Suicide Risk and Social Connectedness in Cisgender and Transgender Lesbian, Gay, Bisexual, and Queer/Questioning Youth in the Emergency Department.

PURPOSE

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are at high suicide risk. Family/peer connectedness may be protective factors; few studies assess social connectedness within cisgender lesbian, gay, bisexual, and queer (cis-LGBQ) and transgender and gender-diverse (TGD) samples. This study aims to identify associations between family/peer connectedness and suicidal thoughts/behaviors (STBs) among cisgender-LGBQ and TGD youth to better inform suicide prevention strategies.

METHODS

This study utilized data from LGBTQ youth aged 12-17 in the Emergency Department Screen for Teens at Risk for Suicide study. Youth completed measures for STBs (Ask Suicide-Screening Questions and Columbia Suicide Severity Rating Scale) and family/peer connectedness ("low," "moderate," and "high"). Logistic regression analyses examined associations between family/peer connectedness and STBs in cis-LGBQ and TGD youth.

RESULTS

53.2% (607/1,140) of cis-LGBQ and 69.7% (99/142) of TGD youth self-reported STBs. For cis-LGBQ youth, the odds of reporting STBs increased when comparing low/moderate versus high family connectedness (p < .001, adjOR = 9.8[6.8-14.2]; p < .001, adjOR = 3.5[2.7-4.7]) and low versus moderate (p < .001, adjOR = 2.8[1.9-4.0]). Regarding cis-LGBQ peer connectedness, the odds of reporting STBs increased when comparing low/moderate versus high (p < .01, adjOR = 1.8[1.2-2.7]; p < .05, adjOR = 1.5[1.1-2.1]), not low versus moderate (p = .4). For TGD youth, the odds of reporting STBs significantly increased when comparing low/moderate versus high family connectedness (p < .001, adjOR = 9.8[3.7-28.2]; p < .001, adjOR = 7.7[2.8-22.8]), not when comparing low versus moderate (p = .7). Peer connectedness levels had no significant associations with TGD youths' STB rates (p = .2, p = .3, p = .8).

DISCUSSION

LGBTQ, especially TGD youth, are at elevated suicide risk. High levels of family connectedness may especially help mitigate suicide risk in TGD youth. Future research should replicate findings in larger TGD samples and adapt LGBTQ-specific, family-based emergency department interventions.