Background: Prior studies suggest that female youth are at increased risk of suicide compared to males. However, research suggests that homosexual/bisexual males have increased odds of suicide attempts compared to homosexual/bisexual women. Little is known about gender differences in suicide risk among teenagers with intersectional identities. The objective of this study was to examine gender differences in suicide risk among lesbian/gay/bisexual youth with disabilities.
Methods: We analyzed cross-sectional data from 2015-2017 Oregon Healthy Teens Survey. A total of 25,476 11th graders participated in the survey. We used Poisson regression analysis with robust variance to estimate Prevalence Ratios of suicide attempts. We derived three measures of interaction in the additive scale to estimate the risk of suicide among intersectional teens (disabled and sexual minority), stratified by gender: 1) the excess risk due to interaction (RERI); 2) the proportion attributable to interaction (AP); and 3) the synergy index (SI).
Results: Interaction effects were not significant for female teens: RERI= 0.62 (95% CI:-1.34 – 2.57); AP=0.08 (95% CI: -0.17 – 0.33); SI=1.10 (95% CI: 0.81 – 1.51). Conversely, all three estimations of interaction were significant for male teens: RERI= 9.96 (95% CI: 3.92 – 15.99); AP=0.51 (95% CI: 0.31 – 0.72); SI=2.19 (95% CI: 1.36 – 3.52).
Conclusion: These findings provide strong evidence that the risk of suicide among male gay/bisexual teens who also have disabilities is multiplicative, whereas the combination of disability and identifying as lesbian or bisexual appears to have less than an additive effect on suicide risk among female teens
