Suicidal Behaviors Among Sexual and Racial/Ethnic Minority Female and Male Adolescents in the United States

BACKGROUND AND PURPOSE: Trends in suicidal behaviors during adolescence mimic larger health disparities in society, with sexual and racial/ethnic minority youth burdened with higher rates of suicidal behaviors than their non-minority peers. In addition to disparities by minority status, there are widely known gender variances in non-lethal and lethal suicidal behaviors. Less is known, however, about how sexual orientation intersects with other dimensions of identity to increase suicide risk. Specifically, the aim of this presentation is to examine the intersections of sexual, gender and racial/ethnic identities to increase adolescents' risks to ideate, plan, and attempt suicide.

METHODS: Data are from the 2013 CDC Youth Risk Behavior Survey. We used multivariate logistic regression to assess adjusted odds ratios and 95% confidence intervals. We analyzed data from adolescents between the ages of 14 and 17 separately by gender (N = 22,256; females, n = 11,743, males, n = 10,513).

RESULTS: More females self-identified as either gay, bisexual, or not sure than males (13.3% vs 7.2% respectively). Participants who identified themselves as sexual minority were more likely to be Hispanic. The models run after controlling for gender demonstrated that females were more likely to report suicidal ideation (aOR=1.645, 95% CI = 1.465-1.846), suicidal planning (aOR=1.377, 95% CI= 1.219-1.556) and suicidal attempts (aOR=1.173, 95% CI=1.016-1.355) than their male peers. Almost half sexual minority adolescent females reported suicidal ideation (47.8%), 41% reported suicide planning, and about a third reported suicidal attempts (30.1%). About a third of sexual minority adolescent males reported suicidal ideation and planning (30.9% and 30.6% respectively) and about a fourth reported suicidal attempts (23.4%). Being a sexual minority posed greater risks for suicidal behaviors for adolescent males than females. Among the female and male sub-samples, analyses revealed that being a sexual minority was significantly associated with higher odds of suicidal ideation (aOR = 3.13 and aOR = 4.09 respectively), suicidal planning (aOR = 3.17 and aOR = 3.95 respectively), and suicidal attempts (aOR = 3.49 and aOR = 4.69). In these analyses race/ethnicity were not a significant predictor of suicidal behaviors. However, we ran post-hoc tests by gender and found that there were significant differences in the prevalence of suicidal behaviors between the race/ethnic subgroups of sexual majority/minority adolescent. Sexual minority Latinas reported more suicide attempts than their black and white sexual minority peers (33.6% vs 27.1% vs 28.3% respectively), and almost five times more attempts than their white sexual majority counterparts (33.6% vs 7.1%). Among males, sexual minority Latinos reported more suicide attempts than their black and white sexual minority peers (33.2% vs 25.9% vs 16.8% respectively). The rate of suicide attempts among Latino sexual minority males was more than six times greater than that of white sexual majority whites (33.2% vs 5.4%).

CONCLUSIONS AND IMPLICATIONS: Our findings show the importance of capturing a nuanced description of risk disparities among sexual minority youth by race and ethnicity. Suicide researchers must go beyond identifying universal risk factors to understanding how these contribute to the suicidal behaviors of distinct groups of teens.