Suicide risk is higher among sexual minority (SM) individuals compared to individuals who do not identify as SM (Boyer et al., 2021; Figueiredo and Abreu, 2015; Mak et al., 2020). Heightened suicide risk in this population is likely a byproduct of sexual minority stress (Meyer, 2003), which outlines the health risks associated with living in a society with a pervasive, negative stigma against SM individuals (Boyer et al., 2021; Figueiredo and Abreu, 2015; Mak et al., 2020). As outlined by the cultural model of suicide (Chu et al., 2010), culture influences suicidal behaviors through language and method (i.e., “idioms of distress”), stressors present in a cultural context (e.g., minority stress, social upheaval, or cultural sanctions), and meanings of and perspectives on suicide. The experience of minority stress – in the context of other social systems of oppression for SM adults who are intersectionally marginalized (Williams et al., 2022) - is believed to contribute to the four components of the Interpersonal Theory of Suicide (Joiner, 2005), namely thwarted belonginess (e.g., through social exclusion), perceived burdensomeness (e.g., through rejection by family and peers), acquired capability for suicide (e.g., through higher exposure to discrimination events that may reduce fear of death), and hopelessness [see Chang et al. (2023) for a review]. Minority stress positively predicts both suicidal ideation and attempts, mediated directly by perceived burdensomeness and indirectly by thwarted belonginess through burdensomeness (Fulginiti et al., 2020). Enhancing belongingness, as a way of reducing the pain of burdensomeness, may be a promising intervention for SM individuals at risk for suicide (Hatzenbuehler et al., 2014).

Given the higher prevalence of suicide in SM populations, most studies have taken a deficits-based approach to understanding suicide (Fulginiti et al., 2020; Meyer et al., 2021; Plöderl et al., 2014). This is likely a holdover from debunked pathological models of homosexuality (Drescher, 2015). The reality is that SM individuals often use various internal (e.g., identity pride, hope, and optimism; Kwon, 2013; Riggle et al., 2014) and external (e.g., connection to supportive communities, engagement in social justice; Simon et al., 2015; Parmenter et al., 2020) resources to persevere when faced with adversity and minority stressors (Meyer, 2015). Perseverance in the face of adversity is the hallmark of resilience, commonly conceptualized as comprising individual assets alongside social and community resources (Kuldas and Foody, 2022). The transactional socio-ecological approach to resilience considers the interplay between trait- (i.e., intrinsic, stable characteristics) and state-based (i.e., temporary, situational) factors occurring in an environment that optimizes or detracts from an individual’s resilience (Kuldas and Foody, 2022). In the context of suicide resilience, an individual may survive a suicidal crisis by using intrinsic characteristics, developed abilities (e.g., coping skills), and external supports and resources. An individual’s suicide resilience may fluctuate as the environment either depletes resilience, thus contributing to suicide risk by inculcating feelings of alienation and burden; or alternatively, factors in the environment may boost resilience and protect against suicide risk by providing a sense of belonging and support (Joiner, 2005). Several studies have shown state changes in suicide resilience can occur in response to events and pertinent contexts (e.g., Yurgil et al., 2021). Suicide resilience has been associated with decreased reported suicide attempts among SM college students (Woodford et al., 2018) and has been included as a component in the cumulative factor model for SM youth suicide (Rutter, 2008). Suicide risk and resilience do not appear to exist on a continuum but exist as separate dimensions, and resilience may buffer the relationship between risk and suicide behaviors (Johnson et al., 2011). Thus, in light of the Interpersonal Theory of Suicide, suicide resilience may not necessarily indicate high belongingness or low burdensomeness; rather, it may moderate the relationship between these causal variables dynamically based on trait and state-based factors.

Protective factors are elements of suicide resilience that specifically mitigate the impact of detrimental environmental effects, such as minority stress. These factors, which can be trait- or state-based, are associated with reduced risk for suicide in the general population (Centers for Disease Control and Prevention, 2022), among SM youth (e.g., Gorse, 2022) and in transgender samples (e.g., Moody and Smith, 2013). Although these initial findings are promising, little research has been done with regard to protective factors among SM adults, particularly delineating whether trait- and state-based protective factors can reduce suicide risk for SM adults in the context of minority stress and other cultural factors. Investigating the relationship between protective factors, expressed as suicide resilience and reasons for living, and suicide outcomes (self-reported suicidal ideation and behaviors) in SM adults can inform targeted interventions that optimize trait and state-based assets and resources to save lives. To our knowledge, there exists no other research which explicitly explores suicide protective factors, let alone the concepts of resilience and reasons for living, among SM adults as a means to inform the clinical application of these ideas. This aligns with calls to investigate suicide resilience in a broader range of populations and in relation to a various suicide outcomes (Johnson et al., 2011).

In their seminal work on the construct, Osman and colleagues define suicide resilience as “the perceived ability, resources, or competence to regulate suicide-related thoughts, feelings, and attitudes” (p. 1351). The construct has three domains: (1) internal protective attributes, such as positive self-regard or life satisfaction; (2) external protective resources, that is, an individual’s sense of being able to identify resources and enlist support from others when faced with a suicidal crisis; and (3) emotional stability, which includes the self-perception that one can regulate suicidal thoughts and behaviors during periods of emotional distress. The Suicide Resilience Inventory (SRI) - has not been explicitly defined as a trait-based measure of suicide resilience, yet its individual-level resources closely approximate this conceptualization (Johnson et al., 2011; Osman et al., 2004). Moreover, this measure has not been tested with a SM sample nor as predictive of suicide outcomes. Suicide resilience may serve as a way to measure how trait-based protective factors relate to suicide outcomes among SM adults.

Important questions remain regarding whether trait and state-based protective factors relate to suicide outcomes as well as which protective factors might account for reduced risk. In this regard, most work on protective factors has not considered the unique cultural factors involved in the lives of SM adults. This gap reveals the underlying assumption that either protective factors are shared universally across communities of different sexual orientations, thereby applying generally accepted protective factors to the lives of SM adults; or that SM adults have less access to protective factors given the realities of minority stress in SM individuals’ lives, thus explaining the disproportionate suicide rates in SM populations. Understanding the relationship between specific protective factors using a trait and state-based conceptualization and suicide risk offers implications for counseling and suicide risk assessment.

The present study seeks to address an important gap in the literature by exploring the relationship between trait-based (internal protective, external protective, and emotional stability) and state-based (RFL) protective factors (e.g., suicide resilience and RFL) and suicide risk (e.g., history of suicidal ideation and likelihood of future suicide behavior) among a sample of SM adults. We hypothesized that greater suicide resilience and more RFL, individually, would predict lower perceived likelihood of engaging in future suicidal behavior. As an exploratory analysis, we sought to understand the associations among the subscales of suicide resilience and RFL with each of the two suicide risk outcomes to outline which protective factors, if any, might be more culturally appropriate predictors of reduced suicide risk among SM populations.

Confirming our hypotheses, SM who endorsed greater suicide resilience and more RFL were less likely to envision engaging in future suicidal behaviors. RFL and suicide resilience collectively accounted for nearly 47% of the variance in likelihood of future suicidal behaviors. Our results indicate that both trait and state-based protective factors, like suicide resilience and RFL, are relevant to SM adults, as has previously been shown in one application to a transgender sample (Moody and Smith, 2013). Our findings provide a powerful demonstration of how suicidality may be influenced by the presence of protective factors among SM adults despite being at greater risk for suicide. The average respondent in our survey had experienced some suicidal ideation in the past 12 months, which increases risk for completed suicide on its own in vulnerable populations (e.g., Funahashi et al., 2000) with relevance for SM adults. Their combined predictive power for a lower likelihood of future suicidal behaviors prompts the inclusion of both as a means of assessing future suicide risk, conceptualizing suicide in SM populations, and determining opportunities for intervention that enhances trait-based characteristics and adequately optimizes state-based factors towards decreasing suicide risk and building resilience.

Correlation analyses provided some insight to which of the SRI and RFL subscales were negatively associated with past suicidal ideation and the likelihood of future suicidal behaviors. Based on our findings, all of the SRI subscales and some of the RFL subscales negatively correlated with the two suicide outcomes. It is not surprising that Internal Protective, Emotional Stability, and External Protective Factors are negatively associated with suicide outcomes given findings from previous research in various populations (Moody and Smith, 2013; Osman et al., 2004; Woodford et al., 2018). Surprisingly, Fear of Suicide positively correlated with both outcomes, which may suggest that fearing suicide inevitably involves thoughts of death. It is conceivable that individuals who have considered suicide seriously in the past decided not to go through with it because of the fear of death and suicide indicated by the endorsement of this subscale. In regard to higher likelihood of future suicide, future research could investigate if thoughts about suicide and death desensitize the individual to the point where fear is not a deterrent to suicide. Moral Objections did not significantly correlate with history of suicidal ideation. Supposing that moral objections are informed by religious, spiritual, or cultural teachings, this finding is consistent with literature that suggests that SM often experience rejection and loss of connection to their faith community prior to coming out or shortly after coming out (Rosati et al., 2020). Loss of connection with faith communities could explain why moral objections would not be associated with fewer suicidal thoughts. In their analysis, Garrett et al. (2012) found that respondents considered the morality of suicide to be a personal decision and not one determined by universal truths or the tenets of organized religion; thus, participants in our sample may similarly have not resounded with the items in this subscale. Fear of Social Disapproval did not correlate with likelihood of future suicidal behavior, which is consistent with previous literature (Linehan et al., 1983). One way of conceptualizing this is through various resilience resources SM populations garner to facilitate positive health and well-being as they grow into their SM identities (Meyer, 2003; Riggle et al., 2014). As Garrett et al. (2012) explored, many SM respondents rejected conventional notions of social approval as being tied to heterosexist ideologies and instead, reflected on a sense of self-worth and responsibility to their communities, close members of which might be hurt as a result of suicide. Another way of conceptualizing this is through minority stress, in that exposure to identity-based stress for extended periods may reduce sensitivity to social disapproval (Hatzenbuehler, 2009).

In the exploratory regression analyses, internal protective factors and emotional stability individually and negatively predicted past suicidal ideation, accounting for 34% of the variance in this suicide outcome, whereas external protective factors was not predictive of past suicide ideation. The absence of significant effects for external protective factors may reflect the realities of marginalization and/or that this subscale may not assess specific external resources. For example, even in the presence of general external protective factors, systems of inequity may restrict access to external resources (e.g., peers, family, crisis centers) for SM adults. Further, this subscale measures broad external resources (e.g., “I can find help if I am suicidal,” “If I am in trouble I can find help”) and does not measure external protective factors in specific contexts (e.g., family, peers, LGBTQ+ community). Future research should create suicide resilience measures assessing specific external resources from various contexts.

All three SRI subscales also individually and negatively predicted likelihood of future attempts, accounting for 42% of the variance. Such findings demonstrate that SM adults have access to trait-based internal resources that are protective against suicide. SM adults draw resilience from aspects of their experiences that are specifically relevant to their identities (e.g., identity disclosure) to combat the effects of minority stress (Meyer, 2015); in turn, these effects may extend to suicide resilience as demonstrated in this study. In past research with a transgender sample, only the emotional stability subscale served as a protective factor for suicide (based on a composite score of lifetime suicidal ideation and/or behavior, past-year frequency of suicidal ideation, disclosure of suicidal thoughts to others, and the likelihood of future attempts; Moody and Smith, 2013). As emotion dysregulation is one potential pathway for minority stress to “get under the skin” (Hatzenbuehler, 2009), counselors should use interventions that promote emotional stability as an effective method for suicide mitigation (Pachankis et al., 2022). Moody and Smith (2013) also demonstrated that perceived social support from family played a crucial protective factor in this model as well, which we did not measure in our study and is worth additional investigation.

Among the RFL subscales, Survival and Coping Beliefs and Moral Objections negatively predicted likelihood of future suicidal behavior, which is consistent with previous literature in other samples (Connell and Meyer, 1991). To contextualize how this might be protective for SM adults specifically, SM may draw strength from previous experiences of effective survival and coping (e.g., disclosing their sexual identity, survival and thriving despite oppression) as well as derive hope and meaning from difficult times (Garrett et al., 2012; Parmenter et al., 2020). These beliefs may also show a realistic acceptance of the realities of life based on the experience of difficulty and the experience of overcoming those difficulties and a rejection of naivete (Garrett et al., 2012). Survival and coping beliefs accounted for unique variance in the regression analysis, supporting its conceptualization as a state-based variable. Yet, this RFL subscale also strongly correlated with the SRI subscales (r = 0.52–0.66), showing some predictive overlap between trait-based characteristics and state-based coping. This aligns with interactional perspectives on trait and state variables (Hamaker et al., 2007).

With regards to the relationship between Moral Objections and likelihood of future suicidal behavior, spiritual beliefs may have helped SM individuals who practice faith through difficult times related to their identities (Schuck and Liddle, 2001), and some churches are welcoming of different sexual identities (Gattis et al., 2014). The finding that moral objections are negatively correlated with the likelihood of future suicide suggests that individuals who were once exposed to religious, spiritual, or cultural teachings against suicide may still retain these beliefs regardless of current religious affiliation. Moral Objections did not significantly correlate with the SRI subscales and thus may account for unique state-based prediction of suicide outcomes.

There are a few explanations for the absence of a relationship between the other RFL subscales and likelihood of future suicide behavior. Firstly, the buffering hypothesis of suicide contends that even variables with negative relationships with suicidal thoughts and behaviors do not necessarily buffer risk, and conversely, there may be variables without a linear association to suicide thoughts and behaviors that may still moderate risk (Johnson et al., 2011). Secondly, in this sample, respondents endorsed Moral Objections, Child-related Concerns, and Fear of Social Disapproval at lower levels on average. This might indicate a lack of cultural relevance of these subscales for this sample. For example, past research in a sample of transgender adults also found an absence of relationships among RFL subscales and suicide behavior with the exception of child-related concerns, which negatively predicted suicidal behavior when combined in a model with suicide resilience (Moody and Smith, 2013). Previous research on RFL indicated that SM individuals may have fewer reasons for living than non-SM individuals (Hamilton, 2001; Hirsch and Ellis, 1998), that RFL may not be a valid measure among SM populations (McBee-Strayer and Rogers, 2002), or that it may only be partially culturally-relevant (Garrett et al., 2012). Garrett et al. (2012) used a protocol analysis to investigate SM adults’ perception and interpretation of the RFL items and found that most items resonated with the sample, yet respondents also criticized the heteronormative assumptions and belief systems underlying some of the items. The authors recommended adaptation of the RFL specifically to SM lived experiences (Garrett et al., 2012). Adapted RFL scales may be more predictive of suicide thoughts and behaviors among SM adults. Our study demonstrates that RFL, in particular Survival Coping Beliefs, can be protective against suicide for SM adults, and supports that RFL should be adapted to reflect the particular reasons for living of SM communities.

The awareness of having a life worth living for may, in and of itself, protect SM individuals from the onset of suicidal ideation. As mentioned earlier, conventional suicide risk assessment and treatment focus primarily on risk factors, taking a deficits approach. We support the assertion of Dr. Linehan that the presence and awareness of protective factors may decrease the thought of suicide as a response to life’s stressors. In compiling an individual’s reasons for living, Linehan et al. (1983) believed they could serve as an antidote to the negative beliefs that contribute to suicidality and help individuals choose to continue to live. Merely asking someone about their reasons for staying alive prompts them to consider their strengths and resources, which they may not otherwise have considered (i.e., a state-based intervention). Thus, Linehan and her colleagues recommend counselors use RFL cards as part of a safety plan and/or therapeutic strategy since the person may not have considered their reasons for living until they are asked about them. In addition to this, we encourage counselors and others in a clinical capacity consider discussing reasons for living with their clients in order to help them recognize their strengths and resilience and by doing so, potentially prevent suicidal ideation in response to life stressors.