Gender Paradox and Adolescent Suicidality during the COVID-19 Pandemic: A Socio-Ecological Investigation

The present study examines multilevel factors associated with suicidality among adolescents in South Korea, a country with one of the highest suicide rates among OECD (Organisation for Economic Co-operation and Development) member countries. To that end, we adopt a socio-ecological perspective that considers key explanatory mechanisms across micro (psychological distress), meso (school context), and macro (youth suicide rate) units of analysis. Throughout, we focus on gender as a critical social structure driving the unequal outcomes of suicidality. Our empirical investigation is guided by the following questions. First, how does gender moderate the relationship between psychopathology, namely generalized anxiety disorder (GAD), and suicidality? Second, does attending same-sex school provide a buffer against suicide risks for girls? And third, does regional suicide rate shape the magnitude of the link between GAD and suicidality differently for boys and girls? By drawing on multiple rounds of data from Korean Youth Risk Behavior Survey (2020–2023) fielded during the COVID-19 pandemic, we empirically probe these questions. Using alternative estimation strategies, we find that the associational strengths between GAD and three dimensions of suicide (ideation, plan, attempt) are more pronounced among girls. Results further indicate that for girls attending same-sex school provides protection against suicide plan and suicide attempt. Lastly, our models demonstrate a significant three-way interaction: the age-specific regional suicide rate amplifies the magnitude of the link between GAD and suicidality only for the female gender.