The social determinants of lesbian, gay, bisexual and transgender youth suicidality in England: a mixed methods study

Elizabeth McDermott, Elizabeth Hughes, Victoria Rawlings

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55 Citations (Scopus)
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Background: Lesbian, gay, bisexual and transgender (LGBT) youth have a higher risk of suicidality and self-harm than heterosexual youth populations but little is known about the underlying mechanisms. We aimed to investigate the social determinants of this mental health inequality. Methods: A two-stage sequential mixed method study was conducted. Firstly, 29 semi-structured interviews with LGBT youth (aged 13-25 years old) were completed. Data was analysed thematically. Stage 2 involved a self-completed questionnaire employing an online community-based sampling strategy (n = 789). Logistic regression analysis was performed to predict suicidality. Results: Five social determinants explained suicidal risk: (i) homophobia, biphobia or transphobia; (ii) sexual and gender norms; (iii) managing sexual and gender identities across multiple life domains; (iv) being unable to talk; (v) other life crises. Youth who were transgender (OR = 1.50, P < 0.022), disabled (OR = 2.23, P < 0.000), had self-harmed (OR = 7.45, P < 0.000), were affected by abuse (OR = 2.14, P < 0.000), and affected by not talking about their emotions (OR = 2.43, P < 0.044) were most likely to have planned or attempted suicide. Conclusions: Public health universal interventions that tackle bullying and discrimination in schools, and selected interventions that provide specific LGBT youth mental health support could reduce LGBT mental health inequalities in youth suicidality.

Original languageEnglish
Pages (from-to)e244-e251
JournalJournal of public health (Oxford, England)
Issue number3
Early online date17 Oct 2017
Publication statusPublished - Sept 2018


  • mental health
  • social determinants
  • young people
  • sexual orientation
  • gender identity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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