Salib & Tadros highlight the important issue of high female suicide rates among Indian migrants and the use of female suicide bombers. Like the high suicide rates among young females in rural China (Yip & Liu, 2006), these deviations from the general pattern should not be discounted as mere exceptions but should be considered as representative of the distressing situations faced by some women in Asia.

We also believe that socio-economic deprivation and poor social support – the ‘sad reality’ – faced by young women in rural China are underlying causes of the high suicide rates. Like the young married Indian women in Britain, there is some indication that young married women in rural China might be at high risk (Reference Pearson, Phillips and HePearson et al, 2002). This reminds us that the lives of married women differ greatly across regions, countries, cultures and economies, and there is a need to avoid oversimplification when describing suicide in different countries; one size does not fit all.

Over 60% of the world's suicides occur in Asian countries where low male:female ratios for suicide are common (Reference Yip, Callanan and YuenYip et al, 2000). Although the official male:female ratio for suicide in India was still greater than 1 (1.2:1 in 2002), the ratio was 0.8 among those aged 14 or below (World Health Organization, 2006). However, unlike China (Yip & Liu, 2006), the small size of this population subgroup meant that the national male:female ratio remained greater than 1. (This is the essence of our ecological fallacy argument.) In addition to specific social factors, the similarity in the methods of suicide used by males and females, together with the poor access to medical facilities, might explain the low male:female ratio in India and China. Restricting access to pesticides will prevent many suicides in Asia. In the long term improving economic and educational opportunities, especially for rural women in deprived areas, raising awareness of depression and better treatment will be pivotal for preventing suicides.