cunicular:

antilla-dean:

Towards the end of last year, a shocking statistic appeared deep in the pages of a World Health Organisation report. It was this: suicide has become the leading killer of teenage girls, worldwide.

More girls aged between 15 and 19 die from self-harm than from road accidents, diseases or complications of pregnancy.

For years, child-bearing was thought to cause the most deaths in this age group. But at some point in the last decade or so – statistics were last collected on this scale in 2000 – suicide took over. And, according to the WHO’s revised data for 2000, it had already just inched its way ahead of maternal mortality at the turn of the millennium.

Yet, somehow, we didn’t notice.

I heard the statistic from Sarah Degnan Kambou, President of theInternational Centre for Research on Women (ICRW), at a Gates Foundation breakfast last month.

Most of my fellow guests worked in the fields of global women’s rights or female health. Yet they were as stunned as I was to hear it.

“I’m not quite sure why we haven’t realised this before,” says Suzanne Petroni, a senior director at ICRW. “Maternal mortality has come down so much, which is fantastic,” she says.

That’s a major factor behind the fall in the overall death rate for 15-19 year old girls from 137.4 deaths per 100,000 girls in 2000 to 112.6 today. It’s an amazing achievement.

And it has allowed the spotlight to fall, finally, on what has actually been the biggest killer all along: suicide.

The report looks at six global regions. In Europe, it is the number one killer of teenage girls. In Africa, it’s not even in the top five, “because maternal deaths and HIV are so high,” says Petroni.

But in every region of the world, other than Africa, suicide is one of the top three causes of death for 15 to 19 year old girls. (For boys, the leading killer globally is road injury).

It’s particularly shocking given that suicide is notoriously underreported.

“We don’t really know the extent of the problem,” says Roseanne Pearce, a Senior Supervisor at Childline in the UK. “Because the coroner often won’t record it as suicide. Sometimes that’s at the family’s request, and sometimes it’s simply to protect the family’s feelings.”

In countries where stigma is particularly high, suicides are even less likely to be recorded than they are in the UK. And the poorest countries in the WHO’s report have very patchy data on births and deaths at all, let alone reliable detail on what caused those deaths.

In South East Asia, the problem is acute: self-harm kills three times more teenage girls than anything else. (The Eastern Mediterranean, which includes Pakistan and the Middle East, has the second highest rate.)

Professor Vikram Patel, a psychiatrist who was recently featured in Timemagazine’s 100 Most Influential People for his work in global mental health, is blunt in his diagnosis:

“The most probable reason is gender discrimination. Young women’s lives [in South East Asia] are very different from young men’s lives in almost every way.”

The male suicide rate in this age group is 21.41 per 100,000, compared with 27.82 for girls.

This is the age at which girls may be taken out of school and forced to devote themselves to domestic responsibilities, forgetting all other abilities or ambitions. Hitting puberty can mean no longer being allowed to socialise outside the home. Sometimes it can mean no longer being allowed out of the home at all. And, sometimes, it can mean forced marriage.

[…]

Rhea (not her real name) is 17 and has attempted suicide twice. “Porn was everywhere in my school,” she says. Her boyfriend Andy became “obsessed with it”.

She’d “made it clear,” she says, that she “wasn’t ready to have sex,” but one evening he sexually assaulted her in a park. The assaults became routine. Rhea did nothing.

“The constant talk about porn had made me feel like what was happening was normal,” she says. She uses that word repeatedly to describe her attitude towards Andy’s assaults: normal.

“I felt trapped, like everyone thought it was normal and I had to go along with it if I wanted to be accepted.” The pressure to conform to these perceived expectations was so great that, eventually, Rhea says, “I felt like there was no way out.” She tried to kill herself.

“The suicide attempt rate for young women in the UK is extremely high,” says Prof Patel. He believes “sexual pressure” is a significant factor in their unhappiness.

Roseanne Pearce agrees, adding that “sexting is another big issue among our callers. Girls become desperate, even suicidal, because they’ve sent a picture and it’s been posted online.”

There is also relentless pressure on Western girls look a certain way: to be thin and sexy. The boys at Rhea’s school constantly compared the girls’ bodies to women they saw in porn films, almost always negatively.

[…]

But, he says, “groups that have less power” tend to be most vulnerable – suicide rates are consistently higher among the unemployed, and the economically or socially marginalised.

Young women in parts of the Middle East and South East Asia are some of the most disempowered and marginalised people in the world.

Even in the West, adolescence is a time when girls feel their choices become restricted: that they must look and behave in certain ways to be accepted.

“Gender is a pervasive global issue,” says Prof Patel. And, as we’re somewhat belatedly realising, the consequences can be fatal.”

this is so fucking sad

Suicide is now the biggest killer of teenage girls worldwide. Here’s why