Trends and Disparities in Suicidal Behaviors for Heterosexual and Sexual Minority Youth 1995-2017

The current study examines disparities and longitudinal trends of suicidal behaviors among sexual minority youth disaggregated by self-reported sex and sexual orientation. Despite evidence that attitudes toward sexual minorities have improved during recent decades, few studies have examined whether suicidal behaviors in youth of varying sexual minority identities have likewise improved. Using population-based data from Massachusetts, this study conducted a series of logistic regression analyses to examine disparities and trends for suicidal ideation (SI), suicide attempt (SA), and suicide attempt resulting in medical treatment (SM) by sexual minority and heterosexual youth during four cohort periods ranging from 1995 to 2017. Results found that the overall prevalence of suicidal behavior has decreased over time for all groups. However, there were significant disparities between sexual minority and heterosexual groups for all suicidal behaviors across cohorts. Sexual minority groups ranged from being 1.28 times to 15.45 times more likely to engage in suicidal behavior as heterosexual peers within a cohort period. During the most recent cohort period (2013 to 2017), the rates for SI and SA across sexual minorities ranged from three to seven times that of heterosexual peers. The gap for SI and SA widened across time for almost all female sexual minority groups. The gap for SA and SM narrowed for all male sexual minorities but varied across groups for SI. These results indicate that despite societal improvement in acceptance of sexual minorities, sexual minority youth continue to be at higher risk for suicidal behavior, particularly females for whom most disparities increased over time. Public Significance Statement This study demonstrates that despite societal improvements in attitudes toward sexual minorities, sexual minority youth continue to engage in significantly higher rates of suicidal ideation and attempt compared with heterosexual peers, and the risk for suicidal behaviors vary between identity groups. This indicates that suicide prevention strategies should include targeted interventions for sexual minority youth that consider nuanced issues and stressors specific to different sexual and gender identities within this population.