Sexual minority youth report earlier age of onset and faster progression of suicidal ideation

1. Sexual minority youth (i.e., sexual attraction to the same sex, both sexes, or questioning) reported suicidal ideation, plans, and attempts at an earlier age compared to heterosexual youth.

2. Sexual minority youth progressed from suicidal ideation to suicidal plan more quickly than heterosexual youth.

Evidence Rating Level: 2 (Good)

Study Rundown: Suicidal ideation is common in adolescence and may progress to suicidal plans and attempts late into adolescence and early adulthood. Suicidal ideation can impact quality of life and have negative financial, legal, and health consequences. Adolescents who are described as having sexual minority status are at a higher risk of experiencing suicidal ideation, plans, and attempts, however the timing of onset of suicidal ideation in this group has not been thoroughly investigated. The current study aimed to identify the age of onset of suicidal ideation and behaviors in sexual minority adolescents. In a sample of 1771 10^th grade students across the United States, 5.8% of participants indicated sexual minority status. Sexual minority youth were more likely to report an increased lifetime prevalence of suicidal ideation, plan, and attempt compared to heterosexual youth. The relationship between sexual minority status and suicide attempt onset was strongest prior to age 15. Furthermore, sexual minority youth progressed more quickly from suicidal ideation to suicidal plan than heterosexual youth. Although this study only assessed sexual orientation at a single time point and did not assess other aspects of gender identity or expression, the results support the role of early screening of sexual minority youth for depression and risk of suicidal ideation in order to provide timely interventions.

Click to read the study in PEDIATRICS

Click to read an accompanying editorial in PEDIATRICS

Relevant Reading: Sexual minority status and psychological risk for suicide attempt: A serial multiple mediation model of social support and emotion regulation

In-Depth [prospective cohort]: This population-based longitudinal cohort followed 2783 youth in 10^th grade annually from 2009-2010 to 2015-2016 as part of the NEXT Generation Health Study across the United States. In total, 1771 youth completed the annual self-report questionnaires, reported sexual minority status, and reported lifetime history of suicidal ideation and behaviors and depressive symptoms. Sexual minority status was described as sexual attraction to the same sex, both sexes, or questioning, whereas heterosexual participants were described as sexual attraction to the opposite sex. In total, the mean age of adolescents was 17 years at year two, and 5.8% of participants were sexual minority adolescents. The lifetime prevalence of suicide ideation, plan and attempt in sexual minority adolescents was 26%, 17% and 12%, respectively, which was higher compared to heterosexual youth, at 13%, 5% and 5%, respectively. The mean age at first suicidal ideation and plan was earlier in sexual minority youth (HR = 1.77 and HR = 2.69, respectively). The largest disparities between groups in suicidal attempt occurred prior to age 15 (HR = 3.26, 95% CI 1.25-8.47). Furthermore, sexual minority adolescents progressed from suicidal ideation to plan faster than heterosexual adolescents.

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