Trends in Self-Injurious Thoughts and Behaviors Among US Adults, 2015–2019: Differential Risk According to Sexual Orientation

Abstract

Background

Suicide continues to be one of the leading causes of death in the United States and lesbian, gay, and bisexual (LGB) individuals are disproportionately at risk of suicide in comparison to heterosexuals.

Methods

We examined data from adults participating for five waves (2015–2019) of the National Survey on Drug Use and Health. We first determined whether there is differential risk of suicidal thoughts, suicide plans, and suicide attempts (self-injurious thoughts and behaviors [SITBs]) in the past year according to current sexual orientation. We then estimated linear trends in prevalence of each SITB outcome stratified by each sexual orientation category.

Results

We estimate that compared to heterosexual men and women, gay and bisexual men and lesbian and bisexual women are at greater odds of past-year suicidal thoughts, suicide plans, and suicide attempts, respective to their sexes. Between 2015 and 2019, suicidal thoughts increased among bisexual men (by 34.3%, p = 0.037), lesbian women (by 18.4%, p = 0.033), and bisexual women (by 15.7%, p < 0.001). Prevalence of suicide plans increased among heterosexual men (by 15.3%, p = 0.017), gay men (by 28.5%, p = 0.037), and bisexual women (by 23.2%, p < 0.001). Suicide attempts increased among bisexual women by 26.6% (p < 0.001).

Conclusions

Sexual minority identity is a risk factor for SITBs. Bisexual women in particular are not only at greater risk for SITBs, but estimated prevalence has increased in recent years. More attention needs to be paid to LGB populations regarding future suicide prevention efforts.

Keywords:

• Suicide
• self-injurious thoughts and behaviors
• sexual orientation
• trend analysis

ACKNOWLEDGMENTS

The National Institutes of Health provided financial support for the project and the preparation of the manuscript but did not have a role in the design of the study, the analysis of the data, the writing of the manuscript, nor the decision to submit the present research.

DISCLOSURE STATEMENT

Dr. Palamar has consulted for Alkermes. The authors have no other potential conflicts to declare.

Additional information

Funding

This research was supported by a grant through the National Institute on Drug Abuse: R01DA044207.

Notes on contributors

İbrahim Sönmez

İbrahim Sönmez, Department of Political and Social Sciences, Universitat Pompeu Fabra Barcelona, Spain, and

Joseph J. Palamar

Joseph J. Palamar, Department of Population Health, New York University Grossman School of Medicine, New York, NY, US. Correspondence concerning this article should be addressed to İbrahim Sönmez, Department of Political and Social Sciences UPF, Ramon Trias Fargas, 25–27, 08005, Barcelona, Spain. Email: [email protected].