Sexual Identity–Behavior Profiles and Suicide Outcomes Among Heterosexual, Lesbian, and Gay Sexually Active Adolescents

Abstract

Objective Adolescents’ sexual behaviors can be incongruent with those assumed to align with their sexual identity. Identity–behavior profiles permit the characterization of youth who might remain undetected using a single‐dimensional assessment of sexual orientation. This study examined suicide risks among four distinct sexual identity–behavior profiles of youth: heterosexual with other‐sex partners only, heterosexual with any same‐sex partners, lesbian or gay (LG) with same‐sex partners only, and LG with any other‐sex partners. Method Data were analyzed from the 2017 National Youth Risk Behavior Survey. Participants’ reported sex, sexual identity, and the sex of their sexual contacts were used to construct the identity–behavior profiles. Multivariate logistic regression was used to examine the relationship between identity–behavior profiles and suicide outcomes. Results Compared to heterosexual respondents with other‐sex partners only, heterosexual respondents with any same‐sex partners and LG respondents with same‐sex partners only had greater odds of having a suicide plan; LG respondents with any other‐sex partners were over seven times more likely to have suicidal thoughts and attempt suicide and 14 times more likely to have a suicide plan. Conclusions Health and mental health providers can expand the identification of youth at risk for suicide by assessing both sexual identity and behavior.

Racial and ethnic differences in suicidal behavior and mental health service use among US adults, 2009–2020

“…Our results provide updated epidemiologic estimates of racial and ethnic differences in past-year SI and SAs and are believed to be the first study in adults to show that among individuals with past-year SI, Black adults may be more likely than Whites to report a past-year SA. These findings are consistent with several recent studies of adolescents showing that Black and Hispanic adolescents are less likely to report past-year SI but may be more likely to report SAs (Lindsey, Sheftall, Xiao, & Joe, 2019 ; Romanelli, Xiao, & Lindsey, 2020 ; Xiao, Romanelli, & Lindsey, 2019 ). Data from older epidemiologic surveys of adults, including the ECA, NCS, and NCS-R, either found no significant racial/ethnic difference or greater rates of SAs among White adults (Baca-Garcia et al, 2010 ; Kessler et al, 2005 ; Moscicki et al, 1988 ; Olfson et al, 2017 ).…”

Is sexual orientation a categorical or spectrum dimension? An exploratory study of different sexual orientation measurements and scales

“…Differences can also be observed across age and gender and can be different across time and location. One study that looked at sexual minorities by gender in the U.S. reported females as more likely to use tobacco than any other subgroups (Delahanty et al, 2019) while adolescents that live through adverse experiences due to their sexuality have a higher risk of substance misuse (Goldbach et al, 2013) and suicide (Romanelli et al, 2020).…”

Identity development, attraction, and behaviour of heterosexually identified men who have sex with men: scoping review protocol

“…Sexual orientation discordance has also been associated with increases in depressive symptomology among mostly-heterosexual male adolescents with same-sex partners [ 19 ]. Similarly, adolescents who identify as heterosexual with same-sex partners are more likely to have a suicide plan than those who exclusively have other-sex partners [ 20 ]. H-MSM may also be more likely than those with concordant sexual orientations and behaviors to use alcohol and inhalants [ 21 ].…”