Lay Summary

We examined the combined effects of bullying and social support on the relation between same-sex attraction, self-harm, and suicide attempt using a using a large sample of 6850 adolescents across the UK. We found greater risk for self-harm and suicide attempt in adolescents with same-sex attraction, with this risk increasing when bullying was experienced; Conversely, social support was only associated with lower risk for suicide attempts, whilst social support was not associated with lower risks for self-harm or suicide when same-sex attracted individuals experienced bullying. This is important as it shows that additional measures to social support are needed to protect adolescents with same-sex attraction, especially those bullied.

Background

Sexual minority youth are at higher risk of attempting suicide and self-harming than heterosexual adolescents. Past research has shown that this risk is increased through bullying and reduced through social support. The joint effect of these factors has not yet been determined, however.

Methods

We used the Millennium Cohort Study (MCS) – a nationally representative longitudinal exploration of 6850 UK children born in the 2000s – to investigate how same-sex attraction at age 14 is associated with suicide attempts and self-harm at age 17. Additionally, we examined the effects of bullying, social support, and social support following bullying in adolescents using mediation and moderation analyses.

Results

Sexual minority youth status at age 14 is associated with a 2.44 times likelihood of attempting suicide and a 2.59 times likelihood of self-harming at age 17. There was no evidence for an association between greater social support and lower levels of self-harm. However, greater social support in sexual minority youth is associated with reduced risk of suicide attempt. Bullying in sexual minority youth was associated with a 1.58 times risk of attempting suicide in sexual minority youth compared to non-bullied sexual minority youth. Bullied sexual minority youth were also 1.12 times more likely to self-harm than non-bullied sexual minority youth. However, greater social support in bullied sexual minority youth was not associated with reduced risk of self-harm or suicide attempt compared to bullied sexual minority youth receiving lower levels of social support.

Conclusion

It seems that social support is associated with reduced suicide attempts in sexual minority youth, albeit the effects might not sufficiently protect against bullying with regards to suicide attempt and self-harm or sexual minority status with regards to self-harming. Thus, health and educational practitioners should address this heightened risk for poor mental health outcomes, particularly by preventing bullying as a risk factor. Additionally, further interventions are needed to assist sexual minority youth aside from social support provision through friends and family.