The Lesbian, Gay, Bisexual (LGB) population experience significantly higher minority stress and suicidal behaviors than the heterosexual population. This study examined the association between minority stress (including perceived stigma, victimization, everyday discrimination, and internalized homophobia) and suicidal behavior (i.e., suicidal ideation and suicide attempt) and the moderating role of two coping strategies – concealment and community connectedness.

This study used wave 1 data from the Generation Study, a study of the life and health of three generations of LGB people (details seen at http://www.generations-study.com/). Sample (N=1488) were collected nationally using a probability sampling approach between 2016-2018. The majority of the sample were women (50%), White (62%), and from a younger generation (44% were aged 18-25). Approximately 36% of participants were gay, followed by bisexual (33%) and lesbian (20%). Logistic regression models with interaction terms were employed in Stata. Diagnostic and sensitivity analysis were applied.

Results indicated that minority stress, including victimization, everyday discrimination, felt stigma, and internalized homophobia, were associated with increased odds of suicidal ideation and suicide attempts after controlling for key demographics, poverty status, alcohol use, and drug use. Concealment of sexual orientation was a strategy that buffers the association between internalized homophobia and suicidal ideation, especially among people in the younger generation. However, contrary to the hypothesized stress-ameliorating role of community connectedness, we found that increased community connectedness was associated with higher odds of suicidal ideation and suicide attempts. Further, the positive association between felt stigma and suicide attempts was amplified when community connectedness was high.

Minority stress remains a risk factor for suicidal behavior among LGB populations. However, community connectedness was not strong enough to buffer the negative effect of minority stress, and concealment coping is also stressful. Programs and policies are needed to address the structural and cultural determinants of mental health, e.g., stigma and discrimination, instead of solely relying on the LGB individuals and communities to develop coping strategies. Future research should also examine the role of community connectedness, including what positive or potential negative effects community connectedness might have on the LGB population and how these factors can influence their suicidal behaviors.