Suicidal Ideation, Risk Factors for Suicidal Ideation in Gay, Lesbian and Bisexual Youth

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The purpose of the present proposal is to draw out a comprehensive research plan that would be conducted to find out if there exists or not any relationship between sexual orientation of the individual and high rate of suicidal ideation among them. The main aim behind it the estimation of the risk factors for suicidal ideation among sexual perverts including gays, lesbians and bisexuals in the contemporary social set up. Since the topic contains vastness in its fold, it will be supported by two theories. Being the part of social research degree, the Durkheim’s Theory of Suicide (1897) and the Queer Theory of Sex will be applied during the present study. The researcher is interested in conducting his research on the foundation of the following hypothesis:

Different the sexual orientation of the individuals and communities, different the rate of risk factors regarding suicidal ideation among them

The main hypothesis has been supported by the following sub-hypotheses:

More the sexual perversion in a society, higher the chances of young people’s involvement in suicidal ideation

Different the sexual aptitude of the individuals of a society, different the ways of thinking and perception among the people

The researcher intends to apply interview schedule as the tool for data collection for the present study. Forty eight men and women belonging to different age-groups, sexual identity and areas will be selected on the basis of quota (non-probability) sampling for the interview.


The contemporary society has offered lots of freedom of thought and action to individuals, which could be observed in all fields of everyday life. The same is the case with sexual activities too. There was a time when extra marital relations were thought to be a taboo, and the persons involved in such activities were rebuked, penalized and punished. Similarly, there were severe punishments in case of getting indulged in homosexual activities. But the social values have witnessed a drastic change, and homosexual activities have been permitted in many cultures of the world. The new identity of societies has brought new social problems in its wake. The suicidal ideation is one of the most imperative factors in this regards.

Since almost all societies consist of heterosexuals in overwhelming majority, they associate every social evil with sexual orientation of the homosexual individuals. The same is the case with suicidal ideation. “Same-gender sexual orientation”, Silenzio et al submit, “has been repeatedly shown to exert an independent influence on suicidal ideation and suicide attempts, suggesting that risk factors and markers may differ in relative importance between lesbian, gay, and bisexual individuals and others.” (2007:3)

The researches reveal the very fact that the percentage of committing suicidal attempts is comparatively far higher among gays, lesbians and bisexuals than the individuals having straight or heterosexual tendencies.. The U.S. released a report on youth suicide that estimated that 30% of the annual completed suicides were that of the gay, lesbian and bisexual youth (Halpert, 2002).

Brief critique of existing knowledge; identification of gaps to be addressed by the study: Though few researches have also been conducted on the similar topic, and the findings have revealed the nature and causes of depression that force LGB youth towards suicidal ideation consequently, yet there is an urgent need of conducting an in-depth analytical research in order to restore the confidence and mental health of the homosexual youth.

Anticipated application of findings

Homosexuality, bisexuality and other forms of sexual identity has become very common especially in the contemporary society. There are many boys and girls in society who undergo such problems of gender identity and sex roles they are to play. Affiliation of suicidal ideation and consequent rise in suicidal rates particularly among LGB youth is really startling. Same-sex orientation is a very complex phenomenon, and exists in almost all societies of the world.

It may be a latent characteristic of many individuals, though a large majority tries to conceal it. The homosexuals are cursed and rebuked by society by realizing them religious beliefs, cult, social norms, values and laws; but there is no one to solve their problem and to take them out of their miserable state of having attraction towards the people of same sex. Thus, the feelings of hatred and antipathy towards them create inferiority complex as well as idea of committing suicide among them. It is therefore, the percentage of the homosexuals in suicidal ideation is comparatively higher than the people having straight sexual identity.

Review of Relevant Literature

Suicide Ideation in Gay, Lesbian and Bisexual Youth

The previous researches, had been conducted on the topic, similar to the one under study, reveal the very fact that gay, lesbian and bisexual youth has more than twice probability of committing suicidal attempt in comparison with the heterosexual adolescents. A report, Halpert (2002) views, released by the statistical department of the U.S.A. on youth suicide, estimated that 30% of the annual completed suicides were belonged of the gay, lesbian and bisexual youth.

In the same way, previous studies have discovered that the lesbian, gay and bisexual adolescents are reported to have higher rates of suicidal ideation and attempts than their heterosexual counterparts (Silenzo, 2000; Abelson, Lambevski, Crawford et al. 2008) Only few researches have been conducted on this topic, among which mere two researches indicate suicide among homosexuals, while the number of researches revealing completed suicidal attempt is five. (Lebon, 2002) Hence, there is an urgent need of conducting a comprehensive study in order to measure the indicators that push homosexuals towards suicidal ideation.

Since the subject maintains great significance for the social workers, due to the very fact that they have to deal with the gay adolescents as their clients, so study of various topics particularly related to homosexuality, including chemical dependency, drug addiction and suicidal ideation, contains imperative significance in this regards. Moreover, as the literature suggests that there is a higher rate of homosexual youth engaging in suicidal ideation and behaviors there is clearly a need to develop more intervention programs aimed at protecting this understudied population.

The literature available on the same topic views that the high rates of suicidal ideation among homosexual youth have not been adequately examined. Relative to their heterosexual peers, sexual minority adolescents (SMAs) are at increased risk for substance use, suicide, and HIV-infection. Emerging research suggests that experiences of parental acceptance and rejection are important predictors of these SMA risk behaviors. (Huebner & Arter, 2006)

The previous researches have been limited to mere one dimension i.e. gender while elaborating the causes of homosexuality. They neglect the very fact that modern civilization and technological advancement are also responsible for the sexual perversion among children. Doweiko (2006) declares both sexual perversion and drug addiction in this scenario. According to him, child abuse is one of the most significant causes of sexual perversion among adolescents. Further, decline in family relationship has also paved the way in this direction. As family is the basic unit of a society and plays primary role in nourishment and socialization of young generation.

The decline of family bondage as well as negligence from observing moral obligations results in the deterioration of the youth of society. Stigma lies at the root of many problems typically experienced by homosexual clients and their families. Sociological theory and research shed light on the dynamics of stigma and its consequences, both for the stigmatized population and for their heterosexual families and associates. (Kiefer, 1987: 178: quoted in Journal of Homosexuality)

Subsequently, homosexuals are more likely to be subjected to verbal and/or physical abuse and increased rejection and social isolation, which may increase the risk factor of suicidal ideation. While both heterosexual and homosexual youth share few same normative risk factors including depression, trouble at school, self esteem etc., there are other risk factors that have a higher impact on gay youth. Some of these include internalized homophobia, awareness of their sexuality, sexual identity, disclosing their sexual orientation, family conflict and the societal stigma attached to being homosexual.

A twofold increased risk of suicidal ideation was found associated with a homosexual or bisexual orientation. A significantly increased risk of attempted suicide associated with homosexuality or bisexuality was found in females. Independent of sexual orientation, depression was identified as a significant risk factor for suicidal ideation, while suicidal behavior was associated with low self-esteem, higher levels of hopelessness and suicidal behavior in someone close. (van Heeringen & Vincke, 2000: 495)

Family Connectedness and lack of family connectedness: The relationship between family acceptance and the lack of acceptance in the suicide ideation of adolescents is an important factor. Parental treatment of youth does have an impact on their mental health (D’Augelli, Grossman, Salter, et al., 2005). Acceptance is a multidimensional concept. It could mean having your family walk next to you in a gay pride parade. Parents who do not reject their children are crucial. It could mean parents allowing their lesbian, bisexual or gay children to continue to live in their home or throwing them out once they learn that their child’s sexual orientation.

Having positive role models that are part of their everyday lives could help lessen the risk of suicide ideation for adolescents. Family connectedness is a significant protective factor against suicide behaviors. Youth with high family connectedness scores had odds of suicidal ideation that were almost half the odds for youth with lower family connectedness scores (Eisenberg, Resnick, 2006).

Predicting the Suicide Attempts of Lesbian, Gay, and Bisexual Youth (D’Augelli, Grossman, Salter et al., 2005) identified parental mistreatment as a factor of suicide ideation in gay youth. In the sample used 61% reported that they had been called names such as “sissy” by their parents. One third reported that their parents discouraged their gender atypical behavior. It is important that future studies include family connectedness to show the importance of its relationship to suicide ideation.

Children and adolescents are the most innocent stratum of society. They try to imitate the footprints of their elders and mould the structure of their life as they observe the senior members of family. The effects of harshness of family members compels the adolescents seek love out of family. A large preponderance of the adolescents searches for the methods to give up the curse of sexual perversion that tells upon reputation, honor, prestige and respect of the family, and ultimately decides to commit suicide in a state of utter isolation.

Society and Homophobia

An overwhelming majority of religious circles and significant percentage of general heterosexuals looks down upon the homosexuals by declaring their orientation as perversion. Homosexuality is really a variation of the “it’s not natural” argument, and so there’s no need to reiterate what has been said in the above paragraphs, other than to say that it is the ‘natural’ argument with a religious overtone. And being essentially a religious argument, it has little place in a society that believes in the separation of the powers of church and state. (Bidstrub, 2000: quoted in )

Such type of hatred serious tells upon the nerves of homosexuals and increases the risk factors regarding suicidal ideation among them. While there have been great steps taken to be more understanding and accepting of homosexuality there is still a great stigma attached to it. Since the 1990’s the focus has been on the risks and protective factors in explaining why homosexual youths are at a higher risk for suicide ideation.

Much of the literature shows that one of the greatest risk factors that contribute to suicide ideation in lesbian, gay and bisexual adolescents is our society. Gay adolescents face “double jeopardy” having to deal with being an adolescent and having to deal with the additional burden of affirming their homosexual identity in a heterosexist society (Halpert, 2002). Homophobia is widespread in our society manifested by shame, self hatred and hostility.

Homophobia may increase suicide ideation in youth because of the lack of social support and feelings of alienation from social norms. Homophobic bullying leads to more gay, lesbian and bisexual pupils playing truant and leaving school earlier than their heterosexual counterparts. Only 6% of schools have specific policies to address the problem. (Society Guardian, 2006: quoted in

Homophobia contributes to social isolation, generalized fear and low self-esteem, which can also expedite suicidal ideation in gay youth. Discrimination due to the social stigmatization of homosexuality in our culture has important mental health consequences for gay youth. Adolescents are vulnerable no matter what their sexual orientation is as they try to understand who they are. However, gay adolescents appear to be more vulnerable to low-self esteem because of the negative imagery and stereotypes in our associated with being gay and queer. Gay, lesbian, and bisexual teens are more likely than their peers to report past victimization and problems with substance abuse and depression, all of which are risk factors for suicide in adolescents (Kulkin, Chauvin, Percle, 2000).

The ‘coming out” process especially at a younger age is also a vulnerable period. Faced with discrimination by the heterosexual population and the sense of difference may lead to a higher rate of depression ( Kaulkin, Chavin and Percle, 2000). Gay youth who disclose their sexual orientation at a young age are likely to experience the loss of friends and peers triggered by internalized prejudicial attitudes about homosexuality in our culture. Our heterosexual culture depicts homosexuality as deviancy, perversion and humiliating. A large number of heterosexuals view homosexuality as a sign of mental retardation; hence these assumptions can lead to feelings of isolation which can lead to suicide ideation and subsequent suicidal attempts out of utter frustration.

The sociological researches do not regard homosexuality mere one single cause of suicidal ideation. Rather, there are many other reasons behind the high rate of committing suicide. The studies suggest that just being gay is not the cause of the increase in the number of suicides among individuals. (Kitts, 2005) Suicide is the most extreme outcome of domestic violence and imbalance between professional work and domestic responsibilities.

In fact, domestic violence is the ‘leading contributor to death, disability and illness in Victorian women aged 15–44 years’ (Victorian Health Promotion Foundation, 2004). Domestic violence, which affects the lives of millions of women, children and men worldwide (Mishra, 2000) Moreover, joblessness, poverty and ethnic diversity also drives individuals towards committing suicide. The increased risk for suicide appears to affect children and adolescents as well as adults. Rates of suicide attempts have also been reported to be elevated among people with epilepsy. A suicide attempt is a significant risk factor for completed suicide. (Jones et al, 2003: 33) Hence, homosexuality and bisexuality should not be taken as the only causes of increase in suicidal attempts.

Suicide Among Gay and Lesbian Adolescents and Young Adults: A Review of the Literature (Kulkin, Chauvin, Percle, et al., 2000) discussed the difficulty in finding youth who identify themselves by their sexual orientation because of the stigma attached to that title. There was one study that refutes the previous sentence showing that feeling suicidal was significantly related to sexual identity (Abelson, Lambevski, Crawford, et al., 2006).

This paper reviewed the current literature that discussed specific risk factors which may be characteristic in gay adolescents who exhibit suicidal ideation. There are many limitations with most of the current research. Many other studies have not adequately discussed other variables including different racial constructs which is a must because social workers and other human service occupations do have clients other than white males and they need to know how to work effectively with these other populations. Other issues in the research included small sample sizes therefore conclusions about suicidality were based on a small population lacking reliability and validity (Russell, 2003).

Where larger sample sizes were used they were used in major cities which does not account for the gay adolescents who reside in the suburbs or other unmeasured areas. Where stratified cluster sampling was used the disadvantage is that there is a higher sampling error which is difficult to measure (Remafedi, French, Story, et al., 1998).

There were strengths in some of the sampling methods used in the research. Where adaptive sampling techniques were used the ability to incorporate population characteristics allowed more precise estimates of the population density (Paul, Catania, Pollack, et al., 2002). One factor that might be contributing to these inconsistent findings is the under-representation of gay youth in study populations due to the difficulty in finding youth who identify themselves by their sexual orientation because of the stigma attached to that status

The whole literature that has been gone through, suggests that there is a further need to address the lesbian, gay and bisexual adolescent population because they are still the most dominant population that exhibits increased risks for suicidal ideation than their heterosexual counterparts.

We do not provide the same treatment plans for everyone and it is apparent that we need different treatment programs and alternative ways of dealing with this at risk group. The implications for further research should show us the direction we need to go for suicide prevention and intervention programs for the care of our individual gay youth clients.

Theoretical Framework

The present study has been supported by suicide Theory articulated by Emile Durkheim. Durkheim discusses different kinds of suicides including egoistic, altruistic, anomic and fatalistic suicides. (Durkheim, 1897: quoted in Ritzer, 1998: 86) Among which, egoistic suicide comes under the fold of present study. Societies with a strong collective conscience and the protective, enveloping social currents that flow from it are likely to prevent the widespread occurrence of egoistic suicide. (Ritzer, 1998: 87) High rates of egoistic suicide is found in the societies that individuals are least integrated with the larger social unit.

The same is the case with the suicidal ideation among gays, lesbians, and bisexual youth, which finds no integrity with overwhelming heterosexual majority. The feelings of disliking, non-acceptance, antipathy, abhorrence and rejection push them into a state of sheer isolation and aloofness subsequently. The inferiority complex, idea of rejection and self-pity creates feelings of escape among them, so they first get indulged in chemical dependency and drug addiction, and take their life at their own hands at last.

The present research proposal has also been supported by the Queer Theory. The Queer Theory refers to the growing body of research findings that challenges the heterosexual bias in the USA. (Macionis, 2006: 214) The theory seeks its roots in the idea that the US societies are characterized as heterosexual, where homosexuals maintain no respectable place.

Proposed Presearch Design

Hypothesis: The hypothesis formulated for the present study is:

Different the sexual orientation of the individuals and communities, different the rate of risk factors regarding suicidal ideation among them

Operationalization of the Concepts

To completely comprehend the problem under study, it would be advisable to explain the concepts within the hypothesis.

  1. Sexual Perversion: Sexual perversion or deviant sexual behavior simply means the adaptation of sexual activities other than the traditional modes of fulfilling sexual desires prescribed by the religious beliefs, social norms, values and mores and the prevailing statutes of law. Hence, sexual relations with the person, other than husband or wife, are considered as perversion. Bisexuality, homosexuality, masochism, sadism, exhibitionism, voyeurism, nudism, onanism, masturbation, oral sex, anal sex, bestiality, buggery and others are considered as the divergent forms of deviant sexual behaviors.
  2. Bisexuality: Bisexuality refers to an individual’s sexual interest and aptitude towards the members of both the sexes. In other words, a bisexual looks for developing sexual relationship with both the members of the same as well as opposite sex.
  3. Homosexuality: The term homosexuality defines the sexual inclination of individuals towards the members of their own sex. They feel least appeal in the members of opposite sex and take gratification in the company of the people of their own sex.
  4. Society: Society can be defined as a large group of people having a distinguishing cultural and economic organization, and containing diversified ethnic, cultural, religious and socioeconomic groups.
  5. Victimization of Crime: Victimization is an act of assault, maltreatment, molestation, cheating or doing something criminal with a member of society to harm or hurt him physically, mentally or financially.


There were selected two variables in the present study. These include:

  • Independent variable: The research was conducted on the risk factors of suicidal ideation among homosexuals, so, the independent variable is the gay, lesbian and bisexual population. Here the individuals belonging to both heterosexual and homosexual orientation have been taken as independent variable.
  • Dependent variable: The present study was articulated to define the problems faced by the homosexuals, leading towards suicidal ideation; thus, causes of suicidal ideation have been taken as dependent variable.
    • Universe: As the researcher is the student of the New York University, he aims to select both male and female population from the white and black communities of New York. The researcher is interested in conducting the interviews of thirty six individuals belonging to various age groups to find out the results and concluding the problem.
    • Sampling: The researcher intends to apply quota/non-probability sampling to represent different genders, age-groups, ethnic groups and socioeconomic classes of the society. The research will be comprised of both males and females from upper, middle and lower classes, containing divergent sexual orientations. Nine males and nine females will be selected as the respondents from straight sexual orientation, and the same number of the respondents having homosexual tendencies. The study will be focused on two types of respondents. The first category belongs to the individuals, who are the victims of the positive HIV. On the other hand, the second category will be comprised of the respondents, who have fear of positive results of their HIV test. The age group will be divided in three categories i.e. the individuals from 14 to 23, 24 to 33 and 34 to 43 years of age will be the units of analysis in the data under study.
    • Tool for Data Collection: Interview-schedule will be applied as a research tool in order to gather the data from the respondents. Interview schedule will be consisted of twenty nine questions and will be divided into three parts. First part will be about the general enquiry including the questions related to age, socioeconomic group, profession and other basic information. Second portion of the study will be formulated to professional life and surroundings of the victims as well as the atmosphere in which they are leading their lives and the difficulties faced by them. The final section will represent the sexual orientation and nature of their sociological, economic, medical and personal worries prevailing in their surroundings and the situation under which they got victimized.
    • Pre-testing: The researcher will conduct pre-testing to draw out errors and flaws in the interview schedule. At first, ten individuals will be interviewed and changes will be made in the questions after the pre-testing.
    • Data from Home Office: The researcher intends to contact the Admin of the Home Office Department through its online service to get the data related to the men and women who have committed or attempted to commit suicide throughout their life. In addition, the researcher will visit hospitals, therapeutic institutions, apartments and flats in order to get them interviewed for the collection of data for the present data. The participant will be assured that their identity, statistics or any material or information related to them or their personal and professional life will not be disclosed at alls, which has been enquired from them during gathering of data from them.

Ethical Issues

Moral values and ethical principles contain significant place in a social set up. It is therefore, the questions and research work on the topic of sexual orientation and identity are taken as a sensitive and serious matter as well. People not only conceal their sexual identity, but also curiosities of others, especially of a researcher, consider a direct interference in their personal matters and private issues. It is fact beyond doubt that questions and researches related to religious affiliations, ethnical diversity, racial discrimination, medical deficiencies, sexual orientation and communal issues are always sensitive matters all over the globe.

So, the research may undergo some problems in the beginning. But as soon as people are informed that the present research would serve as a comprehensive analysis of the very serious problem of suicide as well as HIV and other health issues, they will not only take an active part sin the whole process, but will also render unconditional support to the researcher throughout the study.


The primary goal of the present research will be to determine what percentage of the homosexuals, lives in the area under study. Keeping in view that all from demographic surveys and previous researches made on the same topic, the researcher will hire the services of quantitative research team in order to get the exact data of the homosexuals and bisexuals as well. On the basis of the data gathered, the research will be conducted on the suicidal ideation among them and the sociological, psychological, economic, domestic, societal and emotional causes leading them towards the idea of suicide.

Educated and professional strata will be convinced regarding the benefits and advantages of the research under study, which will probably be helpful in data collection. On the contrary, religious, ethnic and racial groups would serve as obstacles on the way. Similarly, as the research is based on sexual orientation and its consequences, it may be rejected by the homosexuals and bisexuals in order to conceal their identity. Moreover, it would also be difficult to convince them share their sexual orientation, which is taken as a very private issue. In addition, since females are particularly reserved in respect of disclosing their sexual preferences, researcher will have to hire the services of female data collectors too to get the exact number of lesbians in the area under study.


Prepared in subjective and numerical format, along with the tabular and graphical presentation, the research will evaluate all aspects of the risk factors regarding suicidal ideation among homosexuals. The research will be highly supportive in respect of understanding the problems faced by the homosexuals who make a significant part of the total population of not only the USA, but also of almost all the societies of the globe at large. In addition, the present research proposal will be highly beneficial for research organizations, health departments, therapeutic centers and future researchers. In addition, the research may not only decrease the level of hatred among heterosexuals for homosexuals, but also help out the gays, lesbians and bisexuals to lead a life of joy and hope.


The thorough study of the previous researches as well as demographical records reveal the very fact that suicidal ideation rate is higher among homosexuals in comparison with the heterosexual adolescents. A similar study was undertaken to explore patterns of sexual orientation in a representative sample of Minnesota junior and senior high school students. The sample included 34,706 students (grades 7 through 12) from diverse ethnic, geographic, and socioeconomic strata. (Remafedi G, Resnick M, Blum R, Harris L. Demography of sexual orientation in adolescents. Pediatrics, 1992 Apr;89 (4 Pt 2):714-21.)

It clearly indicates towards the need of comprehensive research to explore the causes of this high rate among LGB youth, and preventive measures in this regards. The present research proposal has been prepared keeping in mind all the aspects creating frustrations among gays and forcing them towards the extreme thought of committing suicide in order to get rid of the worries they undergo in life.


  1. Abelson, J., Lambevski, S., Crawford, J., Bartos, M., & Kippax, S. (2006). Factors associated with ‘feeling suicidal’: The role of sexual identity. Journal of Homosexuality, 51(1), 59.
  2. D’Augelli, A. R., Grossman, A. H., Salter, N. P., & Vasey, J. J. (2005). Predicting the suicide attempts of lesbian, gay, and bisexual youth. Suicide & Life – Threatening Behavior, 35(6), 646.
  3. Halpert, S. C. (2002). Suicidal behavior among gay male youth. Journal of Gay & Lesbian Psychotherapy, 6(3), 53.
  4. Kitts, R. L. (2005). Gay adolescents and suicide: Understanding the association. Adolescence, 40(159), 621.
  5. Kulkin, H. S., Chauvin, E. A., & Percle, G. A. (2000). Suicide among gay and lesbian adolescents and young adults: A review of the literature. Journal of Homosexuality, 40(1), 1.
  6. Jana E. Jones, Bruce P. Hermann, John J. Barry, Frank G. Gilliam, Andres M. Kanner and Kimford J. Meador. (2003) Rates and risk factors for suicide, suicidal ideation, and suicide attempts in chronic epilepsy. Epilepsy & Behavior Volume 4, Supplement 3, Pages 31-38.
  7. Lebson, M. (2002). Suicide among homosexual youth. Journal of Homosexuality, 42(4), 107.
  8. Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: Results of a population-based study. American Journal of Public Health, 88(1), 57.
  9. Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91(8), 1276.
  10. Silenzio, V. M. B., Pena, J. B., Duberstein, P. R., Cerel, J., & Knox, K. L. (2007). Sexual orientation and risk factors for suicidal ideation and suicide attempts among adolescents and young adults. American Journal of Public Health, 97(11).
  11. Van Heeringen, C., Vincke, J., & Van Heeringen, C. (2000). Suicidal Acts and Ideation in Homosexual and Bisexual Young People: A study of prevalence and risk factors. Social Psychiatry and Psychiatric Epidemiology, 35(11), 494.

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Premium Papers. 2023. "Suicidal Ideation, Risk Factors for Suicidal Ideation in Gay, Lesbian and Bisexual Youth." January 15, 2023.

1. Premium Papers. "Suicidal Ideation, Risk Factors for Suicidal Ideation in Gay, Lesbian and Bisexual Youth." January 15, 2023.


Premium Papers. "Suicidal Ideation, Risk Factors for Suicidal Ideation in Gay, Lesbian and Bisexual Youth." January 15, 2023.