How Does Sexual Identity-Attraction Discordance Influence Suicide Risk? A Study on Male and Female Adults in the US

BackgroundSuicide continues to be one of the main causes of death among adults in the U.S. Research showed an association between sexual identity-attraction discordance (IAD) and adverse health outcomes, including suicidal ideation.MethodsWe sought to determine whether sexual IAD is associated with self-injurious thoughts and behaviors (SITBs), namely suicidal thoughts, plans, and suicide attempts, in the past year. We examined data from adults participating in the most recent six waves (2015-2020) of the National Survey on Drug Use and Health.ResultsMen who report sexual identity-attraction discordance were at greater risk of reporting suicidal thoughts (aOR = 3.67, 95% CI: 2.24-6.00) and plans (aOR = 5.71, 95% CI: 3.32-9.81) in the past year. Stratified by sexual identity, results showed that gay (aOR = 5.92, 95% CI: 1.54-22.7) and bisexual men (aOR = 4.38, 95% CI: 2.17-8.83) had higher odds of reporting suicide plans and heterosexual (aOR = 2.66, 95% CI: 1.06-6.68), gay (aOR = 7.05, 95% CI: 1.88-26.4), and bisexual men (aOR = 5.30, 95% CI: 4.37-22.9) had higher odds of suicide attempts when compared to men with concordant sexual identity-attraction. We found that bisexual women who report sexual identity-attraction discordance had less odds of reporting suicidal thoughts (aOR = 0.36, 95% CI: 0.21-0.63) and suicide plans (aOR = 0.43, 95% CI: 0.20-0.89) than women with concordant sexual identity-attraction. Among bisexual-identified males, those who experience sexual identity-attraction discordance were at greater risk for past-year suicidal thoughts (aOR = 3.82, 95% CI: 2.12-6.91) and suicide attempts (aOR = 5.30, 95% CI: 2.13-13.1) when compared to bisexual men with concordant sexual identity-attraction.ConclusionSexual IAD is associated with SITB and particularly concerning results emerged concerning bisexual-identified men.