A Prospective Examination of Sexual Orientation and Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors Among a Diverse Sample of At-Risk Young Adult Women

Minoritized sexual orientation is an established correlate for suicide ideation (SI) and nonsuicidal self-injury (NSSI); however, research on the prospective associations between sexual orientation and SI and NSSI is limited. The current study builds on existing literature by examining sexual orientation as a prospective distal risk factor for SI and NSSI risk among a diverse sample of young women after adjusting for histories of SI and/or NSSI and empirically supported correlates and risk factors. Participants were 135 young adult women (aged 18-24) who were predominately Black, with approximately half of the sample experiencing poverty. Participants completed an interview that assessed SI and NSSI at baseline and 6- and 12-month follow-ups. A single item was used to collect participants' self-identified sexual orientation at baseline. Minoritized sexual orientation was strongly associated with NSSI history and future SI and NSSI, adjusting for baseline correlates and predictors of interest. Psychological and physical victimization, race, and poverty were nonsignificant prospective predictors of SI and NSSI. Race and poverty did not moderate the associations between sexual orientation and follow-up SI and NSSI. These findings suggest young adult women who self-identify as lesbian, gay, bisexual, queer, or questioning (LGBQ) are more likely than those who identify as heterosexual to experience both SI and NSSI in the following year. Sexual orientation should be part of a culturally informed comprehensive risk assessment. A culturally informed intersectionality approach may be necessary to identify culturally specific risk and resiliency factors for SI and NSSI that can guide effective prevention and intervention strategies for LGBQ individuals. Public Significance StatementThis study suggests that young adult women who self-identify as lesbian, gay, bisexual, queer, or questioning (LGBQ) are more likely than those who identify as heterosexual to experience both suicide ideation (SI) and nonsuicidal self-injury (NSSI) in the following year. Neither race nor poverty influenced the associations between minoritized sexual orientation and future risk for SI and NSSI. Sexual orientation should be part of a culturally informed comprehensive risk assessment. A culturally informed intersectionality approach may be necessary for future research to identify culturally specific risk and resiliency factors for SI and NSSI that can guide effective prevention and interve