While much progress has been made in recent years to identify suicide risk factors, one aspect that is frequently considered – but not yet fully understood – is the role that gender plays in the frequency and severity of suicidal thoughts and behaviors.
Numerous studies and statistics point to one glaring truth: men die from suicide much more often than women, despite the fact that women are more likely to report thoughts of suicide and even attempt suicide more often than men.
Understanding the impact of gender on the risk factors for suicidal ideation and outcomes is essential to treating and preventing suicide for everyone. This article will take a closer look at the rates of suicide among men and women, the most common causes of suicide for males and females, and how certain factors might explain why the risk of death by suicide is so much higher for men than women.
Suicide Rates by Gender: Gender Differences in Suicide
According to the CDC, 45,979 Americans died by suicide in 2020, making it the 12th leading cause of death in the U.S. And the vast majority of these suicide deaths — 76% — were men. The National Institute of Mental Health (NIMH) recently reported that men were 4 times more likely to die from suicide than women, despite the fact that women report thoughts of suicide more often and make more non-fatal suicide attempts than men.
Worldwide, the WHO found that nearly 40% of countries have more than 15 suicide deaths per 100,000 men, compared to just 1.5% of countries with 15 suicide deaths per 100,000 women.
This disparity is known as the “gender paradox.”
And although rates of suicide vary across demographics like age — older adults die by suicide more than younger adults — and race — non-Hispanic White and Indigenous people die by suicide more often than people of Black or Hispanic ethnicity or racial identity — the differences between men and women are still striking.
This inverse relationship between suicidal ideation and outcomes between men and women has been part of the suicide prevention landscape for years, and as we learn more about suicide in transgender and gender diverse (TGD) individuals, the relationship between gender and suicide gets even more complex.
Suicide Attempts: Men vs. Women
On average, every 40 seconds someone in the world dies by suicide. And while women are far more likely to attempt suicide than men — 3 out of 4 suicide attempts are made by women — suicide attempts by women are far less likely to result in death. Researchers believe this is largely due to the suicide methods women choose, compared with men.
The National Institute of Mental Health (NIMH) reports that more than half (57.9%) of male suicides involved a firearm, while another study found that men were 8 times more likely to use more lethal methods of suicide, like firearms, than women, although the number of women using more lethal means is on the rise.
According to the Prevent Firearm Suicide, a project of the EFSGV, 9 out of 10 firearm suicide attempts result in death. This reliance on deadlier methods like firearms is a key to understanding different rates of suicide among men and women, and the increase in suicide attempts and deaths by suicide in the past decade.
Different Methods of Suicide Used by Men and Women
A controlled study of 302 individuals who had made a “medically serious suicide attempt” found that there were an equal number of men and women. However, “twice as many women used non-violent methods” suggesting that the biggest difference in suicide mortality between men and women is the method of choice, not suicidal intent.
Statistical evidence also strongly supports this difference in method. In 2022, the NIMH reported the most common suicide methods:
- Women: Firearm (33.0%), suffocation (29.1%), and poisoning (28.6%)
- Men: Firearm (57.9%) followed by suffocation (26.7%)
Men are twice as likely as women to attempt suidice using a firearm, which may account for the fact that 77% of people who die by suicide on their first attempt are male.
Another study titled, “Method choice, intent, and gender in completed suicide,” found that women were more likely to use methods such as “drug overdose and carbon monoxide poisoning,” while “men tend to use firearms and hanging” to attempt suicide.
Firearms considerably increase the risk of death by suicide, and while firearm use among suicide attempts is rising among women, this single factor could explain suicide mortality rate differences, as firearms greatly reduce one’s chance of survival or rescue compared to drug overdose or poisoning.
Suicide Over Time
Over the last 50 years suicide deaths have doubled, while nearly every other leading cause of death, from car accidents to heart disease, have fallen. And according to the CDC, this trend is set to continue.
In 2020, the CDC estimated that 12.2 million Americans had serious thoughts of suicide, 3.2 people million planned to commit suicide, and 1.2 million attempted suicide, marking a steady increase, especially among young people, where suicide has become the second leading cause of death for people ages 10-14 and 25-34.
The CDC went on to say that “Suicide rates have increased more than 30% in half of states between 1999 and 2016.” Only one state, Nevada, saw a decrease in suicide rates, and only by 1%. The ongoing mental health crisis is concerning.
Suicide Prevention and Treatment
Suicide prevention and treatment is an immensely complicated and ever evolving field. However, thanks to evidence-based assessment and treatment frameworks, like The Collaborative Assessment and Management of Suicidality (CAMS) and tools like the Suicide Status Form (SSF) which is becoming a part of electronic health records across the country, clinicians are more equipped to identify, treat, and ultimately prevent suicide.
CAMS has more than 30 years of evidence, five published randomized control trials, and two meta analyses one of which shows that CAMS is a “Well Supported” treatment by CDC criteria and is even proven to “reduce hopelessness and increase hope” in as few as six sessions. In fact CAMS is one of four evidence-based treatments that are referenced by the Joint Commission, Surgeon General, Zero Suicide, and the CDC.
Emphasizing the four “pillars” of CAMS—collaboration, empathy, honesty, and being suicide-focused—is a proven way of reliably decreasing suicidal ideation and reducing serious psychiatric distress, while keeping the patient stable and identifying the “drivers” that compel the patient to consider taking their life.
An Infographic: Suicide Rates by Gender
Although additional research is clearly needed to more fully understand how gender and gender identification affect suicidal behavior, we are making progress in learning how gender impacts suicide.
Here are some more known statistics on the subject of gender and suicide:
Click here to learn more about how we train physicians to use CAMS to treat and prevent suicide.
1 Centers for Disease Control and Prevention, Suicide rising across the US. https://www.cdc.gov/vitalsigns/suicide/index.html
2 Bostwick, J. M., Pabbati, C., Geske, J. R., & McKean, A. J. (2016). Suicide attempt as a risk factor for completed suicide: even more lethal than we knew. American journal of psychiatry, 173(11), 1094-1100
3 National Center for Biotechnology Information, Prevalence of gender identity disorder and suicide risk amount transgender veterans utilizing veterans health administration care. https://www.ncbi.nlm.nih.gov/pubmed/23947310
For more information
To learn more about how gender and gender identification affects suicidality, read “The Gender Paradox of Suicide: How Suicide Differs Between Men, Women, and Transgender/Gender Diverse Individuals” by Dr. Raymond P. Tucker.
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