Eighteen physicians, residents, and medical students from the University of Colorado School of Medicine presented on their research this week at the Academic Surgical Congress, an annual convention hosted by the Society of University Surgeons.
Among the CU School of Medicine representatives presenting virtually due to the COVID-19 pandemic was Monica Patten, a second-year medical student who conducted research on the increased risk of suicide among lesbian, gay, bisexual, and transgender individuals.
“I care a lot about the LGBTQ population, as I myself am a part of the population, and I am interested in the social determinants of health and health care policy in general,” says Patten, a former president of the CU chapter of Medical Student Pride Alliance. “I wanted to make sure that my research focused on those policies and populations in addition to just being surgical in nature.”
Reasons for higher risk
Along with her mentors, general surgery resident Heather Carmichael, MD, and Catherine Velopulos, MD, associate professor in the Division of GI, Trauma, and Endocrine Surgery, Patten combed through four years of data from the National Violent Death Reporting System to analyze data on suicides among the LGBTQ population. LGBTQ individuals are at a higher risk for suicide than their heterosexual counterparts, and Patten’s research looked at the many factors that account for the disparity, including past treatment for mental illness, rates of intimate partner violence and number of prior suicide attempts. Her goal is to better inform health policy, as well how primary care providers assess and address patients at risk of suicide.
“I hope this can be the beginning of more research into more effective ways to communicate with providers about suicide risks and prevention in these populations to inform their practice."
“We wanted to see if we could do a deeper dive into not just how many LGBTQ individuals are committing suicide vs. how many heterosexuals are committing suicide, but what does that look like and how does that differ,” she says. “We focused on age, race, ethnicity and weapon type, as well as if there were there other issues in the home: family issues, other personal relationship issues, a history of substance abuse, or mental health concerns.”
Patten says among the findings that surprised her were the fact that gay men are much less likely to use a firearm to commit suicide than straight men are, and that suicides due to intimate partner issues were highest among lesbian and bisexual women and lowest among transgender people.
“I hope this can be the beginning of more research into more effective ways to communicate with providers about suicide risks and prevention in these populations to inform their practice,” says Patten, who also is working on a paper on her findings that she plans to submit for publication soon. “It’s already becoming more commonplace to make sure we’re asking patients about their gender identity and their sexual orientation, so now we’re trying to take it even a step further when we’re assessing for things like intimate partner violence or suicide risk.”
Better data needed
Patten says she also found through her research a need for better data collection regarding LGBTQ populations. The National Violent Death Reporting System, for instance, has only been factoring sexual orientation and gender identity into its data since 2013, and information on sexual orientation and gender identity can be difficult to get postmortem as it relies largely on the knowledge of family and friends who may not know someone’s complete story.
“There’s such limited data because it’s an understudied population,” she says. “That’s beginning to change, but it’s still hard to know the scope of a lot of issues that affect that community. It feels really meaningful to be able to contribute to research that’s already lacking.”