(WOMENSENEWS)--Eliza Noh received a call from her parents 16 years ago that she can never forget. They told her that her older sister had purchased a gun in their hometown of Houston and shot herself in the head.
As shocking as the news was, Noh said she and her family--of Korean and Vietnamese descent--also saw it coming.
Her sister, a junior at Houston Baptist University when she died, had attempted suicide before by cutting her wrists.
"Growing up in predominantly white schools in Texas, where Asian Americans were marginalized as model minorities and undesirable people, my sister dealt with body image problems," Noh said. "She hated looking Asian American."
Her sister underwent cosmetic surgery to have a European bridge put in her nose and eye-widening folds in her upper lids.
Her problems didn't ease with her change in appearance, however.
"She wrote an essay for an English class and got a B on the essay. When she inquired to her professor, he said he didn't give foreign students A's on English papers," said Noh, noting that she and her sister were born in the United States. "This is the kind of racism she would come up against. And that really depressed her."
When her sister took her life, Noh was a sophomore at Columbia University in New York. She decided then she'd dedicate her life to finding out why Asian American women commit suicide.
In 1998, Noh graduated with a doctorate in ethnic studies from the University of California, Berkeley, where she interviewed dozens of Asian American women who had attempted suicide or had overcome chronic depression.
Studying Survivors and Statistics
Now an assistant professor of Asian American studies at California State University at Fullerton, Noh continues her research today and says she is profoundly aware of the statistics surrounding her sister's death.
Asian American women between 15 and 24 had the highest number of suicides among all U.S. women in that age group in 2003, with about 3.5 deaths per 100,000 residents, the U.S. Department of Health and Human Services reported in 2005. And Asian American females had the second highest rate of suicide in every other age group.
The women behind those numbers have shown up in the news.
In 2000 Elizabeth Shin, a 19-year-old Korean American, was found engulfed in flames in her dorm room at the Massachusetts Institute of Technology in an apparent suicide. The death, later ruled an accident, followed previous suicide attempts.
Like Noh's sister, Shin began showing signs of a mental health crisis in high school. When Shin barely missed becoming her high school's valedictorian, she contemplated taking her life, USA Today reported in January 2002.
Many more Asian American women have had their private suffering exposed, including Iris Chang, the Chinese American author of the 1997 book "The Rape of Nanking," who in 2004 shot herself at the age of 36 after suffering long bouts of depression.
In New York Hejin Han, a 35-year-old Korean American, drove herself and two children over a cliff at Bear Mountain in June, in what police are calling a suicide. Later, police investigated her husband for allegedly neglecting her suicide threats and writing them off as idle.
Suicide is the 11th leading cause of death in the United States, outpacing homicides by a ratio of 3-to-2. In 2001, according to the National Institute of Mental Health, there were 20,308 homicides and 30,622 suicides across the nation.
Hazard Tied to Cultural Premise
The explanation for the problem of depression and suicide among Asian American women is often tied to a culture that health experts say pressures Asian Americans to succeed in all areas of life and is sometimes offered to explain why Asian Americans may outperform other racial groups in academics.
In May, for instance, New York Times columnist Nicholas Kristof wrote about why Asian American children do well in U.S. schools: "Success goes to those whose ancestors came from the Confucian belt from Japan through Korea and China to Vietnam. If I am right, the success of Asian Americans is mostly about culture and there's no way to transplant culture."
Noh says the stereotype of Asian cultures being hard-wired for success creates a dangerous "model minority" image that can devastate Asian American women who don't meet unrealistic expectations.
In a portion of her research study to be published in next spring in Women and Therapy, a journal published out of Binghamton, N.Y., Noh argues that depression and suicide are linked to a model-minority myth that makes it difficult for Asian American women to accept their "flaws."
Asian American women attempt suicide more than Asian American men, Noh said. But because men use more fatal tactics, their suicide rate is higher.
Four men commit suicide for every woman, according to the National Institute of Mental Health, and in 2001, white males represented 73 percent of all deaths by suicide.
Historically, Noh said, Asian American women face conflicting sexual stereotypes that force many to juggle their identities between a seductive and treacherous dragon lady and the soft, lotus blossom character made famous by the century-old "Madame Butterfly" story, in which a submissive Japanese woman falls for a white man and commits suicide when she loses her love.
Affected by Female Image
"Many of my interviewees said they were affected by these dualistic images, either as hyper-sexualized and domineering, or passive and submissive," Noh said. These images, she said, combined with familial expectations, narrow the spectrum for Asian women's sense of identity and self-worth.
Several of the women Noh interviewed, for instance, told her that daughters were expected to take care of their families, and later, their own families, while it was assumed that someone would care for the sons.
"The son would be allowed to do anything," Noh said. "No curfew, no strict supervision."
While many women rebelled, others bottled up their feelings, never to explode but to ooze out in creeping depression.
"There was a lot of anger," Noh said.
Dr. Peter Yee, assistant executive director for behavioral health services at Hamilton-Madison House, a community agency in New York's Lower East Side, said that of the 1,000 patients his clinic sees each year, 60 percent are women.
He agrees that women face special social limitations and said that when women do enter the clinic, their mental health problems are likely to be more severe.
Asian "women have an extra burden to be dutiful daughters," Yee said. "If you don't go and get a husband, then you're a loser. The whole model minority thing is at stake."
Helen Zia, author of the 2000 book "Asian American Dreams: the Emergence of an American People" about the history of civil rights struggles of Asians in America, said the welfare of Asian American women is also at stake if health care providers succumb to stereotypes of Asian women.
"We have a phenomenon where people are actually ill," Zia said. "People are ignoring that and using culture as an excuse not to recognize, or diagnose or treat."
Malena Amusa, from St. Louis, Mo., is a freelance journalist.
Health and Human Services Department,
National Strategy for Suicide Prevention: