Prevalence and clinical indices of risk for sexual and gender minority youth in an adolescent inpatient sample

Abstract

Objective: Rates of self-injurious thoughts and behaviors have increased in adolescents over the past two decades. Sexual and gender minority (SGM) youth report elevated rates of self-injurious thoughts and behaviors compared to heterosexual and cisgender youth. Studies of factors influencing suicide risk in SGM youth remain limited, however, and have largely been conducted in community or epidemiological samples.

Method: The present study aimed to address these limitations by examining the prevalence and clinical characteristics of sexual and gender minority youth in a sample of 515 youth admitted to an adolescent inpatient unit. In addition, the present study aimed to compare rates of self-reported self-injurious thoughts and behaviors, adverse early childhood experiences, and rates of rehospitalization in sexual and gender minority compared to non-sexual and gender minority youth.

Results: Results show that nearly 40% of the sample identified as sexual and/or gender minority. Sexual minority youth reported higher rates of suicidal ideation (t = -6.19, p < .001), higher rates of prior suicidal behavior (Chi² = 27.44, p < .001) and non-suicidal self-injury (Chi² = 48.09, p < .001), and greater numbers of adverse childhood experiences (t = -3.99, p < .001); gender minority youth reported higher rates of suicidal ideation (t = -3.91 p = .001). There were no group differences for SGM youth in rates of rehospitalization in the 6-months following initial admission. These results held when controlling for sex assigned at birth and current depression status in multi-variate analyses.

Conclusions: The study illuminates the importance of assessing SGM status in clinical care and highlights the need to evaluate sexual and gender minority specific risk factors for self-injurious thoughts and behaviors in youth.

Keywords: Adolescent; Gender identity; Self-injury; Sexual orientation; Suicide.