Peer-reviewed article
Do Victimization and Hopelessness Relate to Suicidality Differently Across Sexual Orientation? Evidence from the 2015–2023 U.S. Youth Risk Behavior Surveys
Wenyi Wang ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study used U.S. Youth Risk Behavior Surveys from 2015 to 2023 (20,367 complete cases) to see whether victimization and hopelessness relate to suicidal thoughts, plans and attempts differently for heterosexual, bisexual, homosexual and unsure-orientation youth. After statistical balancing of many background factors, sexual minority youth had higher odds of suicidal ideation and planning than heterosexual youth. Victimization and hopelessness were strongly linked to ideation and planning in all groups, but their links to suicide attempts were inconsistent. Tests of whether these links differ by orientation gave inconsistent results. A supplementary look at 2023 data on transgender youth suggested a weaker link for victimization and a stronger link for hopelessness, but the subgroup was small.
Key points
- Bisexual, homosexual and unsure-orientation youth had higher odds of suicidal ideation and planning than heterosexual peers (ORs = 2.06-4.19).
- Adjusted differences in suicide attempts were varied (ORs = 0.89-1.46).
- Victimization and hopelessness were robustly associated with ideation and planning across all groups (ORs = 1.73-3.32), but inconsistently with attempts (ORs = 0.32-1.45).
- Interactions between sexual orientation and the stressors were inconsistent (ORs = 0.54-1.69), so the impact may not vary uniformly by orientation.
- Among transgender youth in 2023, victimization had a weaker association with suicide outcomes (ORs = 0.56-0.99) and hopelessness a stronger one with ideation and planning (ORs = 1.46-5.73).
Limitations
The data are cross-sectional survey data, so the study cannot show cause and effect or the order of events, and the abstract itself calls for longitudinal research. The transgender estimates rest on a small subgroup with limited covariate overlap and should be read with caution.
Abstract
This study assessed whether associations between suicidality, victimization, and hopelessness varied across heterosexual, bisexual, homosexual, and unsure-orientation youth. Data comprised 20,367 complete cases drawn from the 2015-2023 Youth Risk Behavior Surveillance System. Overlap propensity score weights balanced more than 40 suicidality-related covariates (e.g., gender, age, race/ethnicity, health behaviors, substance use, and risk-seeking behaviors) across groups. Weighted logistic regressions estimated group differences and tested sexual orientation by stressor interactions. After weighting, bisexual, homosexual, and unsure-orientation youth exhibited significantly higher odds of suicidal ideation and planning compared to heterosexual peers (ORs = 2.06-4.19), though adjusted differences in suicide attempts were varied (ORs = 0.89-1.46). While victimization and hopelessness were robustly associated with ideation and planning across all groups (ORs = 1.73-3.32), their associations with suicide attempts were inconsistent (ORs = 0.32-1.45). Interaction analyses between sexual orientation and these stressors showed inconsistent results (ORs = 0.54-1.69), suggesting that, the impact of victimization and hopelessness may not vary uniformly by orientation. Supplementary analyses of 2023 data indicated that among transgender youth, victimization had a weaker association with suicide outcomes (ORs = 0.56-0.99), whereas hopelessness was more strongly correlated with ideation and planning (ORs = 1.46-5.73). These transgender-specific estimates should be interpreted with caution due to small subgroup size and limited covariate overlap. Together, these findings highlight heterogeneity in suicidality across sexual-orientation groups and emphasize the need for longitudinal research with richer contextual and biological measures to clarify mechanisms and subgroup-specific risk and protective factors.