Intimate Violence and Suicide Attempt Among Lesbian, Gay, Bisexual, and Questioning Adolescents in the United States

Background and Purpose: Suicide remains the third leading cause of death among US adolescents.  Furthermore, for individuals identifying as lesbian, gay, bisexual, and questioning (LGBQ), and for those who have experienced sexual assault or teenage dating violence victimization (TDVV), rates of suicide attempts are disproportionately higher.  While previous studies have found suicide attempts to be significantly associated with dating violence, and sexual assault, these experiences among LGBQ youth are understudied.  We sought to understand if experiencing sexual assault and/or TDVV placed LGBQ youth at higher odds of attempting suicide.     

Methods: The current study draws from the Youth Risk Behavior Survey (YRBS 2015), a nationally-representative survey of high school students in the US where 15,624 students were randomly sampled using a three-stage cluster design.  Self-reported data were collected using pen and paper, without skip patterns to obfuscate among those answering more or less questions.  Multiple regression analysis was used to examine associations between lifetime experience with forced sex, recent experience of TDVV, and recent suicide attempt (outcome).

Results: LGBQ adolescents reported significantly higher odds of lifetime sexual assault (AOR=2.62, 95%CI: 2.00-3.43), recent physical TDVV (AOR=1.92, 95%CI: 1.50-2.47), recent sexual TDVV (AOR=2.00, 95%CI: 1.49-2.69), and recent suicide attempt (AOR=4.15, 95%CI: 3.36-5.13). In a comprehensive model including experiences of violence as covariates, elevated odds of recent suicide attempt were observed for LGBQ adolescents (AOR=3.74, 95%CI: 3.03-4.61), and those who reported ever experiencing sexual assault (AOR=2.60, 95%CI: 1.96-3.46), recent physical TDVV (AOR=3.54, 95%CI: 2.37-5.29), or recent sexual TDVV (AOR=2.03, 95%CI: 1.45-2.86). Interactions between sexual identity and experiences of violence were not significant.

Conclusions and Implications: In populations where suicide risk is high, it is imperative to understand potential risk factors.  Findings confirm previously identified associations of victimization and suicide attempts, and enrich our understanding of these risk factors specific to LGBQ youth.  In the interest of suicide prevention, professionals working with LGBQ youth should assess for lifetime sexual assault and recent history of dating violence.