The “noise” of suicide attempts – relating LGBTQ+-specific vs. non-specific factors

Abstract Background Despite the numerous research on the determinants and risk factors of suicide attempts, an understanding of suicide attempts as a process that holistically captures the perspectives of the actors involved is still lacking. Our study, therefore, aimed to better understand, from different perspectives, how (process) and why (subjective meaning, patterns of interpretation) (a) suicide attempt(s) among LGBTQ+ youth happen and to relate LGBTQ+-specific vs. non-specific factors. Methods From 2021 to 2024, we interviewed LGBTQ+ youth in Switzerland who had attempted suicide between the ages of 14 and 25. As part of a multi-perspective approach, we also interviewed people from their social environment where possible. Data were collected and analysed using Grounded Theory Methodology, including theoretical sampling. The final sample consisted of 41 people: 7 bisexual/lesbian cis women, 4 bisexual/gay cis men, 15 trans/non-binary people of different sexual orientations, 3 heterosexual cis people, and 12 people from their social environment. Results Sexual orientation and gender identity (SOGI) emerged as either background or foreground “music” of the suicidal processes. In some LGBTQ+ youth, SOGI were key factors influencing their suicidality, e.g. experiencing a major lack of acceptance and barriers to accessing gender-affirming transition (foreground music type). In others, suicidality was mainly related to other aspects than SOGI, especially fundamental ones such as unsafe familial circumstances or sexualised violence, which were accentuated by SOGI-related factors e.g. feeling a lack of belonging (background music type). Further, a mixed type was identified, with SOGI and non-SOGI-related factors being equally important for suicide attempt(s). Conclusions Our study implies the need to adapt health promotion, suicide prevention, and early detection and intervention strategies according to the identified types of suicidal processes.