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Background <p>The relationship between state policies related to sexual orientation (SO) and gender identity (GI) and suicidal thoughts and behaviors (STBs), including suicide ideation, suicide planning, and suicide attempts among adolescents, is not well understood.</p> Objective <p>This study examined the association between state-level SO- and GI-related policies and STBs among a nationally representative sample of high school students, and tested whether this association differed by individual-level SO and GI.</p> Methods <p>Using data from the 2023 Youth Risk Behavior Survey merged with a state-level index of SO and GI policies (n = 15,269), we conducted logistic models with robust standard errors for clustering.</p> Results <p>More inclusive state-level SO policies were associated with lower odds of suicide planning (<i>OR</i> = <i>0.99, p</i> &lt; <i>0.05</i>). More inclusive state-level GI policies were not statistically significantly associated with STBs.</p> Conclusions <p>Supportive SO policies may provide safer environments for youth and decrease suicide planning.</p>

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Associations Between State-Level Policies Related to Sexual Orientation and Gender Identity and Suicidal Ideation, Suicide Planning, and Suicide Attempts Among a Nationally Representative Sample of High School Students in the United States

  • 期刊论文

  • 发表日期：

    2025年12月18日

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  • Christina M. Sellers,
  • Antonia Diaz-Valdes,
  • Philip Baiden,
  • Emma Cho,
  • Shawndaya S. Thrasher,
  • Hector Perez,
  • Julie Stubbs,
  • Sky Gavis-Hughson,
  • Joanna Almeida

摘要

Background

The relationship between state policies related to sexual orientation (SO) and gender identity (GI) and suicidal thoughts and behaviors (STBs), including suicide ideation, suicide planning, and suicide attempts among adolescents, is not well understood.

Objective

This study examined the association between state-level SO- and GI-related policies and STBs among a nationally representative sample of high school students, and tested whether this association differed by individual-level SO and GI.

Methods

Using data from the 2023 Youth Risk Behavior Survey merged with a state-level index of SO and GI policies (n = 15,269), we conducted logistic models with robust standard errors for clustering.

Results

More inclusive state-level SO policies were associated with lower odds of suicide planning (OR = 0.99, p < 0.05). More inclusive state-level GI policies were not statistically significantly associated with STBs.

Conclusions

Supportive SO policies may provide safer environments for youth and decrease suicide planning.