165. Prevalence and Sociodemographic Correlates of Suicidality Among Sexual and Gender Minority Youth Residing in the South

ABSTRACT

Purpose: Rates of suicidal ideation and attempts among adolescents, especially young sexual and gender minority (SGM) adolescents, have been on the rise over the last several years. The COVID-19 pandemic has only exacerbated risk factors for suicidality and introduced additional barriers to accessing needed medical care and other help-seeking resources. This study sought to estimate the prevalence of suicidal thoughts, plans, and attempts among young SGM adolescents residing in the South, a geographic region with high unmet health needs, greater multi-level experiences of discrimination, and a hostile policy landscape marked by numerous anti-LGBTQ bills and few protections on the basis of sexual and gender identity. Methods: Tailored social media advertising was used between July 2021 and April 2022 to recruit and enroll 384 SGM adolescents aged 13-17 years residing in eight southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee). Study staff used multiple authentication procedures to verify the uniqueness and validity of each enrollment. Respondents completed an online cross-sectional survey that assessed prior suicidality (thoughts, plans, attempts). Respondents were provided a number of help-seeking resources at the conclusion of the survey. The mean respondent age was 16.1 years (SD = 1.0), and respondents were primarily female (45.6%, n=175), bisexual (38.0%, n=146), and non-Hispanic White (52.6%, n=202). We used unadjusted and adjusted logistic regression analyses to identify sociodemographic, health, and relationship correlates of prior suicidal ideation and attempts. Results: Overall, 70.6% (n=271) of SGM adolescents reported ever having serious suicidal thoughts. Of these respondents, 74.9% (n=203) had planned and 43.9% (n=119) had attempted suicide. Adjusted analyses showed that the likelihood of prior suicidal ideation was higher among respondents who identified as Hispanic (AOR 2.7;95% CI 1.1, 7.0), non-Hispanic Multiracial (AOR 4.1;95% CI 1.2, 13.9), and non-Hispanic White (AOR 3.0;95% CI 1.4, 6.3) as compared to non-Hispanic Black, and was twice as high among respondents 17 years of age (AOR 2.3;95% CI 1.1, 5.0) compared to those 15 years of age. Having a diagnosed disability (AOR 3.4;95% CI 1.9, 6.1) and poor parental relationship quality (AOR 2.3;95% CI 1.2, 4.1) were also associated with an increased likelihood of prior suicidal ideation. The likelihood of prior attempted suicide was significantly greater among SGM adolescents who reported poor parental relationship quality (AOR 2.0;95% CI 1.1, 3.6), a diagnosed disability (AOR 2.1;95% CI 1.1, 4.0), and a chronic health condition (AOR 2.5;95% CI 1.4, 4.7). Conclusions: The prevalence of lifetime suicidality was quite high among SGM adolescents in the South, even higher than estimates reported by national studies among similarly aged adolescents. The findings suggest the immediate need for tailored efforts to prevent and address suicidality among SGM adolescents, especially given the compounding effects of the COVID-19 pandemic on adolescents' health. The findings also suggest the need to intervene with the parents of SGM adolescents or increase acceptance and connectedness in other close relationships. Sources of Support This study was funded by the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control (K01CE003226).