Coming Out as a Period of Increased Vulnerability to Suicide Risk Among Sexual Minorities

Sexual minority youth experience elevated suicide risk compared with their heterosexual peers. Identifying opportunities for intervention during adolescence (where suicide risk disparities first arise) is a priority. This study estimates the dynamic association between sexual identity disclosure ("coming out") and suicide intention, plan, and attempt.

This retrospective cohort study uses data from the Generations Study (2016-2019) and fixed-effects models to identify within-person changes in suicide behaviors around the timing of coming out to a family member or a friend among sexual minorities.

Identity disclosure to a family member was associated with a within-person increased risk of suicide intention (8 [95% CI:7-9]] percentage points), plan (10 [95% CI: 9-11] percentage points), and attempt (6 [95% CI: 5-6]] percentage points). Identity disclosure to a friend was associated with a within-person increased risk of suicide intention (10[95% CI: 9-11]] percentage points), plan (12 [95% CI: 11-13] percentage points), and attempt (6 [95% CI: 5-6] percentage points). Results indicated that these increases in suicide risk occurred around the timing of identity disclosure and increase in magnitude in subsequent years.

Coming out is a period of increased vulnerability to suicide risk. Multilevel interventions may be especially effective in preventing suicide behavior among sexual minorities.