Abstract

Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested whether body mass index (BMI) had a moderating effect on that association. Data were collected from 7th to 12th graders from seven randomly selected provinces of China in the 2015 School-Based Chinese Adolescents Health Survey. In total, 72,409 male students completed the questionnaires regarding sexual attraction, self-reported weight and height, and suicide attempts. After adjustment for covariates, sexual minority status was associated with suicide attempts among male students (AOR = 1.74, 95% CI = 1.57–1.93). Stratification analyses showed that BMI category moderated this association; compared with the results before stratification analyses, sexual minority males who were obese had increased risk of suicide attempts (AOR = 2.15, 95% CI = 1.09–4.24), sexual minority males who were overweight had reduced odds of suicide attempts (AOR = 1.40, 95% CI = 1.01–1.92), and no significant association change was found in sexual minority males who were underweight (AOR = 1.82, 95% CI = 1.43–2.33). Our study indicated that BMI moderated the risk of suicide attempts in sexual minority males. Suicide prevention targeting sexual minority males should be focused on weight status disparity and the creation of a positive climate to reduce minority stressors due to body image.

Highlights

  • Suicide is a leading cause of death among adolescents and youth adults, and suicide attempts are an important marker of suicidality [1,2]

  • The male students ranged in age from 12 to 20 years, and the proportion of male students who ranged in age from 12 to 13 and from 14 to 15 years was higher among sexual minority males than heterosexual males (p < 0.001)

  • The weighted prevalence of having past-year suicide attempts was significantly greater in sexual minority males than in heterosexual males (4.2% vs. 2.2%, p < 0.001)

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Summary

Introduction

Suicide is a leading cause of death among adolescents and youth adults, and suicide attempts are an important marker of suicidality [1,2]. A previous study showed that suicide attempts are currently a serious problem among adolescents in developing countries [3]. China is the largest developing country, with a high rate of suicidality, and the suicide patterns stratified by sex in China are different from those in Western countries [4,5]. In China, females had a consistently higher risk of suicide attempts than males [5]; this pattern reversed in 2008 [6]. Res. Public Health 2018, 15, 2558; doi:10.3390/ijerph15112558 www.mdpi.com/journal/ijerph

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