Alcohol consumption is a prevalent behavior among college students, with 38% engaging in binge drinking, which is associated with numerous adverse outcomes, including impaired academic performance and physical injuries. Although previous research has explored the relationship between alcohol use and suicide risk, there remains a notable gap in understanding suicidal ideation (SI), specifically within the context of alcohol consumption. Notably, sexual and gender minority (SGM) students are identified as particularly vulnerable, exhibiting elevated rates of alcohol use and binge drinking compared to their cisgender and heterosexual counterparts. This study seeks to investigate the association between alcohol use and SI among undergraduate students, with a specific focus on differences across sexual orientation and gender identity.
The study analyzed data from approximately 300,000 students who participated in the American College Health Association National College Health Assessment (ACHA-NCHA) between Spring 2019 and Fall 2022. Participants provided demographic information, including sexual orientation and gender identity, and reported their drinking behaviors and experiences of suicidal ideation over the past year. The study used multilevel models to examine the relationships between identity-based groups, alcohol consumption, and SI, taking into account individual differences within school environments.
According to the study, SGM men exhibited the highest levels of risky drinking behavior, while nonbinary individuals and cisgender/heterosexual men also demonstrated higher levels compared to cisgender/heterosexual women. Students at four-year or higher institutions engaged in risky drinking behaviors more frequently than those at two-year institutions. Regarding suicidal ideation (SI), SGM individuals, particularly nonbinary individuals, displayed the highest risk, followed by SGM women, SGM men, and cisgender/heterosexual women. Additionally, risky drinking behaviors and higher blood alcohol content (BAC) during recent social drinking episodes were associated with an increased likelihood of experiencing SI while drinking. These findings highlight that SGM students, especially SGM men and nonbinary individuals, showed heightened vulnerability to SI in the context of alcohol use, underscoring the need for targeted interventions to address this risk.
Takeaway: Sexual and gender minority (SGM) students face a heightened risk of suicidal ideation (SI) linked to alcohol consumption, highlighting the importance of tailored interventions.