How Does Sexual Identity-Attraction Discordance Influence Suicide Risk? A Study on Male and Female Adults in the U.S.

Abstract

Background

Suicide continues to be one of the main causes of death among adults in the U.S. Research showed an association between sexual identity-attraction discordance (IAD) and adverse health outcomes, including suicidal ideation.

Methods

We sought to determine whether sexual IAD is associated with self-injurious thoughts and behaviors (SITBs), namely suicidal thoughts, plans, and suicide attempts, in the past year. We examined data from adults participating in the most recent six waves (2015–2020) of the National Survey on Drug Use and Health.

Results

Men who report sexual identity-attraction discordance were at greater risk of reporting suicidal thoughts (aOR = 3.67, 95% CI: 2.24–6.00) and plans (aOR = 5.71, 95% CI: 3.32–9.81) in the past year. Stratified by sexual identity, results showed that gay (aOR = 5.92, 95% CI: 1.54–22.7) and bisexual men (aOR = 4.38, 95% CI: 2.17–8.83) had higher odds of reporting suicide plans and heterosexual (aOR = 2.66, 95% CI: 1.06–6.68), gay (aOR = 7.05, 95% CI: 1.88–26.4), and bisexual men (aOR = 5.30, 95% CI: 4.37–22.9) had higher odds of suicide attempts when compared to men with concordant sexual identity-attraction. We found that bisexual women who report sexual identity-attraction discordance had less odds of reporting suicidal thoughts (aOR = 0.36, 95% CI: 0.21–0.63) and suicide plans (aOR = 0.43, 95% CI: 0.20–0.89) than women with concordant sexual identity-attraction. Among bisexual-identified males, those who experience sexual identity-attraction discordance were at greater risk for past-year suicidal thoughts (aOR = 3.82, 95% CI: 2.12–6.91) and suicide attempts (aOR = 5.30, 95% CI: 2.13–13.1) when compared to bisexual men with concordant sexual identity-attraction.

Conclusion

Sexual IAD is associated with SITB and particularly concerning results emerged concerning bisexual-identified men.

HIGHLIGHTS

• Sexual IAD is associated with SITBs, especially among men.

• Sexual IAD is not the strongest indicator of SITBs if sexual identity is considered.

• Among bisexual men, there is a high SITB risk if sexual IAD is reported.

Keywords:

• National Survey on Drug Use and Health
• self-injurious thoughts and behaviors
• sexual identity-attraction discordance
• suicide

ACKNOWLEDGMENTS

The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

DATA AVAILABILITY STATEMENT

NSDUH data is publicly available on the NSDUH website.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Notes on contributors

İbrahim Sönmez

Dr. İbrahim Sönmez, Ph.D., Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain.