Risk and protective factors for suicidality among Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) young people, within the context of the socio-ecological model: a scoping review

Introduction: LGBTQ+ young people experience higher prevalence rates of suicidality than their heterosexual and/or cisgender peers. However, there is limited research that can inform suicide prevention efforts. Our aim was to synthesise quantitative, qualitative, and mixed methods research on risk and protective factors among LGBTQ+ youth. Methods: A scoping review guided by Arksey and O’Malley’s five-stage framework, using the PRISMA-ScR protocol. Five databases and grey literature were searched for relevant studies. Identified factors were clustered by thematic type, according to the socio-ecological model to identify empirical trends and knowledge gaps. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment of studies. Results: Sixty-six studies met our inclusion criteria. Overall, 59 unique risk factors and 37 unique protective factors were identified. Key risk factors include childhood adversities, minority stress, interpersonal violence, bullying, a lack of adult support, barriers to inclusive healthcare as-well as societal marginalisation and discrimination. Key protective factors include adult and peer support, family acceptance, at-school safety and inclusive educational programmes, access to inclusive healthcare including gender affirming services, and LGBTQ+ inclusive policies and legislation. Conclusions: Our findings affirm that multiple risk and protective factors interact in complex, unique and diverse ways upon suicidality among LGBTQ+ young people. Findings underscore the importance of educational settings as an opportunity for the practice of inclusion, diversity, support, and preventative care which can reduce suicide risk among LGBTQ+ young people. Implications for practitioners working with LGBTQ+ youth, policymakers, and those interested in early intervention as-well as for suicide prevention strategies.