Educators, psychologists, sociologists, and human service and medical professionals have heightened their concern for and increased their research efforts into adolescent suicide. Their increased interest is due in part to the dramatic rise in suicide rates among U.S. adolescents over the past thirty-five years, and because suicide is now the third leading cause of death among adolescents in the United States (p. 7). Even more alarming, however, is that epidemiological evidence reveals that the incidence of suicide attempts among gay, lesbian, and bisexual youth is much higher than it is among heterosexual youth. Despite this disparity among the suicide attempt rates, research specific to gay, lesbian, and bisexual adolescent suicide is very limited.

Death by Denial: Studies of Suicide in Gay and Lesbian Teenagers offers an antidote to the dearth of research in this area by bringing together six research articles previously published between 1983 and 1993, plus two unpublished articles about suicide among gay, lesbian, and bisexual youth. Several articles in Death by Denial identify and discuss challenges that are specific to the development of gay, lesbian, bisexual, or trangender identity. In one of these articles, "Gay Male and Lesbian Youth Suicide," author Paul Gibson, a licensed social worker, discusses fifteen different risk factors associated with gay and lesbian suicide. For example, gay and lesbian adolescents have to contend with societal oppression and discrimination toward homosexuals; their own potential to internalize the images and portrayals of homosexuals as sick or bad people; potential rejection of parental or family love and connection due to their sexual identity; feeling sinful because their sexual orientation is incompatible with their own or their family's religious beliefs; harassment and abuse by peers due to their homosexuality, often leading to social isolation; or professionals labeling them as pathological and sick. Gibson also discusses how the threat of AIDS and the lack of positive images and adult gay and lesbian role models contribute to the stresses and risk factors for suicide affecting today's gay and lesbian youth.

In the article "Violence against Lesbian and Gay Male Youths," Joyce Hunter documents the frequency of violent attacks on gay and lesbian youth who seek counseling, education, or health services at the Hetrick-Martin Institute in New York City, and the associated suicidal behavior of these adolescents. She uses a sample of five hundred self-identified gay or lesbian adolescents, aged fourteen to twenty-one years, many of whom are Black or Latino. Hunter finds that 46 percent of reported assaults were gay-related, and that 61 percent of these gay-related assaults occurred within the victim's families. She found further that 41 percent of these girls and 34 percent of these boys tried to kill themselves. While Hunter points out that this correlation is not conclusive of a link between gay-related violent assault and suicide, her study does indicate a potential connection. Accordingly, Hunter makes a plea for further research into the possible association between gay-related assaults and suicide among adolescent victims of these assaults.

Other articles in Death by Denial include "Parasuicide: Gender and Gender Deviance" by Joseph Harry and "Making Schools Safe for Gay and Lesbian Youth: Breaking the Silence in Schools and in Families," a 1993 report by The Massachusetts Governor's Commission on Gay and Lesbian Youth. By compiling these articles on gay and lesbian suicide, Death by Denial offers concerned educators and professionals an important resource on issues that researchers and clinicians theorize may account for the increased incidence of suicide among gay, lesbian, and bisexual youth. Author and editor Gary Remafedi reminds us that when educators and human service professionals ignore the reality of the high incidence of gay and lesbian suicide among adolescents, it is "tantamount to sanctioning death by denial" (p. 13).

H.S.G.