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He added that the country adopts an open policy in welcoming foreign tourists and would "never place any unnecessary obstacles to our guests based on their sexual orientation, religion and cultural practices. The statement added that the country has, as a sovereign nation, its own views on both the LGBT community and Israel, and expected other nations to respect the country's sovereignty. An aide told Malaysian online news portal Malaysiakini that the comments were made in a personal capacity, but were in line with official Malaysian government policy, which does not recognize the LGBT community.

The aide, who was not named in the report, added: Gay rights campaigner Thilaga Sulathireh told CNN that the remarks were "outlandish and completely disconnected from reality" but not entirely surprising to hear.

She added that it was "also an embarrassingly ignorant comment which carries high socioeconomic costs," should it impact LGBT tourism to Malaysia. Same-sex relationships are still a crime in 69 countries. The country's stance on homosexuality, as well as its alleged antisemitism -- in January this year it tried to ban Israeli athletes from an international swim meet -- had been criticized ahead of its participation at ITB Berlin. German Green party politician Volker Beck had sought to exclude Malaysia from exhibiting at the Berlin event, one of the world's largest tourism expos, saying that its government has specific policies which are discriminatory to gay people and Jews.

He expressed disbelief at the minister's controversial response to what he said should have been a straightforward question to answer. All he needed to say was that Malaysia is a safe country and every tourist is safe here," he said. Homophobia is ingrained in Malaysian politics and culture, and homosexual sex is illegal throughout Malaysia under colonial era criminal law.

According to the minority stress model, 16 the excess prejudice, stigma, and discrimination encountered by sexual minority individuals lead to increased mental health problems in this population and a resulting increased risk of suicide. Explanations for disparities in suicide rates between the LGB and heterosexual populations often cite the increased prevalence of such problems, including depression and substance abuse. First, this pattern is the inverse of the pattern in the general population, in which the rate of suicide among Whites is more than double that among Blacks and Latinos.

We tested 2 hypotheses in an effort to explain this unexpected finding. First, we hypothesized that although lifetime prevalence rates of mood and substance use disorders are lower among Black and Latino LGB adults than they were among White LGB adults, the opposite pattern would be observed among youths i. Because most suicide attempts in the LGB population occur among those younger than 25 years, 21 lifetime prevalence estimates of mood and substance use disorders may not provide an accurate understanding of disparities in suicide attempts between different LGB subgroups.

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To test our hypothesis, we determined whether major depressive disorder MDD or substance use disorders were present among LGB minority youths before a suicide attempt or before the age by which most suicide attempts occur. Our overall aim was to assess whether such disorders mediate the higher prevalence of suicide attempts among LGB minority youths despite the lack of lifetime between-group disparities in these disorders.

According to this hypothesis, despite the lower prevalence of MDD and substance use disorders in the Black and Latino LGB population, individuals in this group who are affected by one of these disorders are more likely than are White LGB individuals with such a disorder to attempt suicide.


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Our study population included New York City LGB residents aged 18 to 59 years who were recruited through sampling at Project Stride Stress, Identity, and Mental Health venues across 32 different zip code areas in the city and through snowball referrals made between February and January Project Stride is described in more detail at http: The computer-assisted World Mental Health Survey version of the World Health Organization's Composite International Diagnostic Interview version 19 25 was used to evaluate respondents with respect to diagnoses of MDD and substance use disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition 26 and to assess suicidal behaviors.

We compared groups with respect to their suicide risk to test the hypothesis that MDD and substance use disorders in youth mediate 27 , 28 the association between minority status and increased risk for suicide attempts. In evaluating youth-onset disorders, we coded a disorder as present only if its onset preceded age at first suicide attempt. Among those with no history of suicide attempts, we coded a disorder as present if its onset occurred before a specified critical age, defined as the age before the majority of suicide attempts might have occurred had they occurred among respondents who did not actually attempt suicide.

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We calculated this critical age as 1 standard deviation above the mean age at which suicide attempts occurred among attempters in our sample One standard deviation above that age was 6. To do so, we used a logistic model interaction term to compare the risk of suicide attempts among Black and Latino respondents with MDD and substance use disorders with the risk among Whites with these disorders.

Table 1 displays the prevalence of lifetime suicide attempts as well as the prevalence of MDD and substance use disorders before a suicide attempt or before the age of 24 years i.

Our first hypothesis was that mood and substance use disorders in youth would mediate this increased risk. This hypothesis required that Black and Latino respondents have a higher prevalence of these disorders than White respondents. The data failed to support the hypothesis: New York, NY, — Our data failed to support this hypothesis as well: The same finding was true for substance use disorders.

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Also, we assessed whether this increased risk was associated with depression or substance use disorders. These results suggest that Black and Latino LGB individuals may be at elevated risk for suicide attempts even in the absence of the traditional markers of depression and substance abuse. This study involved a nonrandom sample from an urban American city, and thus our prevalence estimates may not be generalizable to all LGB groups.

The strength of the sample, however, is that it included a large number of LGB individuals recruited from a diverse selection of venues. Our results are preliminary and suggest that further work is necessary to explain the perplexing findings that motivated our research. For example, although researchers have suggested that the shame and stigma associated with nonheterosexual behavior are increased in Latino cultures, in which collectivism and familial honor are strong, 29 this hypothesis has not been formally tested. The Western Institutional Review Board approved this study.

Increased Risk of Suicide Attempts Among Black and Latino Lesbians, Gay Men, and Bisexuals

All respondents provided written informed consent. National Center for Biotechnology Information , U. Am J Public Health. Author information Article notes Copyright and License information Disclaimer. Matt Chun, who lives in Washington, D. Kimo Omar, a Pacific Islander living in Portland, Oregon, said he has experienced racial discrimination on gay dating apps but has a simple solution: As for Keodara, he plans to tackle the issue head on with his proposed class-action lawsuit.

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