ArticleSocial psychiatry and psychiatric epidemiology2025
State policies and suicidal behavior among sexual and gender minority college students.
Article in Social psychiatry and psychiatric epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWhile lesbian, gay, bisexual, transgender/nonbinary, and queer/questioning (LGBTQ+) college students are at heightened risk of suicidal ideation and attempt compared to cisgender and heterosexual students, few studies have examined system-level factors to reduce these risks. We investigated associations between state-level policies and suicidal behavior by gender identity (cisgender sexual minority; CSM, and transgender/nonbinary; TNB) among U.S. LGBTQ + young adults attending 135 institutions.
methodsState policy tallies, from the Movement Advancement Project, represent a sum of LGBTQ+-related laws, with indices for protective (positive) and discriminatory (negative) legislation for an overall score (range: -23.5 to 42.5). We linked tallies with student survey data from LGBTQ + young adult participants (18-24 years) in the 2022-2023 Healthy Minds Study (n = 15,861). We used multilevel models to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between 10-point increases in overall, sexual orientation, and gender identity tallies and suicidal behavior.
resultsA 10-point increase in overall policy tally was associated with an 8% reduction in the odds of suicidal ideation in CSM participants (OR = 0.92, 95% CI = 0.87, 0.97) and a 7% reduction in TNB participants (OR = 0.93, 95% CI = 0.87, 1.00). Associations were observed between overall policy tallies and suicide attempt among CSM, but not TNB students. We observed congruent results for sexual orientation- and gender-specific tallies.
conclusionProtective state policy was associated with lower odds of suicidal ideation among LGBTQ + college students. We build upon evidence demonstrating the importance of system-level protections for LGBTQ + individuals.
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