(PS13-20) Exploring the Link Between Sexual Orientation Concealment and Suicidal Ideation Frequency Among Sexual and Gender Minority Adults

Abstract Text: Intro: Sexual and gender minority individuals (SGM) are at heightened risk of suicidal ideation compared to their heterosexual and cisgender peers (Liu et al., 2023). Discriminatory and heterosexist experiences may motivate SGM adults to conceal their sexual orientation. This concealment has been associated with poor mental health outcomes (Pachankis et al., 2015). Additionally, conflict present in the family of SGM individuals may increase their desire to conceal their orientation status, further exacerbating their suicidal thoughts. This study examined the effects of concealment motivations on the frequency of suicide ideation at its peak among a sample of SGM adults with a history of suicidal ideation, while also examining how family conflict affects this relationship. It was expected that family conflict would moderate this relationship such that as conflict increased, the association between concealment motivation and peak suicide ideation frequency would strengthen.

Methods: Data were collected from 162 SGM adults aged 19-78 in the U.S. using the online survey platform Prolific. The mean age was 39.93 (SD=14.14); most identified as cis-gender female (53%), White (79%), and Bisexual (44%). All participants completed the Self-Injurious Thoughts and Behaviors Interview (SITBI), the Lesbian, Gay, and Bisexual Identity Scale (LGBIS), and the Cultural Assessment of Risk for Suicide (CARS). Participants who endorsed a lifetime history of suicide ideation on the SITBI also completed an item assessing frequency of suicidal ideation at its worst point.

Results: The hypothesis was tested using the PROCESS macro for SPSS (Hayes, 2018). Concealment motivation was significantly associated with peak ideation frequency (b= .18, 95% CI [.013, .342], t = 2.13, p< .05), and a significant association was also found between family conflict and peak ideation frequency (b = -.05, 95% CI [ -.073, -.019], t = -3.33, p< .001). A significant interaction was observed between concealment motivation and family conflict (b = -.02, 95% CI [-.042, -.004]), t= -2.45, p< .05). Conditional effects (simple slopes) of concealment motivation at -1SD, mean, and +1SD levels of family conflict found that concealment motivation was significantly associated with peak ideation frequency at low levels of family conflict (b =.37, t = 3.44, p< .001). This relationship was stronger when compared to the association of concealment motivation and peak ideation frequency at mean and high levels of family conflict (b =.18, t = 2.13, p< .05; b = -.01, t= -.10, p = .92, respectively).

Conclusion: Family conflict moderated the relationship between concealment motivation and peak suicidal ideation frequency, but not as hypothesized. The effect of concealment motivation on peak suicide ideation frequency was greatest when individuals experienced low, and then average levels of family conflict. SGM adults may encounter reduced family conflict when concealing their sexual orientation, leading to increased stress for these individuals and potentially heightening their vulnerability to suicidal ideation. Further research is needed to understand how low family conflict contributes to perpetuating sexual orientation concealment among SGM adults with prior suicidal ideation.