In 2017, suicide was the second leading cause of death for individuals 10 to 24 years old.1 After a stable period from 2000 to 2007, the suicide rate among 15- to 19-year-old youth increased 76% through 2017. Sexual minority youth (SMY) have been known to be at increased risk.2 In this issue of Pediatrics, 2 groups of authors address the important question of whether the social progress toward acceptance of SMY has ameliorated this disparity. Liu et al3 report on trends of suicidal ideation and behaviors across a 23-year period (1995–2017) using data from the Massachusetts Youth Risk Behavioral Surveillance. Rates of suicidal ideation and behaviors declined for both SMY and heterosexual youth, with a steeper decline for heterosexual youth; rates remained markedly high for SMY across the 23 years with upward of 40% reporting ideation, 41% a plan, and 33% an attempt. Raifman et al4 expanded their consideration of suicide attempts among adolescents to include Youth Risk Behavioral Surveillance data (2009–2017) across 10 US states. Although suicide attempts declined among SMY, these youth were >3 times more likely to attempt suicide relative to heterosexual students in 2017. Although decreases in suicidal ideation and behaviors in both studies is encouraging, limitations must be considered. First, Liu et al3 examined data from 1 state, and the analyses from Raifman et al4 were limited to 10 states in the Northeast and Midwest, which might not represent the experiences of SMY in other states, especially those who opt out of administering sexual orientation questions. Second, treatment of all SMY as 1 group and no analyses for transgender youth are limitations because we know rates of suicidal attempts vary within these groups.5,6 Third, a paradoxical finding of these studies is their reporting of declines in self-reported suicide attempts, although deaths by suicide increased.1 Whether these diverging results are explained by differences in data quality (eg, honesty in reporting, better cause of death characterization), increased lethality of means, or another explanation needs further investigation ...
Language: en
LA - en SN - 0031-4005 UR - http://dx.doi.org/10.1542/peds.2019-4002 ID - ref1 ER -