for Suicide Prevention and the efforts underway to improve the health and well-being of LGBT people—particularly youth that need to know there are people out there ready and willing to help them,” said Human Rights Campaign spokesman Michael Cole-Schwartz. “With public and private resources coming together, this is a positive step toward lessening tragic deaths by suicide.”