The Tsunamic Model of LGBTQ+ Deaths of Despair: A Systemic Review to Identify Risk Factors for Deaths of Despair Among LGBTQ+ People

J Homosex. 2022 Nov 10;69(13):2167-2187. doi: 10.1080/00918369.2021.1935620. Epub 2021 Jun 4.


The term Deaths of Despair (DOD) was introduced to capture the phenomenon of mortality associated with suicide, drug overdose, and alcoholic liver disease. The LGBTQ+ population consistently evidences disproportionately high rates of DOD. This study reviewed the literature on DOD within this community to create a conceptual model that identifies risk factors that work together to potentiate DOD in the LGBTQ+ community. Ten DOD-Related Factors were identified and used to create The Tsunamic Model of LGBTQ+ Deaths of Despair. DOD-Related Factors include: (1) Stigma, (2) Demographics, (3) Identity Development, (4) Internalized Homophobia, (5) Depression, (6) Victimization, (7) Isolation/Rejection, (8) Sensation Seeking, (9) Risky Behavior, and (10) Uninformed Care. Each factor is associated with increased risk for DOD among the LGBTQ+ community. This model can help health professionals by providing a framework for prevention and early intervention programs.

Keywords: Deaths of despair; LGBTQ+; alcoholic liver disease; drug overdose; informed care; mental health; prevention; suicide.

Publication types

  • Systematic Review

MeSH terms

  • Bullying*
  • Crime Victims*
  • Humans
  • Risk Factors
  • Sexual and Gender Minorities*
  • Suicide*