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The Relationship Between School Bullying and Suicide-Related Behaviors Among Sexual Minorities: A Systematic Review
Huan Chen1,2, Siwen Sun1, Yu-Pei Yang3
1Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, Zhejiang, 317000, China.
Abstract:
Suicide is the third leading cause of death among adolescents and young adults (aged 10-24). Among sexual minorities, various forms of bullying victimization are strongly associated with suicide. This review aimed to explore the relationship between school bullying and suicide-related behaviors among sexual minority adolescents. We searched PubMed, Web of Science, EMBASE, Cochrane, Scopus, APA PsycInfo, and ProQuest databases from inception to June 16, 2025. A meta-analysis was performed to combine odds ratios (ORs) with 95% CIs. The heterogeneity of the studies was assessed using the I2 statistic. Publication bias was evaluated using a funnel plot analysis and Egger's test. A meta-regression model was developed to examine the associations between school bullying and suicide-related behaviors. This systematic review and meta-analysis included 11 studies, involving a sample of 113,039 sexual minority students. The results revealed that, among sexual minorities, bullying was positively associated with suicidal ideation (OR 2.36, 95% CI 1.65, 3.36, p < .001) and suicide attempts (OR 2.30, 95% CI 1.71, 3.11, p < .001) but was not significantly associated with self-harm (OR 1.56, 95% CI 0.82, 2.96, p = .06). Sexual minorities who reported being bullied in schools are at a higher risk of suicidal ideation, suicide attempts, and suicide plan. This finding suggests that, to reduce suicide risk in sexual minority students, it is crucial to focus on and prevent school bullying.
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