The Epidemiology of Suicidality Among Black LGB+ Adolescents: 2023, USA

Suicide remains a leading cause of death among U.S. adolescents, with significant disparities by race/ethnicity and sexual orientation. Black adolescents and those identifying as lesbian, gay, bisexual, or with alternative sexual identity labels (LGB+) are at elevated risk for suicidal ideation and behaviors, yet limited research has examined the intersection of these identities. This study assessed the prevalence of suicidal thoughts and planning among Black adolescents in the United States and explored disparities by sexual identity using nationally representative data. We conducted a secondary analysis of 1,381 Black adolescents from the 2023 National Survey on Drug Use and Health (NSDUH). Suicide ideation and planning were based on self-reported thoughts or plans in the past 12 months. Covariates included demographics, sexual orientation, mental health, and substance use. Weighted frequencies, Rao–Scott chi-square tests, and multivariate logistic regression analyses were used to examine associations. Among Black adolescents, 10.36% reported past-year suicidal ideation and 5.51% reported suicide planning. Compared with heterosexual peers, adolescents identifying as gay/lesbian, bisexual, or using alternative sexual identity labels had significantly higher adjusted odds of suicidal ideation (AOR = 3.32–12.74) and planning (AOR = 4.81–15.28). Youth with alternative sexual identity labels exhibited the highest risk for both outcomes. Findings highlight disproportionately high rates of suicidal thoughts and planning among Black LGB+ youth and underscore the need for culturally responsive, identity-affirming prevention strategies, improved mental health access, and tailored interventions. Future research should identify protective factors that buffer suicide risk among Black LGB+ adolescents.