(PS11-59) Heterosexist Experiences Are Associated with Suicide Risk Among Trauma-exposed Sexual Minority People

Suicide is a major public health concern among sexual minority women and sexual minority people assigned female at birth (henceforth referred to as SMP). SMP are especially likely to be exposed to trauma and receive a diagnosis of posttraumatic stress disorder (PTSD) in their lifetime, which is problematic given that PTSD is a known risk factor for suicide. SMP are also vulnerable to heterosexist discrimination (i.e., discrimination based on marginalized sexual orientation), which has been indicated as a risk factor for both more severe PTSD symptoms and suicide risk. However, it is not yet known whether heterosexist discrimination exacerbates suicide risk in association with PTSD symptoms among trauma-exposed SMP. It was expected that among a trauma-exposed sample of SMP, experiences of heterosexism would be associated with more severe PTSD symptoms, which would in turn be associated with more elevated suicide risk, even when controlling for demographic covariates.

Participants were users of the online survey platform Prolific and completed a one-time, 20-minute online survey for which they were compensated $3.17. Eligibility criteria were: 1) identify as women or assigned female sex at birth, and 2) identified as lesbian, bisexual, queer, pansexual, or another non-heteronormative orientation, 3) age 18+, & 4) living in U.S. All participants (M age = 28, SD = 8.9) in the analytic sample (n = 503) endorsed ≥1 lifetime trauma exposure, as measured by the LEC-5. 88% identified as cisgender women, and 12% identified as gender-diverse (e.g., transgender woman or person, non-binary, gender fluid). The majority identified as bisexual (60%) and White (65%).

ANOVA indicated significant differences by gender identity such that gender-diverse participants on average reported more severe PTSD symptoms and greater suicide risk, compared to cisgender participants. ANOVA indicated no other significant differences between demographic groups (i.e., sexual identity, racial identity). For this reason, gender identity (gender-diverse vs. cisgender) was entered in the indirect effects model as a covariate. Indirect effects analysis indicated that the total model was significant, F(2, 498) = 18.71, p < .001, R² = 0.07. Heterosexist experiences were related to PTSD symptoms, B = 15.22, SE = 1.60, p < .001, which were in turn related to suicide risk, B = 0.10, SE = 0.01, p < .001, even when the effect of gender identity was accounted for, B = 1.62, SE = 0.53, p = .002. Heterosexist experiences did not have a direct effect on suicide risk, B = 0.45, SE = 0.42, p = 0.28. However, indirect effect of PTSD symptoms in the heterosexist experiences – suicide risk association was significant, B = 1.51, SE = 0.24, 95%CI [1.08, 1.99]. 

Heterosexist experiences were associated with greater PTSD symptoms, which were in turn associated with greater suicide risk. This suggests that heterosexist discrimination may contribute to suicide risk by exacerbating PTSD-related pathology among SMP who have been exposed to traumatic events. Results suggest that not only may reduction of PTSD contribute to reduction of suicide risk among this group, but also that reduction of heterosexist stigma is necessary to reduce the mental health burden of trauma and suicide risk among trauma-exposed SMP.