When Suicide Exposure Raises Risk in Vulnerable Teens

TOPLINE:

A substantial proportion of teens who identified as sexual and gender minorities were exposed to suicidal behavior and ideation by friends and family members and reported experiencing more suicidal thoughts and behaviors than their cisgender and heterosexual peers.

METHODOLOGY:

• Adolescents between ages 14 and 21 years filled out surveys identifying themselves by gender identity (nonbinary, genderqueer, transgender, etc.) and sexual orientation (queer, pansexual, gay, lesbian, etc.)

• Researchers ran the survey between December 2022 and May 2023 to find out if these adolescents who were exposed to others’ suicidal behavior were more likely to experience suicidal thoughts or actions themselves

• Sexual and gender minority status was determined by asking each adolescent their sex assigned at birth, current gender identity, and sexual orientation

• Adolescents completed the Paykel Suicide Scale and Suicide Capacity Scale to assess suicidal thoughts and behaviors, evaluate past-year suicidal thoughts and attempts, and disposition to feeling low fear of pain or death, among others.

• Exposure to suicidal behavior of friends and family was assessed by asking adolescents whether any friends or family members had attempted suicide or died by suicide. The teens also reported their experiences of racial or ethnic discrimination in the previous 30 days.

TAKEAWAY:

• They included 1126 students (mean age, 16.2 years; 55% assigned female sex at birth; 51% African American or Black individuals; 35% White individuals) from four public high schools in one US county.

• Overall, 50.2% of sexual and gender minority adolescents reported being exposed to a suicide attempt by a friend, and 36.3% reported exposure to a suicide attempt by a family member.

• These adolescents reported higher levels of suicide capability (t, -4.0; P < .001) and more frequent suicidal ideation (t, -6.3; P < .001) and attempts (t, -6.9; P < .001) than their cisgender and heterosexual peers.

• Sexual and gender minority adolescents reported higher levels of peer, school, and institutional racial or ethnic discrimination than cisgender and heterosexual youth (P < .05 for all).

• Sexual and gender minority status was associated with exposure to suicide attempts by friends and family members (P < .05 for both); this exposure, in turn, was associated with increased suicide capability and suicidal thoughts and behaviors (P < .05 for all).

IN PRACTICE:

“[The study] findings suggest that existing models of suicide risk among [sexual and gender minority] adolescents should be expanded to include social network factors, particularly exposure to others’ suicide attempts,” the authors wrote. “Peer-engaged interventions may be one strategy to address and disrupt the potential for suicide contagion within SGM [sexual and gender minorities] adolescent peer networks.”

SOURCE:

This study was led by Kirsty A. Clark, PhD, of the Department of Medicine, Health, and Society at Vanderbilt University in Nashville, Tennessee. It was published online on August 20, 2025, in Journal of Adolescent Health.

LIMITATIONS:

Information on network size, density, member demographics, and the nature of exposure (online or in person) was missing. The cross-sectional design of this study limited the assessment of cause-and-effect relationships.

DISCLOSURES:

This study was supported by a grant from the US CDC. One author reported receiving funding from the National Institute of Mental Health. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.