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The Truth of Queer Youth Depression and Suicidality

Matty Avers

School of Social and Behavioral Sciences, Arizona State University

PSY 290: Research Methods

Alma Arce, Ph.D.

October 1, 2023
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The Truth of Queer Youth Depression and Suicidality

Problem Statement

For centuries, common law dictated that sodomy was a criminal offense worthy of legal

repercussions. Homosexuality was a great sin that would forever mark offenders as outcasts,

unworthy of inclusion within society. Archaic laws like these would establish a social structure

where a person’s self-worth was defined by a fabricated social hierarchy. Despite the

repercussions, many would express their pride for their queer identity in secret. In the 1960s,

there would be a great popularization of gay bars where patrons could freely express themselves

without fear of ostracization. However, these havens would be frequently raided by police,

detaining patrons for the criminal act of existing as an openly queer person within society. The

subsequent Stonewall Riots that ensued sparked a major shift in the well-established social order

of the time. No longer would queer people hide in the shadows as both figurative and literal scars

of society. Due to their efforts to organize, many of these archaic laws would be eventually

overturned in 1980. Unfortunately, adjusting public sentiment would be a much more difficult

feat. Rather than fearing any legal repercussions, queer persons were increasingly becoming

victims of hate crimes, preserving their social status as outcasts.

Much work has been done to alter public sentiment towards queer identities. Notably, in

2004 Massachusetts became the first state to recognize same-sex marriage, which would

eventually become nationally recognized by the U.S. Supreme Court in 2015. Despite these

progressive attempts, public sentiment has not altered as dramatically. Queer persons are still at

the center of hate crimes within the United States. Only a year after the Supreme Court’s

monumental ruling, forty-nine queer people were murdered, and fifty-three others were injured
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the night of June 12th, 2016. The Pulse nightclub shooting would be the remembered as the

largest attack against LGBT people in the United States.

Unfortunately, anti LGBTQ+ sentiments have become the centerpiece of many

republican leader’s ideologies as of the 2016 election. The harmful effects of the popularization

of these hateful sentiments can be seen in the growing number of anti LGBTQ+ legislation in

recent years. According to the ACLU (2023), during the 2023 legislative session a total of 496

anti LGBTQ+ bills have been introduced to both state and federal congresses across the United

States. LGBTQ+ hate is on the rise, with there being a total of 356 reported incidents of hate and

violence against the queer community from June 2022 to April of 2023 (ADL, 2023).

With public and media sentiment of queer persons being overwhelmingly negative, there

must be an adverse psychological effect on the queer community. For many, this hate can be

easily internalized; eventually resulting in self-harm behaviors that develop into self-destructing

ones. The increased attacks on queer existence in recent years attempts to establish a society in

which queer persons are a victim to their own existence. Is it possible that the most dangerous

being that a queer person can encounter is themselves? How does that translate to adolescent

individuals who have not fully developed an understanding of their own identity? Thus, do queer

adolescents have an increased risk of suicide due to the amount of mainstreamed queer hate?

Literature Review

It should be noted that other possible factors could impact the mental health of

adolescents, such as sleep. Matamura and their colleagues (2014) performed a meta-analysis that

spanned over four years in order to understand the relationship between mental health and sleep

habits in Japanese junior high and high schoolers. Their study involved yearly self-report surveys

of over 700 students, finding that there is in fact a direct correlation between sleep habits and
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mental health in adolescents (Matamura et al., 2014). Specifically, they found that poor sleep

habits contribute to worse levels of mental health. Their findings are rather extraordinary, as they

were able to assess approximately ten pairs of twins each year they surveyed; removing possible

genetic factors or other extraneous variables from contributing (Matamura et al., 2014).

Unfortunately, their research was rather superficial in the fact that they did not attempt to

understand or address the occurrence of poor sleep habits in students. Thus, there may be more

research that is required to fully understand the full scope of adolescent mental health, at least

when referring to how sleep habits can contribute. Nevertheless, from sleep habits alone

adolescents are vulnerable to experiencing poor levels of mental health, which is an important

understanding that Matamura and their colleagues were able to provide in their study (2014).

Noting a steadily increase in rates of suicide over recent years, especially around the

COVID-19 epidemic, Rogerson and their colleagues (2022) created a study to identify if

childhood trauma caused suicidal risk in adulthood, as well as understanding the mechanics of

suicide risk. Ultimately, their goal was to understand how the COVID-19 epidemic could have

such a dramatic impact on the mental health of large populations (Rogerson et al., 2022). Their

study was performed at a university in the UK, with 457 total respondents who reported

experiencing suicidal ideation within the last year (Rogerson et al., 2022). The researchers found

that childhood trauma is directly related to recent suicidal ideation in adulthood, and that poor

executive function and high impulsivity can contribute to suicidal ideation as well (Rogerson et

al., 2022). Overall, helping to explain the increased trends in suicide within the general

population around the COVID-19 epidemic. Though their study was very small, Rogerson and

their colleagues (2022) provided much needed insight on the mechanics of suicidal ideation.
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From this study, researchers can better identify populations that are vulnerable to suicidality,

such as those exposed to childhood trauma.

In a study performed by Zhai and their colleagues (2023) in China, they aimed to identify

the effects of childhood trauma within gay men. Specifically, they wanted to understand the

prevalence of suicidal ideation that occurs from childhood trauma within this population (Zhai et

al., 2023). Their study consisted of 499 biological men ages 16-25 years old, have had sex with

other men, and are from three different Chinese cities (Zhai et al., 2023). The researchers found

that within the last twelve months: 17.86% reported suicidal ideation, 2.27% reported making a

suicide plan, and 0.65% reported attempting suicide (Zhai et al., 2023). Notably, it was found

that those who reported more instances of childhood abuse were more likely to develop suicidal

ideation in adulthood (Zhai et al., 2023). Unfortunately, the scope of this study was very

restrictive in its nature, but it does shine light on the mental health of gay men, especially since

China’s general population rate of suicidal ideation is as low as 3.9% (Zhai et al., 2023). Due to

the correlation between childhood trauma and suicidal ideation within gay men, it is relevant to

research whether this association can be attributed to other queer groups, especially adolescents

as they may be more vulnerable than adults.

Abuse is known to have a detrimental impact on a person’s mental health. For those that

experience abuse, they are at risk of internalizing the trauma from their abuse, likely to result in

self-harm and eventually self-destructive habits without proper therapeutic intervention and

treatment. Out of concern for the mental health of queer persons, Borgogna and their colleagues

(2023) wanted to identify if queer persons experienced higher rates of abuse than their cishet

(cisgendered and heterosexual) counterparts. Borgogna and their colleagues (2023) analyzed date

from a Healthy Minds Study that encompassed 119, 181 undergraduate students across 140
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higher education institutions throughout the United States. Despite the large size of the study, its

restriction to only include undergraduate students makes it harder to generalize the data to the

broader population. It is worth noting though that U.S. colleges do have one of the highest rates

of queer participation when compared to other institutions in the country, thus studying college

students is an effective strategy such that you are likely to poll an array of sexual and gendered

minorities. Importantly, their study included a diverse array of sexual, racial, and gender

identities (Borgogna et al., 2023). Borgogna and their colleagues aimed to specifically identify

the rates of experiencing emotional, verbal, and physical abuse within gendered and sexual

minorities (2023). Notably, demisexual individuals experience the highest rate of any types of

abuse at 49.5%, with specifically experiencing emotional abuse at 45.7% (Borgogna et al., 2023).

Pansexual individuals reported experiencing physical abuse at a rate of 12.5%, sexual assault at

17.3%, and experience all three types of abuse at 4.7% (Borgogna et al., 2023). These were the

highest rates of reporting within all categories, with heterosexual individuals reporting the lowest

rates for all categories (Borgogna et al., 2023). As seen from this study, when compared to their

cishet counterparts, queer individuals experience abuse at a heavily increased rate (Borgogna et

al., 2023). While there could be a plethora of explanations for the specific experiences of abuse

that different gendered and sexual minority groups experience (i.e., the fetishizing of bisexual or

demisexual women (Borgogna et al., 2023)), there is a clear risk on queer lives within our

society. When coupled with the fact that queer individuals are repeatedly exposed to increasing

physical and political attacks on queer lives, it is necessary to fully understand the possible

effects that may result from this trauma that queer persons disproportionately experience.

Through a meta-analysis that encompassed fifty surveys spanning ten years from fourteen

different countries, Marchi and their colleagues (2022) compared 3,735,601 cishet persons with
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87,252 queer persons to fully identify the threat suicide places on queer people. This impressive

feat of data analysis “confirms the strong relationship between sexual variant status and NSSI

(non-suicidal self-injury), SI (suicidal ideation), and SA (suicide attempt)” (Marchi et al., 2022).

It is worth mentioning that the meta-analysis included respondents ages 14-84 years old, but the

researchers did not draw any definitive conclusions based on age (Marchi et al., 2022). While

there may be minor issues with the data since many of the studies used self-reported data, the

findings should still be considered due to the researcher’s intense review process that was

enlisted (Marchi et al., 2022). Overwhelmingly, across the world queer persons are a danger to

themselves. The researchers note “Minority Stress Theory”, which “suggests that the LGBTIQ

population experiences chronic stress related to stigmatizing attitudes and victimization,

prejudice, and discrimination” (Marchi et al., 2022). The globalization of this experience is

something that deserves more research as the global queer population is in danger.

Former President Donald Trump’s 2016 “Culture Wars” platform, marks an increase in

negative public opinion of queer people. The new figure head of the Republican political party

would promote a rapid increase in anti-LGBT legislation and policy. Wanting to understand if the

2016 presidential election sparked an increase in queer suicide, Ream in their study (2022)

analyzed queer suicide records from the Center for Disease Control and Prevention’s National

Violent Death Reporting System. Their analysis would involve a reverse regression of all queer

suicides from ages 11-29 years old, spanning across the United States from 2014 to 2019 (Ream,

2022). The analysis found that there was an increase in queer suicide from 13% to 20% of total

accounts after the 2016 election (Ream, 2022). Notably, this increase was led by both

transgender youth and queer/questioning youth, with suicide rate increases of 2.5% to 6% and

0.5% to 1.7% respectively (Ream, 2022). This study not only proves that the presence of anti-
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LGBT sentiment within society is detrimental to the mental health of queer persons, but it is

especially significant to that of queer youth. According to the data, they are the ones that are

impacted the most by anti-queer sentiment. More research needs to be done to fully understand

the current threat on queer youth, especially as anti-queer sentiment continues to grow.

Gaps in Literature

The previously mentioned articles are well-structured and thoroughly reviewed studies

that work to identify populations that are vulnerable to mental health struggles, specifically

suicidal ideation. Separately, each article identifies a different portion of the global population

that is vulnerable based on the studies limitations. Collectively, these studies express a narrative

that the most vulnerable group is queer youth, without fully identifying what causes so much

mental strain on them. From this research, it has been discovered that there is a strong correlation

with traumatic adolescent experiences and adult (present-day) suicidal ideation. Perhaps queer

persons have a higher risk of experiencing trauma as adolescents and that is the systemic cause

of queer youth vulnerability. Research that is able to confirm this hypothesis is necessary in order

to fully establish a proper claim of why queer groups are more prone to suicidal ideation, and to

what extent that threat disproportionately extends to queer youth.

Research Question, Variables, and Hypothesis

After identifying an important gap within the current literature regarding an increase in

queer suicidal ideation, the following research question has been constructed: Are queer youth

significantly impacted by the public perception of queer identities such that they experience

higher rates of trauma as adolescents compared to their cishet counterparts? The null hypothesis

states that queer youth experience of trauma is not affected by public perceptions of queer

persons. The research hypothesis states that when properly measured, queer youth will
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experience an increased rate of traumatic instances as public perception decreases. According to

studies performed by Zhai and their colleagues (2023) and Rogerson and their colleagues (2022),

experiencing trauma during adolescence causes development of suicidal ideation and depression

within adulthood. From this understanding, I predict that due to the presence of negative social

stigmas of queer identities, the increased social pressure will have an adverse effect on queer

youth: exposing them to trauma at an increased rate, causing a decrease in their mental health

and overall increasing the risk of suicidality at all ages.

Within my study, I want to fully understand if there is a causal relationship between

public perception and the experience of trauma within queer youth. The independent variable

present within this study is presence of negative queer sentiments within the United States. The

dependent variable is the experience of trauma within the last twelve months. Through an

experimental design, the independent variable will adjust on its own over time, and the

dependent variable will be measured. The study will be done by recording adolescent

experiences of trauma each year for three years, identifying natural fluctuations in social

perception of queer identities, and noting changes in the rates of traumatic experiences,

specifically in queer youth.

Methods

Participants and Recruitment

This experiment will require two different surveys to be completed by two different

populations once a year for three years. The sample size for each survey should have a minimum

of 300 responses each year. According to Cozby and Bates (2020), 266 participants are required

for a study with a power of 0.90 and an effect size of 0.20. I have chosen this combination of

effect size and power because I think that it will help to yield the best result in determining the
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correlation that my hypothesis is looking to confirm. Zhai in their 2023 study used a sample size

of 308 respondents for their study which involved the use of the ACE-Q, a scale that I intend to

use in my study. I will elaborate on usage of the test further in the Measures and Materials

section. Requiring a slightly larger than recommended sample size of 300 participants is

necessary in order to account for any problems that may occur from data acquisition and usage,

as well as helping to prevent Type II error from occurring. Thus, a sample size of 300 will likely

yield the best results for my experiment.

The first survey in my experiment will have queer adolescents complete the ACE-Q to

measure their experience of trauma within the last 12 months. Queer middle school and high

school students, ages 10-19, will be randomly selected and asked to willingly participate in the

survey. A random selection is best so that the sample used is more likely to reflect that of the

general U.S. adolescent queer population. To account for region-based fluctuations, it is best that

this survey is only distributed to students from the same state.

The second survey will have adults completing a feeling thermometer survey that

measures queer sentiment. All responses should come from the same state that is used in the

previous survey, such that we can better compare the results of the two surveys, and regional

fluctuations are accounted for. Like the sample for the previous survey, simple random sampling

should be utilized, and the sampling can be done using voter registration or driver’s license

records from the state.

For this study, it is relevant that participants do not know the full extent of the study and

the correlation that is being studied in order to prevent any response biases. Instead, participants

will be disclosed only on the information contained within the survey that they are completing,

the length of the study (three years), and that all responses are confidential and voluntary.
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Following APA guidelines, a debrief will be necessary once all data is collected over the three-

year period (American Psychological Association, 2019). This will be done with a mailed letter

to participants that outlines the nature of the study, the reason for withholding information, the

final results, and a way for participants to contact the survey conductors with questions.

Measures and Materials

As mentioned earlier, to measure exposure to trauma the Adverse Childhood Experiences

Questionnaire (ACE-Q) developed by Felitti et al. (1998) will be used. This questionnaire has

been readily used to identify children and adults that are at risk of dangerous behaviors due to the

presence of trauma during developing years. This 17-item questionnaire is divided into 7

categories of childhood exposure to abuse and household dysfunction. A response of “Yes” to

one or more of the questions in each category establishes that the respondent has been exposed to

that category of trauma (Felitti et al, 1998). This questionnaire was created to identify if the

respondent was exposed to trauma during developing years. For this test, the questionnaire will

be slightly altered such that the time of exposure will be contained to the last 12 months. This is

done in order to identify if exposure to trauma remains consistent or if it alters due to changes in

the independent variable.

For the second survey, a feeling thermometer test will be administered to the adult group.

Feeling thermometer tests are very simple, asking respondents their opinion on an issue. This

survey will simply ask if the participants find same-sex relations “Morally Acceptable” or

“Morally Wrong”. Gallop Polls have included a similar question in their “Americans’ Opinions

of Moral Issues” survey since 2001, with approval rating growing from 40% when first

administered, up to 71% in 2022 (James, 2023). This rating dropped to 64% this year.
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The categorical dependent variable, adolescent exposure to trauma in the last 12 months,

includes self-reporting of their experiences of trauma within the last 12 months. Responses that a

student experienced any amount of trauma, meaning that they responded “Yes” to at least one of

the questions in the ACE-Q, will be coded in an Excel document as “1”. Responses where a

student has no experience of trauma will be coded as “0”. The categorical independent variable,

opinion on same-sex relations, will be self-reported. In another section of the Excel document,

responses of “Morally Acceptable” will be coded as “1” and “Morally Wrong” will be coded as

“0”. This will be done for each year the surveys are administered (three years in this experiment).

A computer that can run Excel is all that is needed for this statistical analysis.

Procedures

After random selection, participants will be asked to willingly participate in this year’s

testing for the study. Students that are asked to respond to the ACE-Q survey will be provided

with a paper copy of the survey in person by the researcher, and an envelope to seal their

responses within. The researcher will inform them of the contents of the survey that they are

being asked to complete, the duration of the study, and they will guarantee confidentiality of

their responses. The envelope is used to ensure confidentiality. Once finished, the researcher will

ask the respondent for a means of contact such that they can be informed of the study’s progress,

and the sealed surveys will be collected. Responses will then be recorded within the Excel

document. Selected adults will receive a letter from the researcher that describes the survey they

were selected to participate in, the duration of the survey, an envelope to return their response,

and will be ensured that their response will be confidential. Collected responses will be recorded

within the Excel document. In a separate document, contact information will be recorded for

respondents to each survey such that there is confidentiality with their responses. Mirroring the
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study Ream performed (2022), this study is best done over three years. The year before a

presidential election, immediately following the election, and the subsequent year. As Ream

proved, there was notable shifts in queer sentiment during U.S. presidential elections. Each year,

a new sample will be randomly selected for both surveys.

Since data is coded as “1” and “0”, the “SUM” function can be used to find the total

number of positive responses for each year. The sum for each year will then be divided by the

total number of responses from that year, and then converted into a percent. This will be done for

the results of both surveys. With this conversion, the data for the ACE-Q is now read as “the

percent of respondents that experienced at least one form of trauma within the last year”, and the

data for the feeling thermometer is read as “the percent of respondents that morally approve of

same-sex relations”. For each year of the study, the two values will be plotted against each other.

After plotting, the Spearman’s correlation will be calculated. Spearman’s correlation is

used to determine the strength of a non-linear relationship. Since there is no guarantee that the

relationship between the two variables will be linear, the Pearson correlation cannot be used. The

confidence interval will be set at 0.05% such that the analysis is significant and so that Type II

error is prevented from occurring. In this study, Type II error would mean that the results of this

study were a false negative, meaning that this relationship was incorrectly deemed insignificant.

This would be dangerous as it would likely result in vulnerable queer youth not receiving

necessary mental health support, eventually leading to an increase in suicidal occurrences within

the population. A significant result will reject the null hypothesis, stating that there is a

significant relationship between queer adolescent experience of trauma and public perception of

queer persons. If so, the public should commit themselves to addressing the systemic problem of

anti-LGBT sentiment for the benefit on the global queer population.

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ADL. (2023, June 22). Year in Review: Anti-LGBTQ+ Hate & Extremism Incidents, 2022 –

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lgbtq-hate-extremism-incidents-2022-2023

American Psychological Association. (2019). Public manual of the American psychological

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Borgogna, N. C., Lathan, E. C., & Aita, S. L. (2023). Sexual and gender minority victimization:

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Jones, J.M. (2023, June 16). Fewer in U.S. Say Same-Sex Relations Morally Acceptable. Gallop.

https://news.gallup.com/poll/507230/fewer-say-sex-relations-morally-acceptable.aspx

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