Abstract
Purpose
Lesbian, gay, and bisexual (LGB) youth experience disproportionately high rates of suicidality and exposure to traumatic events, such as sexual violence and teen dating violence. Rates of suicidality and exposure to traumatic events also vary by sexual minority subgroup. The purpose of this study was to: (1) explore the impact of LGB identity on the relationship between violence exposure and suicide; and (2) to examine variations by sexual identity.
Method
A subsample of respondents who reported on their sexual identity in the Youth Risk Behavior Survey (n = 14,690) was used to examine if the associations between sexual and dating violence with suicide outcomes (suicidal ideation, planning, and suicide attempt) depended on the sexual identity of the respondent. Logistic regression models were fitted with an interaction effect to quantify heterogeneity of associations across identity strata.
Results
Overall interaction tests mostly indicated heterogeneity of associations between sexual violence and physical dating violence. Several contrast of strata associations suggested substantive probability differences between sexual minority respondents and their heterosexual peers.
Conclusion
While exposure to violence was broadly associated with increased probability of experiencing any type of suicidality, LGB and questioning youth were significantly more likely to experience suicidality compared to their heterosexual peers. Gay and lesbian youth demonstrated the strongest probability of experiencing suicidal thoughts and behaviors among survivors of sexual violence, while bisexual youth may be more at risk following dating violence. Implications for future research and suicide prevention are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ancheta, A. J., Bruzzese, J. M., & Hughes, T. L. (2020). The impact of positive school climate on suicidality and mental health among LGBTQ adolescents: A systematic review. The Journal of School Nursing, 37(2), 75–86. https://doi.org/10.1177/1059840520970847
Badenes-Ribera, L., Sánchez-Meca, J., & Longobardi, C. (2017). The relationship between internalized homophobia and intimate partner violence in same-sex relationships: A meta-analysis. Trauma Violence & Abuse, 20(3), 331–343. https://doi.org/10.1177/1524838017708781
Blais, M., Hébert, M., Bergeron, F. A., & Lapierre, A. (2020). Dating violence experiences among youths with same-gender and multi-gender dating partners: A dyadic concordance type approach. Journal of Interpersonal Violence, 37(7–8), https://doi.org/10.1177/0886260520957688. NP3981-NP4005
Bornovalova, M. A., Tull, M. T., Gratz, K. L., Levy, R., & Lejuez, C. W. (2011). Extending models of deliberate self-harm and suicide attempts to substance users: Exploring the roles of childhood abuse, posttraumatic stress, and difficulties controlling impulsive behavior when distressed. Psychological Trauma: Theory Research Practice and Policy, 3(4), 349–359. https://doi.org/10.1037/a0021579
Bouris, A., Everett, B. G., Heath, R. D., Elsaesser, C. E., & Neilands, T. B. (2016). Effects of victimization and violence on suicidal ideation and behaviors among sexual minority and heterosexual adolescents. LGBT Health, 3(2), 153–161. https://doi.org/10.1089/lgbt.2015.0037
Centers for Disease Control and Prevention (2010). The National Intimate Partner and Sexual Violence Survey. Retrieved from https://www.cdc.gov/violenceprevention/datasources/nisvs/index.html
Centers for Disease Control and Prevention (2019). Youth Risk Behavior Survey Data. Retrieved from www.cdc.gov/yrbs
Coston, B. M. (2021). Power and inequality: Intimate partner violence against bisexual and non-monosexual women in the United States. Journal of Interpersonal Violence, 36(1–2), 381–405. https://doi.org/10.1177/0886260517726415
Coulter, R. W. S., Mair, C., Miller, E., Blosnich, J. R., Matthews, D. D., & McCauley, H. L. (2017). Prevalence of past-year sexual assault victimization among undergraduate students: Exploring differences by and intersections of gender identity, sexual identity, and race/ethnicity. Prevention Science, 18(6), 726–736. https://doi.org/10.1007/s11121-017-0762-8
Davis, M. T., Witte, T. K., & Weathers, F. W. (2014). Posttraumatic stress disorder and suicidal ideation: The role of specific symptoms within the framework of the interpersonal-psychological theory of suicide. Psychological Trauma: Theory Research Practice and Policy, 6(6), 610–618. https://doi.org/10.1037/a0033941
Ford, J. D., & Gómez, J. M. (2015). The relationship of psychological trauma and dissociative and posttraumatic stress disorders to nonsuicidal self-injury and suicidality: A review. Journal of Trauma & Dissociation, 16(3), 232–271. https://doi.org/10.1080/15299732.2015.989563
Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E., & Stall, R. (2011). A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101(8), 1481–1494. https://doi.org/10.2105/AJPH.2009.190009
Hatchel, T., Ingram, K. M., Mintz, S., Hartley, C., Valido, A., Espelage, D. L., & Wyman, P. (2019). Predictors of suicidal ideation and attempts among LGBTQ adolescents: The roles of help-seeking beliefs, peer victimization, depressive symptoms, and drug use. Journal of Child and Family Studies, 28(9), 2443–2455. https://doi.org/10.1007/s10826-019-01339-2
Holmes, K., & Sher, L. (2013). Dating violence and suicidal behavior in adolescents. International Journal of Adolescent Medicine and Health, 25(3), 257–261. https://doi.org/10.1515/ijamh-2013-0059
House, A. S., Van Horn, E., Coppeans, C., & Stepleman, L. M. (2011). Interpersonal trauma and discriminatory events as predictors of suicidal and nonsuicidal self-injury in gay, lesbian, bisexual, and transgender persons. Traumatology, 17(2), 75–85. https://doi.org/10.1177/1534765610395621
International Society for Traumatic Stress Studies (2015). A Public Health Approach to Trauma: Implications for Science, Practice, Policy, and the Role of ISTSS [White paper]. Retrieved from https://istss.org/public-resources/istss-briefing-papers/a-public-health-approach-to-trauma
Keating, L., & Muller, R. T. (2019). LGBTQ + based discrimination is associated with PTSD symptoms, dissociation, emotion dysregulation, and attachment insecurity among LGBTQ + adults who have experienced trauma. Journal of Trauma & Dissociation, 21(1), 124–141. https://doi.org/10.1080/15299732.2019.1675222
LeBouthillier, D. M., McMillan, K. A., Thibodeau, M. A., & Asmundson, G. J. G. (2015). Types and number of traumas associated with suicidal ideation and suicide sttempts in PTSD: Findings from a U.S. nationally representative sample. Journal of Traumatic Stress, 28(3), 183–190. https://doi.org/10.1002/jts.22010
Mallory, C., Sears, B., Hasenbush, A., & Susman, A. (2014). Ensuring access to mentoring programs for LGBTQ youth. Williams Institute, UCLA School of Law
Mustanski, B., & Espelage, D. L. (2020). Why are we not closing the gap in suicide disparities for sexual minority youth? Pediatrics, 145(3), e20194002. https://doi.org/10.1542/peds.2019-4002
Niolon, P. H., Vivolo-Kantor, A. M., Tracy, A. J., Latzman, N. E., Little, T. D., DeGue, S., Lang, K. M., Estefan, L. F., Ghazarian, S. R., & McIntosh, W. L. K. (2019). An RCT of Dating Matters: Effects on teen dating violence and relationship behaviors. American Journal of Preventive Medicine, 57(1), 13–23. https://doi.org/10.1016/j.amepre.2019.02.022
Olshen, E., McVeigh, K. H., Wunsch-Hitzig, R. A., & Rickert, V. I. (2007). Dating violence, sexual assault, and suicide attempts among urban teenagers. Archives of Pediatrics and Adolescent Medicine, 161(6), 539–545. https://doi.org/10.1001/archpedi.161.6.539
Pennings, S. M., Finn, J., Houtsma, C., Green, B. A., & Anestis, M. D. (2017). Posttraumatic stress disorder symptom clusters and the interpersonal theory of suicide in a large military sample. Suicide and Life-Threatening Behavior, 47(5), 538–550. https://doi.org/10.1111/sltb.12317
Pompili, M., Lester, D., Forte, A., Seretti, M. E., Erbuto, D., Lamis, D. A., Amore, M., & Girardi, P. (2014). Bisexuality and suicide: A systematic review of the current literature. Journal of Sexual Medicine, 11(8), 1903–1913. https://doi.org/10.1111/jsm.12581
Raifman, J., Charlton, B. M., Arrington-Sanders, R., Chan, P. A., Rusley, J., Mayer, K. H., Stein, M. D., Austin, S. B., & McConnell, M. (2020). Sexual orientation and suicide attempt disparities among US adolescents: 2009–2017. Pediatrics, 145(3), e20191658. https://doi.org/10.1542/peds.2019-1658
Rees, S. N., Crowe, M., & Harris, S. (2021). The lesbian, gay, bisexual and transgender communities’ mental health care needs and experiences of mental health services: An integrative review of qualitative studies. Journal of Psychiatric and Mental Health Nursing, 28(4), 578–589. https://doi.org/10.1111/jpm.12720
Roberts, A. L., Rosario, M., Corliss, H. L., Koenen, K. C., & Austin, S. B. (2012). Elevated risk of posttraumatic stress in sexual minority youths: Mediation by childhood abuse and gender nonconformity. American Journal of Public Health, 102(8), 1587–1593. https://doi.org/10.2105/ajph.2011.300530
Rogers, M. L., Hom, M. A., Janakiraman, R., & Joiner, T. E. (2021). Examination of minority stress pathways to suicidal ideation among sexual minority adults: The moderating role of LGBT community connectedness. Psychology of Sexual Orientation and Gender Diversity, 8(1), 38–47. https://doi.org/10.1037/sgd0000409
Rostad, W. L., Clayton, H. B., Estefan, L. F., & Johns, M. M. (2020). Substance use and disparities in teen dating violence victimization by sexual identity among high school students. Prevention Science, 21(3), 398–407. https://doi.org/10.1007/s11121-019-01049-7
Saewyc, E. M., Konishi, C., Rose, H. A., & Homma, Y. (2014). School-based strategies to reduce suicidal ideation, suicide attempts, and discrimination among sexual minority and heterosexual adolescents in western Canada. International Journal of Child Youth & Family Studies, 5(1), 89–112. https://doi.org/10.18357/ijcyfs.saewyce.512014
Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative exposure therapy: A short-term treatment for traumatic stress disorders. Hogrefe Publishing
Selaman, Z. M. H., Chartrand, H. K., Bolton, J. M., & Sareen, J. (2014). Which symptoms of post-traumatic stress disorder are associated with suicide attempts? Journal of Anxiety Disorders, 28(2), 246–251. https://doi.org/10.1016/j.janxdis.2013.12.005
Semprevivo, L. K. (2021). Dating and sexual violence victimization among lesbian, gay, bisexual, and questioning youth: Considering the importance of gender and sexual orientation. Journal of Aggression Maltreatment & Trauma, 30(5), 662–678. https://doi.org/10.1080/10926771.2020.1832175
Shearer, A., Herres, J., Kodish, T., Squitieri, H., James, K., Russon, J., Atte, T., & Diamond, G. S. (2016). Differences in mental health symptoms across lesbian, gay, bisexual, and questioning youth in primary care settings. Journal of Adolescent Health, 59(1), 38–43. https://doi.org/10.1016/j.jadohealth.2016.02.005
Smith, A. U., Reidy, D., & Norris, A. E. (2020). Teen dating violence and suicide risk among bisexual adolescents. Journal of Adolescent Health, 67(5), 685–691. https://doi.org/10.1016/j.jadohealth.2020.04.014
Smith, B. C., Armelie, A. P., Boarts, J. M., Brazil, M., & Delahanty, D. L. (2016). PTSD, depression, and substance use in relation to suicidality risk among traumatized minority lesbian, gay, and bisexual youth. Archives of Suicide Research, 20(1), 80–93. https://doi.org/10.1080/13811118.2015.1004484
Surace, T., Fusar-Poli, L., Vozza, L., Cavone, V., Arcidiacono, C., Mammano, R., Basile, L., Rodolico, A., Bisicchia, P., Caponnetto, P., Signorelli, M. S., & Aguglia, E. (2020). Lifetime prevalence of suicidal ideation and suicidal behaviors in gender non-conforming youths: A meta-analysis. European Child. https://doi.org/10.1007/s00787-020-01508-5. & Adolescent Psychiatry Advance online publication
Swahn, M. H., Simon, T. R., Hertz, M. F., Arias, I., Bossarte, R. M., Ross, J. G., Gross, L. A., Iachan, R., & Hamburger, M. E. (2008). Linking dating violence, peer violence, and suicidal behaviors among high-risk youth. American Journal of Preventive Medicine, 34(1), 30–38. https://doi.org/10.1016/j.amepre.2007.09.020
Tharp, A. T. (2012). Dating matters™: The next generation of teen dating violence prevention. Prevention Science, 13(4), 398–401. https://doi.org/10.1007/s11121-012-0307-0
The Trevor Project (2020). 2020 National Survey on LGBTQ Youth Mental Health. https://www.thetrevorproject.org/survey-2020/?section=Suicide-Mental-Health
Acknowledgements
The author would like to acknowledge the Centers for Disease Control and Prevention who collect the Youth Risk Behavior Survey whose work made this study possible.
Funding
The authors did not receive funding to support this project.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics Approval
This status of this study is exempt according to the policies of the Institutional Review Board at the University of Georgia.
Conflict of interest
The authors declare that they have no conflict of interest.
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Ellis, É.M., Tate, A. Is Trauma Exposure More Harmful for Sexual Minority Youth? Differences in Trauma-Suicide Associations in a Nationally Representative Sample of U.S. Youth and Implications for Suicide Prevention. Journ Child Adol Trauma 16, 173–182 (2023). https://doi.org/10.1007/s40653-022-00475-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-022-00475-0