Introduction
In today's world, even as awareness and tolerance increase, homosexuality continues to be viewed negatively and through stereotypes. Unfortunately, many of us are treated unfairly throughout society - in church, at school and even in our own homes. At various times homosexuality has been considered a crime, a sickness, a sin or at the very least an abnormality. Given these negative social, religious and familial attitudes it is likely that most gay and lesbian people face difficult and challenging experiences on a regular basis.

Most adult homosexuals have the strength and coping skills necessary to deal with such adversity and have a network of friends, coworkers and family members they can turn to for care and support. However, for gay and lesbian teenagers who lack the coping skills, ego strength and support systems needed to endure such hostile and often traumatizing experiences, the results can be devastating.

The teenage years are a confusing and challenging time in any person's life. For the self-identified gay or lesbian teenager adolescence can become a significantly troubling and isolating experience. Ostracized by their peers and rejected by adults, gay and lesbian teens develop disturbing thoughts and feelings about their place in this world. Some wonder if they belong here at all. As their feelings of sadness, confusion, isolation and anger remain ignored by others, they spiral downward into a troubling and painful sense of hopelessness and despair. Without the support and guidance of positive adults, role models, mentors or authority figures and with no place else to turn, suicide becomes the only remaining avenue of escape.

Unfortunately, parents, teachers, police officers, social workers and even health care professionals fail to consider or even acknowledge the struggles these youth live with on a daily basis. Their pain is often acted out through withdrawal, depression, drug and alcohol use, inappropriate or compulsive sexual acting out, truancy, petty crime and running away. Unsympathetically, these behaviors end up being further stigmatized by society, criminalized by law enforcement and pathologized by health care professionals. As their cries for help continue to fall upon deaf ears these youth are literally ignored to death.

Statistics on Teen Suicide
Suicide is the eighth leading cause of death in America and is skyrocketing amongst our youth. For young people ages 15-24, suicide is the third leading cause of death (National Center for Health Statistics, 1997). As staggering as these numbers may appear, it is widely believed that suicide amongst gay, lesbian and bisexual youth is even more profound. According to Gibson (1989) "gay and lesbian youth have a two to three fold risk of suicide" compared to heterosexual youth. In a recent study by Bagley (1994), 5 out of every 8 suicide attempters were gay or bisexual -- or put another way, gay and bisexual youth are 13.6 times more likely to have attempted suicide than their heterosexual counterparts.

Suicide amongst gay, lesbian and bisexual youth is a serious problem. As members of a hated, harassed and rejected group, these youth experience a sense of being different and isolated in the world, and they are at high risk for severe depression and suicide.

Miguel's Story
I met Miguel when he was seventeen years old and shortly after his third suicide attempt. His story is all too familiar amongst gay and lesbian youth that find themselves in a world of exclusion, heartless ridicule and vicious abuse.

"My life became upsetting for me at age nine which was the first time I was molested by my father's best friend. What happened was that I was playing in the back of the house when he walked in and started touching my body in a sexual way. Then he made me masturbate him. At the time I didn't know if what I was doing was wrong since I thought I was sort of attracted to him. But then he threw me face first on the ground and got on top of me. When he stuck it inside me, all I remember is that the pain was so much that I blacked out.

I was molested for the second time at thirteen. What happened was that I was walking through a field to get to the store when a man I didn't know pulled me under a tunnel. He fucked me for about an hour. I didn't tell my mom because I didn't want her to know and I figured she would blame me. I finally told my mom but she didn't believe me. She told my father and he beat me bad because they said I lied and shouldn't have been in the field. I was so angry and sad, I felt like running away. I wanted to kill myself but I didn't know how. I just didn't want to be around any longer because I thought it was my fault."

"One day I was in bed with my little brother and I was tempted to sexually act out but for some reason I didn't. My mom walked in and I think she felt that I was going to do something. She got so upset and beat me like never before. I really didn't care about being hit, and I ended up molesting my brother just to get back at my mom. Then the police showed up and I was taken away from my home and put in a group home."

"After a few days I just couldn't take it any longer. I was so scared and alone. I went into the bathroom with a large plastic bag and a leather belt I stole from my roommate. Nobody cared about me and nobody would listen. I felt so different from the others, like I was a mistake. I missed my family but I knew they didn't want me… I was a freak. I didn't want to be here. There was really only two choices, remain a mistake or leave this world."

Such events would be difficult for anyone to endure, but for an adolescent naturally struggling with identity issues and having no place or no one to turn to for support, it all becomes too much. Miguel saw no reason to go on living.

Why Gay & Lesbian Teenagers turn to Suicide
Let me make a very important point here - gay and lesbian youth do not want to kill themselves because they are homosexual, but rather, they want to end the pain of constant rejection and abuse. They see no other way out. Gay and lesbian youth believe they are "different" or "abnormal", because society taught them well. It is not their sexual identity that leads to depression and the wish to die, but rather, the experiences of living in such an uncaring world.

Here are some common struggles and issues the suicidal gay and lesbian teenager deals with:

• Low self-worth, self-value and self-esteem
• Disturbing beliefs that they are bad, mistakes, sinners, and freaks of nature
• Routine rejection, ridicule, exclusion, harassment, discrimination, neglect, and abuse
• Stigmatized by society, criminalized by law enforcement and pathologized by medical and health care professionals
• Lack of care and support from family, peers, school, church and society
• Tremendous anxiety over fear of exposure
• Painful depression
• Often turn to drugs, alcohol, sexual acting out, running away and/or suicide attempts due to their lack of coping skills, ego strength and support networks

Warning Signs for Risk of Suicide
Suicide Threats

• Suicide notes
• Direct threats ("I'm going to kill myself")
• Indirect threats ("I might as well be dead")

What Can Be Done?
When qualified mental health professionals work with suicidal clients, they take specific steps to ensure the safety of the patient and provide necessary and appropriate treatment. These steps include a) crisis assessment [to determine the degree of risk and possible need for hospitalization], b) evaluate the possible need for medication [completed by a medical doctor], and c) psychotherapy [including support, guidance, education, skill development, connection with resources, and friend & family involvement].

The larger issue is how can we as a community help prevent gay and lesbian youth from ever getting to the point where the think about ending their own lives. Obviously society is not going to change overnight. Therefore, we must realize that most gay and lesbian youth will experience some form of discrimination, harassment and exclusion. Adults, including parents, teachers, clergy, law enforcement personnel, doctors, social workers, and mental health professionals must be made aware of this fact and alerted to possible consequences.

In order for gay and lesbian youth to grow and develop healthily and happily they need:

• Care and support from family, school, church and society
• Acceptance for who they are - different but equal
• A positive social network to learn they are not alone in this world
• Opportunities to connect and socialize with appropriate peers
• Access to positive adult mentors and role models
• Given accurate information to dispel myths and stereotypes
• Given positive reinforcement to build self-worth and self-esteem

If only they knew then what they know now
Billy was 30 years old when we met. He told me of how difficult it was growing up in rural Minnesota as a self-identified but closeted gay youth. He talked of how isolated he felt knowing he was different from the others and fearing the abuse that would come if others knew his secret. Without peer and family support, fearing ridicule and rejection, believing he was a "freak", and fearing that he would one day turn out to be "like those drag queens seen on the news", Billy looked for a way out and attempted suicide on two separate occasions.

Luckily he did not succeed and lived to see the day several years later when he miraculously bumped into four other classmates from his high school hanging out in a local gay bar. The five of them agreed to meet up and talk about their common experiences. To everyone's shock, each of them had felt equally depressed and alone and each had tried to kill himself more than twice.

If only they had known of their shared secret back then. If only they had the support of each other. If only… Thank goodness they survived.

Let us be sure to reach out to today's LGBT youth and give them what they need. Let's not allow society to ignore the impact of harassment and discrimination or we may live to regret the consequences. Let's be positive role models and mentors. Most of all let us not allow society to ignore them… to death.