The roles of minority stress and thwarted belongingness in suicidal ideation among cisgender and transgender/nonbinary LGBTQ+ individuals

Abstract Rates of suicidal ideation (SI), attempts, and death by suicide are consistently elevated among persons from sexual and gender minority groups relative to the general population. Experiences of minority stress and thwarted belongingness may contribute to elevated risk, and be most pernicious among persons with multiple marginalized identities. Aim: The present study sought to examine the relation between gender identity (cisgender vs. transgender and nonbinary individuals [TNB]) and recent SI among a convenience sample of lesbian, gay, bisexual, questioning, and queer adults. Methods: Participants (N = 807) completed an online survey with measures of minority stress, SI, and thwarted belongingness. Results: We tested a mediation model in which TNB identity was indirectly associated with SI via minority stress (β = 1.94, SE = 0.30, Bootstrap 95% CI = [1.39, 2.58]). We also investigated thwarted belongingness as a moderator between minority stress and SI, and found evidence of a two-way interaction (β = 0.01, SE = 0.001, p < .001). The conditional indirect effect of gender identity on SI through minority stress was higher for individuals with higher levels of thwarted belongingness (β = 0.07, SE = 0.02, Bootstrap 95% CI = [0.04, 0.11]). Conclusion: Gender identity was indirectly associated with SI through minority stress and elevations in minority stress were associated with more frequent SI. The minority stress and SI association was strongest for participants reporting higher thwarted belongingness. Building and maintaining strong social support networks may be especially important for persons with intersecting gender and sexual minority identities who face minority stress.