UC Merced

Purpose

Sexual minority East Asian adolescents face distinct stressors that negatively impact mental health and increase suicidality risk. This study examines trends in mental health and suicidality among East Asian adolescents in Canada, focusing on changes in sexual orientation-based disparities over time.

Methods

We analyzed data from East Asian adolescents in the British Columbia Adolescent Health Survey (1998-2023) including 13,086 boys and 13,812 girls. Age-adjusted logistic regression analyses, stratified by gender, were used to examine 25-year trends in extreme stress, hopelessness, suicidal ideation, and suicide attempts by sexual orientation (heterosexual, mostly heterosexual, and lesbian, gay, or bisexual [LGB]).

Results

Positive trends among East Asian adolescents included decreased extreme stress among heterosexual boys and girls, hopelessness among heterosexual boys and mostly heterosexual girls, and suicide attempts among heterosexual and LGB girls. However, hopelessness increased for LGB East Asian girls and suicidal ideation rose for both LGB and mostly heterosexual East Asian girls. When examining disparities, LGB East Asian adolescents had 1.9-4.8 times higher odds of all adverse outcomes compared to heterosexual peers in 2023, while mostly heterosexual East Asian adolescents also showed elevated risk in multiple years. Over time, disparities in extreme stress narrowed for mostly heterosexual girls but widened for hopelessness among LGB girls and mostly heterosexual boys and for suicidal ideation among LGB girls.

Discussion

These findings underscore the need for culturally tailored interventions for sexual minority East Asian adolescents, especially LGB girls, who face widening disparities and increasing risks of hopelessness and suicidal ideation.