Reducing

LGBT(Q) youth
suicides: a
systematic
review.

Robert Avina, MPH (c)

Brailyn Bray, MPH (c)
Carolina Gabaldon, MPH (c)
Kanale Rodrigues, MPH (c)
 Abstract
Objective: To determine the factors contributing to
LGBT(Q) suicide and its prevalence.
Methods: (4) 5 yr, full-text, US/Canada, PubMed searches
following PRISMA guidelines, 16 studies.
Results: Intersectionality of factors and coming out
associated with suicide ideation.
Conclusion: GSAs can influence change and meet the
specific needs of the LGBT(Q) population.
 Introduction
Background:
- Mental disorders 1.5x more common in LGBTQ
population (CDC,2018)
- LGBT(Q) are 5x more likely to attempt suicide
(CDC,2018)
- Linked to discrimination and stigma
- Interventions that improve school climate
- Anti-bullying policies
- Gay-straight alliances
 Why is it Important?
Sexual Minority Stressors
- Unsure of identity
- Discrimination/Victimization
- Expectations to experience them
- Concealment/Disclosure
- Depression and internalization
- Substance abuse
- Family history of suicide
 What We Do Not Know
- Precise LGBTQ population numbers

- Knowledge gap in LGBTQ suicide behavior

- Level of school connectedness

- Gay-straight alliance effectiveness

 Research Question
What is the prevalence of suicidality
(ideation and attempt) and risk factors
among LGBT(Q) populations?
 Methods
• Search process:
– Follow PRISMA Guidelines
– April & May 2018 query was run on PubMed, ONE SEARCH
– Keywords: LGBT, gay, bisexual, transgender, gay-straight
alliance, and suicide (some searches limited to adolescence)
– Limited to the past 5-years
– Inclusion: English language, Free full text, United States and
Canada
– Exclusion: Outside U.S. or Canada, populations with not
defined adolescents, could not access full articles, limited
discussion on suicide or alliances
 Data Analysis
• Evaluation:
– Focused on articles based on title and abstract
– Not meeting inclusion criteria were excluded
– Full texts of resulting articles were evaluated
– Assessed on study characteristics:
• Author/date, title, populations of the study, size of
sample in the study, and type of study
– Collected information on the purpose of the study
and key findings
 (n=196)

Results
16 studies evaluated
 Study Characteristics
• 15 studies were cross-sectional and 1 longitudinal
• Sample size ranged from 108 to 24,626
• Primarily (n=10) studies are among youth
• Rest is a mix of college students and adults (one
study in veterans)
• One study only focused on transgender
population
• Seven studies include nationally representative
data (Youth Risk Behavior Surveillance System)
 Purpose of Studies
• Thematic analysis of the purpose of each study
demonstrate:
– Five studies focused on prevalence of suicidality
(Ideation and attempt)
– Five studies focused on discrimination
– Two studies focused on religion
– Two studies focused on victimization
– Two studies focused on stress
Key Findings
 Key Findings
• Sexual and gender identity minorities are more
likely to have suicidal ideation and attempts
• Intersectionality of factors
– Racial/ethnic minority background
– Gender identity
– Experiences of being bullied
– Depression
• White and Hispanic gay and bisexual males
were more likely to have negative outcomes
 Key Findings
• Minority coming out feeling like a burden was
related to high rates of suicidal ideation and
attempts
• LGB population was 200% higher odds of
suicidal ideation than non LGB population
• Males being unsure were likely to have suicidal
ideation more than other groups
• Predominant factor associated with suicidal
ideation and attempts among any LGBTQ
population
 Limitations
• LGBTQ definition was varied
– Studies only included LGB, while other included Q
as either queer or questioning
• Majority of studies focused on youth
– Emphasis on adults needed since adults are more
likely to live alone and have higher suicidal
attempts
• Study design biases
– Self-report
– Social desirability
– Cannot infer cause and effect
– Research funded by those conducting the study
 Strengths
• Systematic reviews provide foundation for
evidence-based interventions.
• Studies limited to most recent years to
provide current evidence vs historical data.
• Included a variety of terms in diverse
population.
 Discussion
• Current research suggest support groups can
reduce stigma among youth by providing a
protective factor and positive connections.
• Difficulties with gender identity have found to
be significant.
• Religious discrimination towards sexually
diverse individuals contribute to the negative
experiences of LGB community.
 Discussion
• Studies have mixed findings with gender
differences and suicidality.
• Anti-bullying policies and Gay-Straight
Alliances have shown to reduce risk among
LGB students for suicide ideation, attempts,
and discrimination.
• Minority stress and experiences differ and
effect LGB individual willingness to join GSA’s.
 What We Do Know
- Prevention is a priority
- Tailored for sexual and gender minority (SGM)
- Bullying occurs 3x more frequently in LGBTQ
(CDC,2018)
- Socio-Ecological Model
- More likely to sustain prevention efforts
- 4 overlapping influential factors
- Includes the 5 components of a “Protective School
Climate”
- Future research evaluating minority stress is
warranted.
 Funding
• Anti bullying policies
• Increase low-community and Internalized
stigma (Hatzenbuehler et al. 2015)
• Reduce suicide attempts among LGBT
community
• Program development
• Research
 Potential Funders
National Organizations
• Arcus Foundation
• Ford Foundation
• Funds for Global rights
• Levi Strauss Foundation
• Open Society Foundation
• Overbrook Foundations
Community Organizations
 Funding Concerns
• Study’s are independently funded by the
researchers conducting research about
LGBTQ topics.
• Past studies have shown members of the
LGBTQ community may be hesitant in
taking part in research studies.
• National organizations
• Community beliefs
 Conclusion
• The evaluation results, surveillance data, and
research conclusions show the need for suicide
prevention among LGBT(Q) youth.
• With funding opportunities, the development
of health interventions including GSAs will
influence change and serve the specific needs
of the population.
 Journal Considerations
Which journal to submit to?
● Journal of LGBT Youth or Student Journal
What is the impact factor of the journal?
● Specializes in youth populations
● Improve research content on LGBT
Opened or closed access?
● Open access since there is a lack of research
pertaining to LGBT(Q) youth
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