Why Mary McAleese was right to raise LGBT suicide risk

No campaigners are trying to protect themselves from the idea that they are complicit in damaging the mental health of thousands of people in the coming month.

comment1Prof Patricia Casey writes in the Sunday Independent that the claims made by former president Mary McAleese regarding the high suicide risk in homosexuals are “a surprise”, “ignoring the complexity of suicide” and threaten to “muddy our discourse on the subject”. This was specifically in response to McAleese’s statement: “We have, in Ireland, a very serious problem of youth suicide and we now know from the evidence that one of the most at-risk groups or cohorts within that age group of 15 to 25 is the young male homosexual.”

Casey’s response is to question the truth of that claim: that although there are well-studied associations in LGBT populations of higher rates of anxiety, depression, self-harm, suicide attempts and substance misuse, there is a lack of evidence for increased rates of death by suicide in these populations. Casey even goes so far as to say she would not contribute to campaigns to reduce suicide in these populations until there is evidence that rates of death by suicide are higher.

Leaving aside the issue of the data collection of death rates for a moment, I want to make what might seem to be a trivial observation, but one which undercuts much of Casey’s response. Anxiety, depression, substance misuse, self-harm and suicide attempts are risk factors which are all independently associated with conferring a higher risk of death by suicide. It is incredibly confusing to understand why we should support those facts, but at the same time why we should be highly sceptical of the claim that these factors confer a higher risk of death by suicide in LGBT populations. What is the purpose of this scepticism? Are there actually benefits from us holding scepticism as a value above all other claims in this issue; and if so, to whom?

Data collection problems

The reason Casey gives us as to why we should be sceptical of McAleese’s claim is that there are difficulties with data collection of suicide rates and the recording of personal and demographic information which have not borne out high-quality evidence of a definite link between sexuality and death by suicide. It is true that data collection is a difficult task and that scientific methodology can always seek improvement, but if there is a large body of indirect evidence which supports that claim and the only reason that we don’t currently have a body of direct evidence is due to some methodological shortcomings, why should McAleese’s claim be regarded as dangerous when it is highly likely to be true?

Why is McAleese’s claim decried as not just an untruth, but as a dangerous untruth we must completely reject until proven otherwise? Who is this claim dangerous for?

The problems of demographic data collection are problems which exist with any study of this kind, and there will always be problems with sample quality by dint of the fact that our world is not a sterile lab where we can always control for every possible variable. What is true is that research shows a highly-overlapping, if not completely perfect, consensus that risk factors for death by suicide are much higher in LGBT communities and that the extension of this is a higher rate of death by suicide, even if we have found it difficult up until now to precisely define that rate. However, for Casey, McAleese’s claim is not just one which is not completely scientifically verified, but one which is actively dangerous.

It is still unclear to me what harm Casey sees in McAleese’s claim. We are told that the claim is “ignoring the complexity of suicide” and is “muddying our discourse” because it conflates suicidal ideation, suicide attempts and death by suicide. I genuinely do not know why believing the claim that LGBT population are at a higher risk of suicide impacts on my ability to understand that there are degrees of intent of suicide, and Casey actually gives me no reason to believe, beyond an assertion, that believing the first harms my ability to understand the second. We are not told what specific discourse around suicide is muddied by this claim, or in what way it is muddied. Similarly, it is just not explained beyond assertion why the ability of an individual psychiatrist to distinguish between ideation and attempt when diagnosing a patient is made worse off by believing there is a higher suicide rate in LGBT populations.

So what is the purpose of this scientific scepticism? Why is McAleese’s claim decried as not just an untruth, but as a dangerous untruth we must completely reject until proven otherwise? Who is this claim dangerous for? Casey’s characterisation of James Reilly trying to “stifle debate” by claiming that the mental health of LGBT people will be damaged by the No campaign gives us a clue as for whom Casey thinks McAleese’s claim is dangerous. It is an attempt to wrap a political discussion in the supposedly apolitical, objective truth of science.

Complicity in damaging mental health

When a debate can be framed in terms of a mere disagreement over claims to a scientific truth, both sides can claim equal amounts of respect and a goodhearted nature to want to discover the truth. For an example of this, look to the discussion about outcomes for children with same-sex parenting; where it is more politically and socially palatable for the anti-same-sex-adoption side to claim to be cautiously concerned in a politically-neutral manner for children based on the science of parenting, rather than to explicitly defend the discriminatory claim that they have less trust in gay people and their ability to rear children.

Placing an incredibly high bar for the standards of scientific research needed before she will support McAleese’s claim, and outright rejecting it as falsehood until proven otherwise, Casey attempts to protect herself and her fellow No campaigners from the idea that they are complicit in damaging the mental health of thousands of people in the coming month, and contributing to an increased risk of more people dying. The supposed struggle to maintain the integrity of the scientific method is seen as more valuable than any other struggle, while young people continue to suffer and die in this country. It is a poor attempt, loosely wrapped in a thin veil embroidered with the phrase “supported by science”.

If you have been affected by any of the issues raised in this article, you can contact the Samaritans on 116 123 or the National LGBT Helpline on 1890 929 539.