Fallen Flowers

Suicide is a serious social and health problem in Korea [1]. According to a 2005 report by the Organization for Economic Cooperation and Development [2], Korea had the highest suicide rate with nearly 30 deaths per 100,000 population. Many studies have found that suicidal ideation and attempts among lesbians, gay men, and bisexual persons are higher than among heterosexual individuals (or general populations) [3e6]. In addition, these groups have comparatively higher levels of stress and depression. This may be linked to heterocentric cultures and homophobia; Asian cultures, including Korea’s, have higher stigma related to homosexuality. Because Korean tradition places intense value on lineage, marriage, and children, these expectations are considered normal and thus contribute to stigma even just among the unmarried and divorced as well as homosexuals [7]. Homosexuals do not come out for fear of being rejected by family and friends or discrimination in employment, promotion, housing, and other basic rights [7]. The rate of coming out in Korea is only 13.5%, lower than that of other countries [7]. Many studies that have examined determinants of suicidality that are specific to men who have sex with men (MSM) have focused on both developmental life transitions (e.g., adopting sexual identity or coming out) and social and cultural stressors (e.g., perceived stigmatization, antigay hostility). Homosexuals have higher rates of all-cause mortality, and those who live in areas with a higher degree of social stigma towards homosexuality tend to commit suicide at earlier ages [8]. This high prevalence of poor mental health problems and risky behaviors in homosexuals can be explained and understood in terms of minority stress [9]. The stigma, prejudice, and discrimination create a hostile and stressful social environment that causes stress, depression, substance use, and suicidal behavior among minority individuals. Studies on homosexuals focus on perceived stigma and sexual identity, which affect gayrelated stress such as coming out as homosexual. The mechanisms that underlie the associations between sexual identity and stress have been explored in a number of studies with mediation models that affect