Suicides Among Lesbian, Gay, Bisexual, and Transgender People: Medical Examiner Reports in the Special Wards of Tokyo, Japan, 2009-2018

We aimed to report the occurrence of suicide death and to reveal the characteristics among LGBT people in the special wards of Tokyo. All suicide deaths between 2009 and 2018 were identified from the Tokyo Medical Examiner's Office database, and the characteristics were compared between LGBT people and non-LGBT people by retrospective review of the medical examiner reports. Among 17,638 people who died by suicide, 84 (0.5%) were identified as LGBT people, of which a large proportion was gay males (51.2%) and transgender people (42.9%). Smaller proportions of lesbian (3.6%) and bisexual (2.4%) females were identified. Compared with suicides among non-LGBT people, there were several differences in the circumstances surrounding suicides among LGBT people, namely method of suicide, source of income, and number of household members (transgender people), and toxic substance in poisoning and medical history (gay males). The results tentatively suggest the risk or supportive factors that should be considered for preventing suicides among LGBT people; however, the present data are likely to be underestimated. To better understand suicides among LGBT people, systematic efforts to collect sexual orientation and gender identity data for suicide are needed.