Concealment of Sexual Minority Identities in Interviewer-Administered Government Surveys and Its Impact on Estimates of Suicide Ideation Among Bisexual and Gay Men

Bisexual and gay men are at increased risk of suicide ideation. Characterizing this risk requires self-disclosure of sexual identities; however, many will conceal their identity when interviewed. The authors investigated the impact of the resulting information bias within the Canadian Community Health Survey (CCHS). Expected probabilities of disclosure were derived from a community-based survey of bisexual and gay men, stratified by sexual identity and other social characteristics. Forty percent of bisexual men and 86% of gay men were willing to disclose to CCHS interviewers. The odds of suicide ideation were higher for bisexual (odds ratio [OR] = 4.91) and gay (OR = 3.63) men compared to heterosexual men. After bias analysis these disparities remained significant but were attenuated, with greater attenuation for bisexual (adjusted OR = 3.53) than for gay (adjusted OR = 3.52) men. The authors recommend that researchers continue exploring bias in estimated sexual minority health disparities, and that population surveys be more inclusive of bisexual-identified individuals.