Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior

Abstract

OBJECTIVES: To determine if sexual minority adolescents have earlier onset of suicidality and faster progressions from ideation to plan and attempt than heterosexual adolescents. METHODS: A population-based longitudinal cohort of 1771 adolescents participated in the NEXT Generation Health Study. Participants reported sexual minority status (defined by sexual attraction) in 2010-2011 and retrospectively reported age at onset of suicidality in 2015-2016.RESULTS: Sexual minority adolescents (5.8% of weighted sample) had higher lifetime risk of suicide ideation (26.1% vs 13.0%), plan (16.6% vs 5.4%), and attempt (12.0% vs 5.4%) than heterosexual adolescents. Survival analyses adjusted for demographic characteristics and depressive symptoms revealed positive associations of sexual minority status with time to first onset of suicide ideation (hazard ratio [HR] = 1.77; 95% confidence interval [CI] 1.03-3.06) and plan (HR = 2.69; 95% CI 1.30-5.56). The association between sexual minority status and age at onset of suicide attempt was stronger at age <15 (HR = 3.26; 95% CI 1.25-8.47) than age $15 (HR = 0.59; 95% CI 0.21-1.66). The association between sexual minority status and progression from ideation to plan was stronger in the same year of first ideation (HR = 2.01; 95% CI 1.07-3.77) than $1 year after first ideation (HR = 1.33; 95% CI 0.26-6.77).CONCLUSIONS: Sexual minority adolescents had earlier onset of suicidality and faster progression from suicide ideation to plan than heterosexual adolescents. The assessment of sexual minority status in routine pediatric care has the potential to inform suicide risk screening, management, and intervention efforts among early sexual minority adolescents.

HIV and suicide risk across adolescence and young adulthood: an examination of socio‐demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area

“…Similar to studies with the general population, we found that non‐heterosexual identity was significantly associated with attempted suicide in both AYALPHIV and AYAPHEU [ 3 , 18 ]. Extensive research has demonstrated associations between sexual identity discrimination and poor mental health outcomes, with AYA sexual minorities being at the greatest risk for suicidality [ 3 , 17 , 18 ].…”

“…Similar to studies with the general population, we found that non‐heterosexual identity was significantly associated with attempted suicide in both AYALPHIV and AYAPHEU [ 3 , 18 ]. Extensive research has demonstrated associations between sexual identity discrimination and poor mental health outcomes, with AYA sexual minorities being at the greatest risk for suicidality [ 3 , 17 , 18 ]. Further research could inform interventions by exploring how anti‐LGBT discrimination might interact with feelings about growing up with HIV and negatively impact AYA social and emotional development.…”

“…This process includes internalizing values and conceptualizing how identity may impact social experiences and life opportunities [35,38]. Sexual and racial/ethnic minorities are at increased risk for suicidality because of identitybased discrimination, which has the strongest impact during adolescence and young adulthood [3,[13][14][15][16][17][18]39]. For people living with HIV (PLWHIV), establishing an identity can be especially complex as they grapple with a stigmatized, chronic, transmittable infection [40,41].…”

“…Social (e.g. racial, gender‐based discrimination) [ 3 , 13 – 18 ] and contextual (e.g. neighbourhood violence) [ 19 , 20 , 21 ] factors may also contribute to increased suicide risk among specific sub‐groups of AYA, such as sexual and racial minorities.…”

“…Social (e.g. racial, genderbased discrimination) [3,[13][14][15][16][17][18] and contextual (e.g. neighbourhood violence) [19][20][21] factors may also contribute to increased suicide risk among specific sub-groups of AYA, such http://onlinelibrary.wiley.com/doi/10.1002/jia2.25984/full | https://doi.org/10.1002/jia2.25984 as sexual and racial minorities.…”