The influence of minority stress on indicators of suicidality among lesbian, gay, bisexual and transgender adults in Thailand.

Abstract

INTRODUCTION: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists. To examine rates and predictors of suicidality among Thai LGBT adults (N=411). Data collection was conducted via online and in-person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health-related factors, general and minority-specific stressors and suicidality were completed. Thirty-nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12-month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR=1.12, 1.16, 2.75, and 1.46, p ≤ .05, R2 = 0.327). Past-year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR=1.52, 1.20, 2.34, and 4.89, p<.05, R2 =0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR=1.44, 1.06, 1.59, 1.45 and 0.95, p≤0.05, R2 =0.187). General and minority-specific stressors negatively impacted suicidality among LGBT participants. Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals.