Victimization, depression, and the suicide cascade in sexual minority youth

Background: Suicidality remains disproportionately prevalent among sexual minority youth, necessitating novel methods of understanding suicide risk in this population. Victimization and depression are especially salient suicide risk factors.Aims: We aimed to test if victimization and depression were associated with suicidality at each step of a suicide cascade: Ideation, planning, and suicide attempts.Method: In sample of sexual minorities from the 2015 and 2017 Youth Risk Behavior Survey, we tested nine measures of victimization and depression associated with three outcomes in succession: Suicidal ideation among the full sample (n = 3357), suicide planning among those with ideation (n = 1475), and suicide attempts among those who planned suicide (n = 1073).Results: Depression was associated with suicidal ideation (aPR = 3.93, 95% CI 3.36-4.60), planning (aPR = 1.38, 95% CI 1.12-1.69), and attempts (aPR = 1.78, 95% CI 1.32-2.41) in successive subsamples. Victimization measures had different associations with suicidality at each successive stage, with the strongest associations observed with suicidal ideation in the general sample and suicide attempts among those who planned suicide.Conclusions: This may have implications for anti-victimization intervention effectiveness at each stage of suicidality. Additional research into this association among transgender and gender non-conforming youth is recommended.