UNDERSTANDING THE DISPARITY: A SYSTEMATIC REVIEW OF SUICIDAL IDEATION IN GAY MEN AND LESBIAN WOMEN

Siti Khadijah Mohd Nasrah, Nurul Fazzuan Khalid, Syed Mohamad Syed Abdullah

Abstract

Background: Gay men and lesbian women experience higher rates of suicidal ideation than heterosexuals, representing a critical public health concern. The Minority Stress Model helps explain how stigma, discrimination, and social exclusion contribute to this disparity. Methods: This systematic review followed PRISMA 2020 guidelines. Searches were conducted in PubMed, PsycINFO, Scopus, and Web of Science for peer-reviewed studies published in English between January 2003 and December 2023. Studies were eligible if they reported disaggregated findings for gay and lesbian participants and assessed suicidal ideation as an outcome. From 1,020 records screened, 65 studies met inclusion criteria. Results: Minority stress processes, such as enacted stigma, anticipated rejection, and internalized homophobia, were consistent predictors of suicidal ideation. Social support from family and LGBTQ+ communities emerged as a strong protective factor. Subgroup differences were evident: gay men were often affected by HIV-related stigma, while lesbian women experienced compounded risks related to sexism and social invisibility. Six studies from Southeast Asia highlighted the particular influence of family rejection and cultural stigma in shaping suicide risk. Conclusion: Suicidal ideation among gay men and lesbian women reflects systemic stigma rather than sexual orientation. Multilevel prevention should combine affirmative clinical care, family acceptance, community-based support, and stigma-reducing policies, with further research to clarify subgroup-specific mechanisms.