Purpose: This study describes changes in proportions of lesbian, gay, bisexual, transgender, and other gender/sexual minorities (LGBTQ+) among total deaths by suicide in American 11-29 year olds between 2014 and 2019.
Methods: Data came from the Centers for Disease Control and Prevention's (CDC) National Violent Death Reporting System (NVDRS). All cases classified as deaths by suicide since 2014 that had valid data for sexual orientation or transgender identity were included from states that started participating in NVDRS before 2016. The latest year of data available was 2019. Valid n = 4,086, including 673 LGBTQ+ cases. Analyses used "reverse regression" with gender/sexual orientation as the dependent variable, essentially estimating contributions of timing of fatal self-injury and other variables to relative risk of a case being LGBTQ+.
Results: The proportion of decedents who were LGBTQ+ increased between 2014 and 2019. Post-hoc analyses suggested an inflection point or break in the trend at November 9, 2016. The proportion of decedents who were LGBTQ+ increased from 13% before to 20% after that date, driven largely by increases from 2.0% to 6.5% among transgender youth and from 0.5% to 1.7% among those described in medical examiner and law enforcement reports as "struggling" or questioning. Asian bisexual females and gay males were especially overrepresented.
Conclusions: Previous research found that the policy environment affects LGBTQ+ youths' mental health; this study generalizes those findings to actual deaths by suicide. LGBTQ+ youth at risk should be assessed for anxiety, trauma, and perceived physical threat from the political and rhetorical environment.
Keywords: Adolescent; LGBTQ+; Minority stress; NVDRS; Suicide; Young adult.
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