Rethinking Suicide Stigma In LGBTQ Communities: Identity Differences and Suicide Exposure

Background and Purpose: Suicide stigma is a critical barrier to help-seeking, yet limited research has examined whether stigma varies by gender identity and sexual orientation, particularly within LGBTQ communities. LGBTQ populations experience disproportionately elevated rates of suicidal ideation, behavior, and deaths relative to heterosexual and cisgender populations, driven in part by minority stress, discrimination, and structural stigma. Understanding how suicide stigma operates within LGBTQ communities is therefore essential for informing equitable and effective prevention efforts. This study examines: (1) whether vignette gender identity influences suicide-related stigma, (2) whether vignette sexual orientation influences stigma, (3) whether an interaction exists between these characteristics, and (4) whether prior exposure to suicide contributes to variation in stigma.

Methods: Data were drawn from a cross-sectional online survey of LGBTQ adults in Texas (n=596). Participants completed the Stigma of Suicide Scale–Short Form (SOSS-SF) in response to randomized vignettes varying by gender identity and sexual orientation. Confirmatory factor analysis supported a three-factor structure (stigma, isolation/depression, glorification/normalization) with excellent model fit and strong internal reliability. Multivariable regression models examined the effects of vignette characteristics while controlling for respondent sociodemographic factors. Additional models assessed the contribution of prior suicide exposure (direct, indirect) and tested interaction effects with relationship closeness.

Results: Vignette characteristics demonstrated inconsistent associations with suicide stigma. Gender identity of the vignette person was not significantly associated with stigma outcomes. Sexual orientation showed a limited effect, with bisexual vignette persons rated higher on glorification/normalization compared to heterosexual persons (b=0.31, p<.05). In contrast, respondent characteristics showed more consistent associations with stigma. Older age was associated with lower stigma (b=-0.03, p<.001). Transgender respondents reported lower stigma (b=-0.24, p<.05) but higher perceived isolation/depression (b=0.25, p<.01), and BIPOC respondents reported higher glorification/normalization (b=0.28, p<.01).

Prior exposure to suicide emerged as the most consistent correlate of stigma. Direct exposure was associated with higher stigma and lower isolation/depression. Indirect exposure was associated with higher isolation/depression and lower glorification/normalization. Moderation analyses indicated significant interaction between direct exposure and closeness of relationship was observed for glorification/normalization (b=0.15, p<.001). Higher glorification/normalization was observed among individuals with close direct exposure.

Conclusions and Implications: Findings highlight the importance of understanding suicide stigma within LGBTQ communities. Patterns related to suicide exposure, and particularly direct and relationally close exposure, emerged as more meaningful contributors to stigma variation. The glorification/normalization of suicide for respondents with direct exposure within the context of a close relationship is an important finding. This pattern may reflect normalization of suicide or, alternatively, the idealization of individuals following suicide-related loss, and suggests that suicide stigma may be shaped less by identity-based differences and more by lived experience and relational context. Implications for practice include prioritizing assessment of suicide exposure and relational proximity in stigma-related interventions. At the policy and research level, these results underscore the importance of challenging assumptions about within-group differences and highlight the critical need for addressing broader structural factors in suicide prevention.