Outness and suicide ideation: Examining the roles of thwarted interpersonal needs and minority stress in LGBTQ+ Individuals



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Previous research has found that lesbian, gay, bisexual, transgender, questioning, queer, and other sexual and gender minority (LGBTQ+) individuals report greater suicide ideation (SI) than non-LGBTQ+ individuals. The interpersonal theory of suicide (IPTS), the Minority Stress Model (MSTM), and the Gender Minority Stress and Resilience Model (GMSR) are several frameworks used to conceptualize suicide risk among LGBTQ+ individuals. Applying both the MSTM and GMSR to the IPTS would suggest distal and proximal minority stressors among LGBTQ+ individuals may contribute to thwarted interpersonal needs and therefore SI. Previous research found LGBTQ+ individuals who are more out report higher rates of self-esteem and a greater sense of belonging, and lower rates of depression, anxiety, psychological distress, and suicide risk than LGBTQ+ individuals who are less out. LGBTQ+ people who are not yet out to others may feel pressure to hide their feelings and may feel isolated, depressed, self-hatred, and experience SI. Minority stressors such as victimization, discrimination, and internalized homophobia/transphobia may prevent LGBTQ+ individuals from disclosing their sexual or gender identity. The relation between the outness of an LGBTQ+ individual and SI may be influenced by thwarted interpersonal needs and minority stress. Participants in the current study were 826 LGBTQ+ individuals who completed assessments of SI, thwarted interpersonal needs, minority stress, and LGBTQ+ outness. It was hypothesized that there would be significant differences in SI between those reporting different levels of outness and different levels of minority stress, and there would be a significant interaction between outness and minority stress in predicting SI. It was also hypothesized that the relation between LGBTQ+ outness and SI would be mediated by decreased thwarted belonging/perceived burden, and the direct association between outness and thwarted belonging/perceived burden would be moderated by minority stressors. An analysis of variance and moderated mediation nonparametric bootstrapped procedures were used to test the hypotheses. Mediation results from the current study were consistent with previous research; the relation between outness and SI was mediated through thwarted interpersonal needs. However, contrary to our hypotheses, it was found that minority stress did not moderate the relation between outness and thwarted interpersonal needs. Therapists of LGBTQ+ clients may benefit from addressing interpersonal concerns with their clients, especially when the client is first coming out, so that the client can increase feelings of belonging, which may be protective against SI.



LGBTQ, Suicide, Minority Stress, Interpersonal Theory, Thwarted belonging, Perceived Burden, Outness