Suicidality in Thai Lesbian, Gay, Bisexual, and Transgender Adults

Abstract

Suicidality, including depression, suicidal ideation, and suicide attempts are a global challenge that have become a leading cause of disability. Depression is a common illness and a significant determinant inducing suicide. Suicide is one of the leading causes of death worldwide impacting loved ones while causing additional costs to societies. In Thailand, prevalent rates for suicidality have increased and are emerging as one of the leading causes of death in the country. Sexual orientation and gender identity (LGBT) represent additional demographic factors associated with risks for suicidality. Suicide rates are more likely to be higher among LGBT individuals than the general population. Observed disparities in mental health issues are consistently related to social discrimination as a result of minority stress factors associated with membership in a stigmatized minority group. In Thailand, anti-LGBT attitudes are prevalent prompting social discrimination towards LGBT individuals. However, limited research has been conducted, and no studies have systematically examined the influences of minority stress on mental health outcomes. The purposes of this study were to investigate the associations of influencing factors and to explore the predictors of suicidality in Thai LGBT adults. This dissertation conveys the study’s findings in two manuscripts. The first describes the influences of minority stress on the depression outcomes among Thai LGBT adults. The second manuscript focuses on the effects of minority stress on indicators of suicidality (e.g., depression, lifetime suicidal ideation, 12-month suicidal ideation, and suicide attempts) among Thai LGBT adults. Two stressor components were included in this study, comprising general stress (e.g., levels of stress and loneliness) and minority stress (e.g., discrimination based on LGBT identity, discrimination based on social situations, experience of victimization, LGBT identity disclosure, and internalized homophobia). Research findings reported that rates of suicidality in Thai LGBT adults were as high as compared to previous Thai studies. General and minority stressors were strongly associated with depression and indicators of suicidality. For the depression outcome, the combined influences of sociodemographic factors, general stress, coping strategies, and minority stress were uncovered. Multivariate analyses exhibited depression levels that were strongly associated with minority stressors (discrimination based on social situations, the experience of victimization, and LGBT identity disclosure), followed by levels of stress and a diagnosis of chronic disease. For indicators of suicidality, the mixed association between sociodemographic factors, general stress, and minority stress were also observed. In multivariate analyses, minority and general stressors influenced all indicators of suicidality. However, patterns of association varied based on each outcome. The study results were consistent with the Minority Stress Model. Additionally, longitudinal studies and sophisticated annalistic plans are necessary to examine the effects of coping styles and social support on indicators of suicidality.