Intersecting Structural Oppression and Suicidality Among Black Sexual Minority Male Adolescents and Emerging Adults

Abstract

This study examined associations between structural racism, anti-LGBTQ policies, and suicide risk among young sexual minority men (SMM). Participants were a 2017-2018 Internet-based U.S. national sample of 497 Black and 1536 White SMM (ages 16-25). Structural equation modeling tested associations from indicators of structural racism, anti-LGBTQ policies, and their interaction to suicide risk factors. For Black participants, structural racism and anti-LGBTQ policies were significantly positively associated with depressive symptoms, heavy drinking, perceived burdensomeness, thwarted belongingness, self-harm, and suicide attempt. There were significant interaction effects: Positive associations between structural racism and several outcomes were stronger for Black participants in high anti-LGBTQ policy states. Structural racism, anti-LGBTQ policies, and their interaction were not significantly associated with suicide risk for White SMM.

Keywords: Black sexual minority youth; anti-LGBTQ policies; health inequities; intersectional stigma; minority stress; structural racism; suicidality; suicide risk.

Figure 1. National Distribution of Participants in the Analytic Sample

Note. Numbers within states correspond to the State Racism Index Score. Participants in Puerto Rico and Washington DC not included in the analytic sample.

Figure 2. Structural Equation Models with Structural Racism and Anti-LGBTQ Policies Predicting Suicide Risk for Young Black and White SMM

Note: *** p≤ .001, ** p ≤ .01, * p ≤ .05, ^† p ≤ .10 Standardized estimates (STDYX for Structural Racism and interaction term, STDY for Anti-LGBT Policies). This model is adjusted rural-urban classification, subjective SES, income, formal employment status, housing instability, age, sexual identity, relationship status, living situation (living alone/with others), whether participants have living parents/stepparents and are contact with them, insurance coverage, and military experience.

Figure 3. Interactions between Structural Racism and Anti-LGBTQ Policies on Suicide Risk Factors among Young Black SMM

Note: Perceived burdensomeness is recoded to range from 0–36 for this figure Note: Thwarted belonginess is recoded to range from 0–53 for this figure

Figure 3. Interactions between Structural Racism and Anti-LGBTQ Policies on Suicide Risk Factors among Young Black SMM

Note: Perceived burdensomeness is recoded to range from 0–36 for this figure Note: Thwarted belonginess is recoded to range from 0–53 for this figure

Figure 4. Interaction between Structural Racism, Anti-LGBTQ Policies, and Age on Heavy Drinking on Among Young Black SMM

Note: Low Age = 1 SD below centered mean, High Age = 1 SD above centered mean