By Randy Dotinga
"The findings suggest that same-sex marriage policies reduced adolescent suicide attempts," said study lead author Julia Raifman. She's a postdoctoral fellow at Johns Hopkins University's Bloomberg School of Public Health in Baltimore.
"It's important for policymakers to be aware that social policies that affect lesbian, gay and bisexual rights may impact child health," Raifman said.
Prior research has suggested that "sexual minority" teens are more likely to be bullied and to be suicidal. A study published last year found that as many as 40 percent of gay, lesbian and bisexual teens have considered suicide. The same research reported that 29 percent of these teens had attempted suicide in the past year.
The new study looked at the results of surveys of nearly 763,000 U.S. students from 47 states. Their average age was 16. The surveys were conducted from 1999-2015.
In 2015, gay, lesbian, bisexual students and those who were "not sure" made up nearly 13 percent of the teens surveyed. More than 6 percent said they were bisexual. Four percent said they were "not sure" about their sexual orientation. Slightly more than 2 percent said they were gay or lesbian. (The survey didn't ask teens whether or not they identified as transgender.)
Nearly 9 percent of all students and 29 percent of the gay or bisexual students said they'd tried to commit suicide.
Overall, the teen suicide attempt rate dipped by a 0.6 percentage point, a risk reduction of 7 percent, after states allowed same-sex marriage. The overall rate of suicide attempts by gay and bisexual teens dropped 4 percent after the same-sex marriage laws were introduced, a risk reduction of 14 percent, the study found.
The researchers noted that the study only observed an association and didn't prove that approval of same-sex marriage had a direct effect on teen suicides.
"It is possible that states were simply moving in more supportive directions," study lead author Raifman said. Or, she said, state policies approving same-sex marriage may have affected the teens by reducing stigma.
It's not clear how teens will be affected by the recent federal right to same-sex marriage, she added. The U.S. Supreme Court allowed same-sex marriage in all states in June 2015.
Brian Mustanski, director of Northwestern University's Institute for Sexual and Gender Minority Health and Wellbeing, believes policies about issues such as same-sex marriage matter to teens.
"A major focus of the teenage years is figuring out where you fit in the world, and as a side effect of that there is also a focus on who doesn't fit in," he said.
"Teens can take their cues for this from the media, their parents and from social policies. If the law says one group isn't equal to another, it sends a powerful message to young people that they also don't need to treat the 'lesser' group fairly either. Legal discrimination can also fuel existing biases," Mustanski said.
Ritch Savin-Williams is a professor emeritus of developmental psychology at Cornell University in Ithaca, N.Y. He said it's possible that marriage laws had no direct impact on suicide attempts in liberal states that already were more supportive of the LGBT community.
The study appears Feb. 20 in the journal JAMA Pediatrics.