Suicidal ideation among youth: Examining the intersections of multiple social positions and bias-based bullying

OBJECTIVE: Suicidal ideation is prevalent among minoritized youth. This study identified disparities in suicidal ideation across youth with intersecting social positions-including race and ethnicity, sex assigned at birth, gender, and sexual orientation-and examined the role of bias-based bullying (based on race and ethnicity, gender identity, or sexual orientation) related to these disparities. METHOD: Data for this study were drawn from the 2017-2019 California Healthy Kids Survey, with a sample of 458,963 students in grades 9 through 12. Around half of the participants identified as Latina/x/o (50.4 %), 49 % were assigned female at birth, 93.7 % identified as cisgender, and 81.9 % identified as straight. Exhaustive Chi-squared Automatic Interaction Detection was used to analyze how rates of suicidal ideation vary among youth with intersecting social positions and multiple forms of bias-based bullying experiences. RESULTS: Youth with intersecting minoritized social positions, particularly those with both minoritized sexual and gender identities, reported the highest rates of suicidal ideation in the past year (43.9 % to 63.3 %), three to four times higher than the overall sample rate (16.5 %). Furthermore, all youth in the highest prevalence groups of suicidal ideation experienced at least one form of bias-based bullying. Suicidal ideation rates were 26.3 % to 59.0 % higher among youth who experienced bias-based bullying compared to those with the same social positions who did not experience bullying. CONCLUSION: Suicidal ideation is especially prevalent among youth with intersecting minoritized social positions who have also experienced multiple forms of bias-based bullying.