Violence and Suicide Risk Among LGB High School Students, 2015–2019: Little Change

Lesbian, gay and bisexual (LGB) young people face more violence and more suicide risk than heterosexual youth. The 2017 national Youth Risk Behavior Survey (YRBS) found, for example, that LGB high school students were more often bullied at school (33% vs 17%), faced more sexual dating violence (16% vs 6%) and more often attempted suicide (23% vs 5%).

In 2015 the YRBS added questions on sexual identity, and 2019 gave the first chance to look at national trends for LGB students. CDC analyzed the 2015, 2017 and 2019 surveys — 44,066 students in grades 9–12, nationally representative — comparing LGB and heterosexual students and, among LGB students, boys and girls and Black, white and Hispanic students.

What was measured

Findings

LGB students had higher odds than heterosexual students on every one of the 12 measures. And little changed from 2015 to 2019.

Violence

• The one overall improvement: physical dating violence among LGB students fell from 17.5% to 13.1%.
• LGB boys were more likely than LGB girls to miss school feeling unsafe and to be threatened or injured with a weapon; LGB girls were more likely to be bullied electronically, to face sexual dating violence and to have been forced to have sex.
• Worrying for LGB boys: being threatened or injured with a weapon at school rose from 11.6% to 15.9%, and forced sex from 8.0% to 15.6%. Among LGB girls, physical dating violence fell from 16.9% to 12.1%.
• Black and Hispanic LGB students were more likely than white LGB students to miss school feeling unsafe, and Black students more likely to be threatened with a weapon; white LGB students were more likely to be bullied, at school and online. Among Hispanic LGB students, physical dating violence fell from 22.6% to 9.8%.

Suicide risk

• Among LGB students overall, none of the five measures changed significantly.
• LGB boys had lower odds than LGB girls on all five. Suicide attempts among LGB girls fell from 32.8% to 23.6% — yet girls still reported more risk than boys.
• Black and Hispanic LGB students were less likely than white LGB students to feel persistently sad or hopeless or to seriously consider suicide, and Black students less likely to make a plan — but there were no differences by race or ethnicity in attempts, or in attempts needing treatment.

What it means

The gaps fit minority stress: stigma against LGB people acts through external stressors — violence, discrimination, harassment — and internal ones — hiding one's identity, expecting rejection — and both harm mental and physical health. Violence against LGB youth is well documented, as is its link to higher suicide risk.

The fall in physical dating violence follows a wider decline among teenagers — but not, it seems, among LGB boys, for whom weapon threats and forced sex rose, possibly widening a gap with sexual minority women; schools and prevention programs need to address their needs. Among adults, men die by suicide more than women, but reliable data on sexual orientation and suicide deaths do not exist.

What schools and communities can do

• Anti-harassment policies
• Gay-straight alliances or other student-led support clubs
• Programs that improve staff support for LGB students
• Partnerships with community organizations for comprehensive violence and suicide prevention, using CDC's technical packages — attending to physical violence against LGB boys, suicide risk among LGB girls, and differences by race and ethnicity

Monitoring should continue until the gaps close.

Limits

• Three survey cycles is a short period for trends.
• Few students identified as LGB — 8.3% in 2015, 10.9% in 2017, 11.7% in 2019 — limiting power to detect trends in subgroups.
• Students unsure of their identity, and differences by sexual behavior, were not analyzed.
• Pooling years may hide year-to-year changes in the gaps.
• In 2019, some schools used questionnaires without the forced sex, sexual dating violence and attempt-with-injury questions, leaving much missing data.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the United States.

Sources

Based on Johns MM, Lowry R, Haderxhanaj LT, et al., "Trends in Violence Victimization and Suicide Risk by Sexual Identity Among High School Students — Youth Risk Behavior Survey, United States, 2015–2019," MMWR Supplements, volume 69, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report's discussion goes further than its results on two points (weapon threats among Hispanic students, and girls' bullying at school); the results are followed here. Its opening graphic, which includes a stock photograph, is not reproduced.