Investigating Risk and Protective Factors for Suicidal Ideation and Attempts in Bi+ Youth: A Multi-Method Study

Bi+ youth face unique forms of minority stress, yet little is known about how these relate to their high rates of suicidality. This multi-method study takes an exploratory approach to examine risk and protective factors linked to suicidal ideation and attempts among bi+ youth. Quantitative survey data came from Dutch bi+ youth aged 16–22 (M age = 18.71, SD = 1.83). We conducted logistic regression on lifetime suicidal ideation (N = 1,275) and attempts (N = 1,274), including risk and protective factors, as well as interaction effects between sexual orientation, gender identity, and risk/protective factors. To contextualize the quantitative findings, 15 interviews with bi+ youth with a history of suicidality were conducted and thematically analyzed. Quantitatively, stigmatization and binegativity-related prejudice were significantly associated with a higher likelihood of lifetime suicidal ideation and suicide attempts. Social support, support-seeking coping, and resilience were linked with lower suicidal ideation. The association between erasure and suicidality varied by sexual identity. Qualitatively, stigmatization and binegativity-related prejudice involved peers perceiving bi+ youth as ‘strange,’ sexualizing their identities, and assuming incapability of having stable relationships. Findings highlight the need for inclusive mental health interventions that address experiences of bi+ youth and improve protective factors, including social support, coping strategies, and resilience.