Sexual orientation and risk of suicide attempts among a representative sample of youth

Objective: To examine whether sexual orientation is an independent risk fac tor for reported suicide attempts. Design: Data were from the Massachusetts 1995 Centers for Disease Control a nd Prevention Youth Risk Behavior Survey, which included a question on sexu al orientation. Ten drug use, 5 sexual behavior, and 5 violence victimizati on variables chosen a priori were assessed as possible mediating variables. Hierarchical logistic regression models determined independent predictors of suicide attempts. Setting: Public high schools in Massachusetts. Participants: Representative, population-based sample of high school studen ts. Three thousand three hundred sixty-five (81%) of 4167 responded to both the suicide attempt and sexual orientation questions. Main Outcome Measure: Self-reported suicide attempt in the past year. Results: One hundred twenty-nine students (3.8%) self-identified as gay, le sbian, bisexual, or not sure of their sexual orientation (GLBN). Gender, ag e, race/ethnicity, sexual orientation, and all 20 health-risk behaviors wer e associated with suicide attempt (P<.001). Gay, lesbian, bisexual, or not sure youth were 3.41 times more likely to report a suicide attempt. Based o n hierarchical logistic regression, female gender (odds ratio [OR],4.43; 95 %; confidence interval [CI], 3.30-5.93), GLBN orientation (OR, 2.28; 95% CI , 1.39-3.37), Hispanic ethnicity (OR, 2.21; 95% CI, 1.44-3.99), higher leve ls of violence/victimization (OR, 2.06; 95% CI, 1.80-2.36), and more drug u se (OR, 1.31; 95% CI, 1.22-1.41) were independent predictors of suicide att empt (P<.001). Gender-specific analyses for predicting suicide attempts rev ealed that among males the OR for GLBN orientation increased (OR, 3.74; 95% ;, CI, 1.92-7.28), while among females GLBN orientation was not a significa nt predictor of suicide. Conclusions: Gay, lesbian, bisexual, or not sure youth report a significant ly increased frequency of suicide attempts, Sexual orientation has an indep endent association with suicide attempts for males, while for females the a ssociation of sexual orientation with suicidality may be mediated by drug u se and violence/victimization behaviors.