Introduction
Studies among adults have documented association between sexual orientation discordance
and some suicide risk factors. However, studies examining sexual orientation discordance
and nonfatal suicidal behaviors in youth are rare. This study examines the association
between sexual orientation discordance and suicidal ideation/suicide attempts among
a nationally representative sample of U.S. high school students.
Methods
Using sexual identity and sex of sexual contact measures from the 2015 national Youth
Risk Behavior Survey (n=6,790), a sexual orientation discordance variable was constructed
describing concordance and discordance (agreement and disagreement, respectively,
between sexual identity and sex of sexual contacts). Three suicide-related questions
(seriously considered attempting suicide, making a plan about how they would attempt
suicide, and attempting suicide) were combined to create a two-level nonfatal suicide
risk variable. Analyses were restricted to students who identified as heterosexual
or gay/lesbian, who had sexual contact, and who had no missing data for sex or suicide
variables. The association between sexual orientation discordance and nonfatal suicide
risk was assessed using logistic regression. Analyses were performed in 2017.
Results
Approximately 4.0% of students experienced sexual orientation discordance. High suicide
risk was significantly more common among discordant students compared with concordant
students (46.3% vs 22.4%, p<0.0001). In adjusted models, discordant students were 70% more likely to have had
suicidal ideation/suicide attempts compared with concordant students (adjusted prevalence
ratio=1.7, 95% CI=1.4, 2.0).
Conclusions
Sexual orientation discordance was associated with increased likelihood of nonfatal
suicidal behaviors. Discordant adolescents may experience unique stressors that should
be considered when developing and implementing suicide prevention programs.
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Article Info
Publication History
Published online: February 12, 2018
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Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine
