"Am I really alive?": Understanding the role of homophobia, biphobia and transphobia in young LGBT+ people's suicidal distress

An Intersectional Exploration of Outness, Encountered Discrimination and Violence, and Non-Suicidal Self-Injury among Asexual Youth across Gender Identities

Current research on asexual youth is limited, especially in understanding the impact of their outness and the intersection of sexual orientation with gender minority identities. This study investigates the influence of outness on experiences of harassment, discrimination, violence, and the risk of non-suicidal self-injury (NSSI) among asexual youth, with a focus on those with transgender and non-binary identities. Data for this study were obtained from the 2021 Ace Community Survey, an international online survey designed to assess the needs and health status of the Ace community, targeting respondents aged 13 and older. The analysis involved a subsample of 5574 respondents aged 13 to 24 (mean age = 19.28), including 2361 cisgender (mean age = 19.65), 1,195 transgender (mean age = 18.80), and 2,018 non-binary individuals (mean age = 19.13). The results revealed that experienceds of sexual violence, verbal aggression, and physical harassment and bullying not only correlated with but also completely mediated the relationship between outness and NSSI. Asexual transgender youth experienced heightened levels of discrimination and NSSI but demonstrated notable resilience against the negative effects of identity disclosure, highlighting complex dynamics of vulnerability and protection within these communities.

Minority Stressors, Social Provisions, and Past-Year Suicidal Ideation and Suicide Attempts in a Sample of Sexual Orientation and Gender Identity/Expression Minority People in Canada

Purpose: Mental health disparities in sexual orientation and/or gender identity and/or expression (SOGIE) minority groups are well-documented, with research consistently showing higher levels of suicidality, even in Canada, considered one of the world's most accepting countries of SOGIE minority groups. Adverse outcomes in these groups are often framed using minority stress theory, with social support frequently studied as an integral buffer to these outcomes. This analysis explores facets of minority stress and social support associated with past-year suicidal ideation and suicide attempts. Methods: A cross-sectional internet survey of SOGIE diverse people in Canada (n = 1542) was conducted. Binary logistic regression calculated bivariate and multivariate factors associated with past-year suicidal ideation and suicide attempts. Backward elimination (retaining sociodemographic factors and self-rated mental health) identified salient minority stress and social support (provisions) factors. Results: Over half (56.72%) of participants had ever thought of dying by suicide, with 24.84% having attempted suicide. During the past year, 26.80% had thought of dying by suicide, with 5.32% having attempted suicide. Victimization events, and guidance (e.g., someone to talk to about important decisions) and attachment (e.g., close relationships providing emotional security) social provision subscales remained salient after backward elimination procedures. Conclusion: Our findings emphasize that a fulsome, multilevel approach considering structural, community, and individual strategies to address overt discrimination, integrating social connections and guidance, is necessary to prevent dying by suicide.

Risk and protective factors for suicidality among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, from countries with a high global acceptance index (GAI), within the context of the socio-ecological model: A scoping review

INTRODUCTION

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesize quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ young people, from countries with a high Global Acceptance Index.

METHODS

A scoping review guided by Arksey and O'Malley's five-stage framework, using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The mixed methods appraisal tool was used for quality assessment of studies.

RESULTS

Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include past suicidality, adverse childhood experiences, internalized queerphobia, minority stress, interpersonal violence, bullying, familial conflict, and anti-LGBTQ+ policies/legislation. Key protective factors include self-affirming strategies, adult/peer support, at-school safety, access to inclusive healthcare, family connectedness, positive coming out experiences, gender-affirming services and LGBTQ+ inclusive policies and legislation.

CONCLUSIONS

Overall, our findings affirm that multiple risk and protective factors, at all levels of the socio-ecological model, interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Implications for suicide prevention are discussed. Further empirical studies are required, particularly at the communities, policies, and societal levels of the socio-ecological model, and these studies should include a focus on protective factors and significant within-group differences.

A qualitative study of young people's lived experiences of suicide and self-harm: intentionality, rationality and authenticity

BACKGROUND

Suicide is a leading cause of death amongst young people and a major public health concern. Although increasing research has identified contributory and protective factors affecting youth suicide, less is known about how young people make sense of suicidal distress themselves.

METHODS

Using semi-structured interview methods and reflexive thematic analysis, this study explores how 24 young people aged 16-24 in Scotland, UK made sense of their lived experiences of suicidal thoughts and feelings, self-harm, and suicide attempts.

RESULTS

Intentionality, rationality, and authenticity formed our central themes. Suicidal thoughts were categorised by participants dependent on their intention to act on them; a distinction often used to downplay the significance of early suicidal thoughts. Escalating suicidal feelings were then described as almost rational responses to adversities; whereas suicide attempts appeared to be described as more impulsive. These narratives seemed to be somewhat shaped by dismissive attitudes participants experienced in response to their suicidal distress, both from professionals and within their close networks. This impacted how participants articulated distress and asked for support.

CONCLUSION

Suicidal thoughts that participants articulated as lacking the intention to act could represent key opportunities for early clinical intervention to prevent suicide. In contrast, stigma, difficulties communicating suicidal distress and dismissive attitudes could serve as barriers to seeking help, and, therefore, additional efforts should be made to ensure young people feel comfortable seeking help.

The politics of LGBT+ suicide and suicide prevention in the UK: risk, responsibility and rhetoric

Suicide is a major public health concern, patterned by systematic inequalities, with lesbian, gay, bisexual and trans (LGBT+) people being one example of a minoritised group that is more likely to think about and attempt suicide worldwide. To address this, UK national suicide prevention policies have suggested that LGBT+ people should be prioritised in prevention activities. However, there is little research seeking to understand how LGBT+ suicide is re/presented in political and policy spheres. In this article, we critically analyse all mentions of LGBT+ suicide in UK parliamentary debates between 2009 and 2019 and in the eight suicide prevention policies in use during this period. We argue that LGBT+ suicide is understood in two contrasting ways: firstly, as a pathological 'problem', positioning LGBT+ people either as risks or as at risk and in need of mental health support. Alternatively, suicide can be seen as externally attributable to perpetrators of homophobic, biphobic and transphobic hate, requiring anti-hate activities as part of suicide prevention. In response, we argue that although these explanations may appear oppositional; they both draw on reductive explanations of LGBT+ suicide, failing to consider the complexity of suicidal distress, thus constraining understandings of suicide and suicide prevention.

'How can I fix my disrupted life?' Embodied experiences and biocitizenship among men who have sex with men living with HIV in China

Drawing on qualitative data collected from men who have sex with men living with HIV in Fujian and Sichuan provinces in southeast and southwest China, respectively, this study aims to understand their lived experiences in the context of social norms, institutions and roles. We argue that informants encountered biographical disruption as a result of their diagnosed infection. They then painfully experienced different forms of social death on the one hand, while on the other, some also exerted agency/autonomy by strategically fighting for their rights and interests in both private and public domains. By examining these lived experiences, this study discusses the biological citizenship of the respondents so as to deepen understanding of embodied life experiences and trajectories.

Experiences of sexual violence and their associations with suicidal ideation and behavior in the past year: an analysis of adults from the 2021 Ace Community Survey

BACKGROUND

This research assessed forms of sexual violence and their associations with suicidal ideation among adults identifying on the asexual identity spectrum.

METHODS

A secondary data analysis was conducted among adults, identifying on the asexual spectrum of asexual, gray-asexual, or demisexual, from the 2021 Ace Community Survey (n = 8,715). Multiple logistic regression analyses determined potential associations between sexual violence and suicidal ideation, adjusting for the covariates of age group, gender, education, racial/ethnic minority, employment, and asexual spectrum identity.

RESULTS

Demisexual individuals were at statistically greater odds of suicidality compared to gray-asexual and asexual individuals. Sexual violence victims were more likely to be suicidal compared to non-victims. This was especially true for attempted rape and suicidal consideration (OR = 2.10, 95% CI (1.60, 2.75), planning (OR = 1.76, 95% CI (1.32, 2.34), and attempts (OR = 3.15, 95% CI (2.07, 4.81).

CONCLUSIONS

Asexual victims of sexual violence were more likely to be suicidal compared to non-victims. Demisexual individuals were more likely to be suicidal compared to asexual individuals. These findings demonstrate the need for additional research on sexual violence and suicide.

Immigration Status, Legal Vulnerability, and Suicidal/Self-harm Ideation Disparities Among Immigrant-Origin Latinx Young Adults in the U.S

Theories of suicidality typically center intrapersonal processes, with limited attention to social determinants of mental health disparities. Using a legal vulnerability framework, we examined the association between self/parental immigration status and suicidal and self-harm ideation (SI) disparities in three groups of immigrant-origin Latinx young adults attending college in the USA: undocumented students (n = 564), US citizens with undocumented parents (n = 605), and US citizens with lawfully present parents (n = 596). We also evaluated whether self/parental immigration status differences in SI could be accounted for by six dimensions of legal vulnerability and, based on prominent theories of suicidality, explored the role of campus belongingness as a protective factor. Participants completed self-report measures, and SI was assessed using one item from the Patient Health Questionnaire-9, a screening tool that assesses the severity of depression symptomatology. Rates of SI were significantly higher among undocumented students (23.1%) and US citizens with undocumented parents (24.3%) compared to US citizens with lawfully present parents (17.8%). Immigration policy-related social exclusion and discrimination-mediated self/parental immigration status differences in SI. Although food insecurity did not differ by self/parental immigration status, greater food insecurity was associated with higher likelihood of SI. Greater campus belongingness was associated with a lower likelihood of endorsing SI for all students regardless of immigration status or legal vulnerability factors. Findings underscore the importance of examining self and parental immigration status as a social determinant of SI and the value of investigating aspects of legal vulnerability as explanatory factors.

Gender-Affirming Care and Comprehensive Sexuality Education

ABSTRACT

Every year, an estimated 246 million children are subject to some form of gender-based violence, including mistreatment, bullying, psychological abuse, and sexual harassment. Lesbian, gay, bisexual, transgender, two-spirit, or questioning youth are at a heightened risk of experiencing violence and have unique health, educational, and social needs. Fostering an atmosphere of support and acceptance can help alleviate many of these negative outcomes.

Experiences of minority stress and their impact on suicidality among asexual individuals

INTRODUCTION

While the asexual community has become increasingly visible, the pathologization and denial of asexuality remain strong, which may be linked to a higher prevalence of suicidality in this population. The present study examined experiences of minority stress and their relationship with suicidality among asexual individuals.

METHODS

This study included a global sample of 12,449 individuals on the asexual spectrum. They completed an online survey assessing minority stress (including verbal aggression, victimization, and health care discrimination), impairment in different aspects of life, and suicidality.

RESULTS

The results showed that 64.8 % of asexual individuals had experienced minority stress based on sexual and/or romantic orientation. Approximately 32.2 % reported suicidal ideation, 10.6 % had suicide plans, and 2.7 % had attempted suicide in the past 12 months. Suicidality was more prevalent among asexual men and non-binary individuals than among asexual women. Asexual individuals who were younger, identified as transgender, and lived in lower-income countries were more likely to report suicidality. Among the different dimensions of minority stress, victimization was most significantly associated with suicidal ideation, plans, and attempts. The positive association between minority stress and suicidality was mediated by impairment in health.

LIMITATIONS

The cross-sectional nature of the data might prevent causal inferences from being drawn. Validated measures of asexual-specific minority stress were not available.

CONCLUSION

The findings have implications for asexuality-affirming mental health practices supporting asexual individuals in coping with minority stress experiences. Public education efforts are needed to raise awareness of asexuality as a valid sexual orientation and to dispel misconceptions about asexuality.