Suicidal Ideation and Behavior Among Sexual Minority and Heterosexual Youth: 1995-2017

OBJECTIVES: In this study, we determined trends in prevalence of suicidal thoughts and behaviors among lesbian, gay, bisexual, and heterosexual youth from 1995 to 2017 using population-based surveillance data. METHODS: Data were drawn from the Massachusetts Youth Risk Behavior Survey from 1995 to 2017 (unweighted N = 41 636). The annual percent change (APC) in prevalence of suicidal ideation, plans, and attempts was stratified by sexual orientation as indexed by sexual identity and sexual behavior. RESULTS: Among sexual minority youth, prevalence rates declined over the entire study period for suicidal ideation (APC(sexual identity) = -1.25; APC(sexual behavior) = -1.83), plans (APC(sexual) (identity) = -1.88; APC(sexual behavior) = -1.95), and attempts (APC(sexual identity) = -2.64; APC(sexual) (behavior) = -2.47). Among heterosexual youth, prevalence rates declined from 1995 to 2007 for suicidal ideation (APC(sexual identity) = -6.67; APC(sexual behavior) = -6.77) and plans (APC(sexual) (identity) = -5.73; APC(sexual behavior) = -6.25). These declines in ideation and plans were steeper than those for sexual minority youth. Prevalence of suicide attempts declined across the entire study period among heterosexual youth (APC(sexual identity) = -3.66; APC(sexual behavior) = -4.01). Prevalence of all 3 outcomes remained markedly high among sexual minority youth across the 23-year study period. CONCLUSIONS: Although suicidal thoughts and behavior have generally declined among sexual minority and heterosexual youth, disparities in these outcomes persist, and their prevalence among sexual minority youth has remained consistently elevated. Prioritized screening for risk for suicidal thoughts and behaviors in this vulnerable population is imperative to reduce disparities and prevalence of these outcomes.