Primary Sources: Examining the Connection Between Sexual Orientation and Suicidal Behaviors

A serious-looking young person.

“Sexual Orientation and Suicide Ideation, Plans, Attempts, and Medically Serious Attempts: Evidence From Local Youth Risk Behavior Surveys, 2001-2009” (abstract). Deborah M. Stone, Feijun Luo, Lijing Ouyang, Caroline Lippy, Marci F. Hertz, and Alex E. Crosby. American Journal of Public Health, Vol. 104, No. 2 (February 2014).

What it’s about: Researchers Stone, Luo, Ouyang, Lippy, Hertz and Crosby wanted to see how young people’s sexual orientation might impact a range of suicidal behaviors. Specifically, they wanted to know: Do young people’s sexual identities and past sexual experiences affect their likelihood of having suicidal thoughts, planning or attempting suicide, or needing to be hospitalized because of a suicide attempt?

To answer the question, the researchers analyzed data from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System. The YRBS surveys, administered from 2001 to 2009, asked high school students a variety of questions about their health-related risks and behaviors. For this study, the researchers focused on five cities in which teens were asked to choose terms that best described their sexual orientation and with whom they had experienced sexual contact (same sex, opposite sex, both sexes, no contact).

Experiences of transgender youth were outside the scope of this study.

Why read it: Prior studies show that youth who identify as lesbian, gay or bisexual are more likely to consider and attempt suicide. These suicidal behaviors may be linked to risk factors such as depression, isolation and alcohol dependence that often stem from discrimination and stigma.

But researchers haven't always looked at the full range of behaviors associated with suicide, particularly suicide planning and suicide attempts that result in near-fatal injury. Many studies have also looked at sexual identity and behavior interchangeably, despite concerns that some young people engaging in same-sex contact do not identify themselves as lesbian, gay, bisexual, or other non-heterosexual orientations.

Understanding the full scope of suicidal behavior can help family- and youth-serving agencies implement policies and programs that better address suicidal risk factors. The findings of this study could be used to train staff on providing safe, inclusive environments for young people regardless of their sexual orientation and behaviors.

Biggest takeaways for family and youth workers: Compared to their heterosexual peers, youth who identified as lesbian, gay, bisexual or questioning were approximately 2 to 3 times more likely to report the suicide-related behavior and outcomes that the researchers were studying. Youth who said they had sexual contact with both males and females reported the highest levels of suicide risk, while students with no sexual contact reported the lowest.

Interestingly, when researchers accounted for other variables such as dating violence and hard drug use, the relationship between sexual orientation and suicidal outcomes became less clear for boys. But girls who had had same-sex and both-sex contact still showed increased odds of suicidal thoughts, planning and non-medically serious attempts after those factors were taken into account.

These varying results show that lesbian, gay, bisexual and questioning youth—and youth who have same-sex contact—face a wide array of experiences. Still, the authors write, their findings reveal enough of a link between the range of sexual orientations and myriad suicidal behaviors to justify fostering greater awareness of suicide prevention among families, schools and social service providers. Further research is also needed, they say, to examine how factors like how supportive youth's communities are and how hopeful young people feel about their lives impact the connection between sexual orientation and suicidal risk.

Additional references: Find abstracts of other literature on sexual minority youth and suicide prevention in our digital library

Previous studies have looked at suicide risk and prevention for lesbian, gay, bisexual and transgender youth (418KB, PDF). The Trevor Project offers suicide prevention training with a focus on LGBTQ youth for young people, college students and adults.

Publications discussed here do not necessarily reflect the views of NCFY, FYSB or the Administration for Children & Families.


9-5 pm Eastern