Sexual Minorities and Teen Suicide Attempts in a Southeastern State with Prominent Exclusionary Policies

Background and Purpose: Recent investigation has emerged about the relation between suicide attempts among sexual minority populations and geographical location of residence. Puckett et al. (2017) suggest tailoring prevention and intervention efforts in areas in the U.S. that are more politically and socially oppressive towards sexual minority youth. Sexual minority adolescents endure minority stress, including stigma, rejection, shame, and victimization, resulting in increased suffering and a higher risk of suicidality. Although the risk factors for suicide attempts are well documented in normative, heterosexual populations, it is far less researched among sexual minority youths.

Methods: For our sample, we used data from the 2017 Youth Risk Behavior Surveillance Survey (YRBSS) in North Carolina. Of the 3,151 high school participants in North Carolina, 465 identified as either lesbian, gay, bisexual, or not sure/questioning. To test whether sexual minority youth experienced higher rates of suicidality relative to their heterosexual peers, we conducted cross-tabulations and chi-square tests to see if there were relationships between sexual orientation and suicidal thoughts, plans, and attempts. To identify the prominent risk factors for sexual minority suicide attempts, we conducted a logistic regression analysis that examined the likelihood of attempting suicide based on critical risk factors for this population: experiencing physical or sexual dating violence, being bullied, school safety concerns, and feelings of sadness or hopelessness.

Results: Sexual minority youth were more likely to experience suicidal thoughts, develop plans to commit suicide, and attempt suicide, relative to their heterosexual peers. Sexual minorities were over three times as likely to experience suicidal thoughts (χ² = 186.90, p < .001) and plans to commit suicide (χ² = 173.19, p < .001). Sexual minority youths were almost four times as likely to have attempted suicide (χ² = 128.13, p < .001). Further, approximately 1 out of every 4 sexual minority youths attempted suicide (24%), compared to only 1 out of every 17 heterosexual youths (6%) attempted suicide. In terms of sexual minority risk factors, youth who experienced school safety concerns were 3.5 times more likely to attempt suicide, those who experienced forced sexual intercourse were 4.45 times more likely to attempt suicide, and sexual minority youth who experienced sadness or hopelessness were 3.78 times as likely to attempt suicide.

Conclusions and Implications: Findings revealed sexual minority youth in North Carolina had statistically significant higher rates of suicidal thoughts, plans, and attempts relative to their heterosexual peers. Findings also include key risk factors amongst sexual minority youth experiencing suicidality. It is recommended that prevention efforts for this population focus on policy advocacy and inclusion of sexual minority populations. Identified policies within North Carolina that directly impact sexual minority youth include housing nondiscrimination laws, public accommodations nondiscrimination laws, protections within the child welfare system, and hate crime laws protecting sexual minorities. To ensure sexual minority youth have an equal opportunity to participate in society and live free from suicidal ideation and attempts, this research is being used to advocate for more inclusive policies.