State Same-Sex Marriage Policies Associated With Reduced Adolescent Suicide Attempts Interview with:
Julia R.G. Raifman, ScD

Post-doctoral fellow
Johns Hopkins Bloomberg School of Public Health What is the background for this study?

Response: Suicide is the second leading cause of death among adolescents between the ages of 15 and 24 years old in the United States. Gay, lesbian, and bisexual adolescents have elevated rates of suicide attempts. In our study, we found that 29% of gay, lesbian, and bisexual adolescents reported attempting suicide in the past year relative to 6% of heterosexual adolescents. What are the main findings?

Response: The main finding is that state same-sex marriage policies were associated with a 7% reduction in adolescent suicide attempts. The relationship between state same-sex marriage policies and suicide attempts was concentrated among gay, lesbian, and bisexual adolescents, among whom there was a 14% decline in suicide attempts. These are large decreases in suicide attempts relative to the Healthy People 2020 goal of reducing adolescent suicide attempts by 10%. What should readers take away from your report?

Response: State same-sex marriage policies were associated with reduced adolescent suicide attempts. What recommendations do you have for future research as a result of this study?

Response: This study indicates that a social policy was associated with adolescent suicide attempts. There is a need for further research on how other social policies governing rights for gay, lesbian, bisexual, and transgender populations affect health outcomes. Is there anything else you would like to add?

Response: I’ll share a bit about the design of the study. We took advantage of a natural experiment created by variation in  years when states passed same-sex marriage policies. We compared adolescent suicide attempts before and after same-sex marriage was implemented in 32 states that implemented those policies by January 1, 2015. We then compared those changes in states that implemented same-sex marriage to changes over time in 15 states that didn’t implement same-sex marriage policies by January 1, 2015.

The authors have no conflicts of interest to disclose Thank you for your contribution to the community.


Raifman J, Moscoe E, Austin SB, McConnell M. Difference-in-Differences Analysis of the Association Between State Same-Sex Marriage Policies and Adolescent Suicide Attempts. JAMA Pediatr. Published online February 20, 2017. doi:10.1001/jamapediatrics.2016.4529

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on February 21, 2017 by Marie Benz MD FAAD