Introduction: In 2015, suicide was the second leading cause of death among youth aged 15-24 years old in the United States. In the U.S., data shows substantial gender differences in suicidality reporting. Yet, it is unknown if these gender differences in suicidality reporting remain among certain high-risk groups.

Aim: The purpose of this study is to 1) examine if there are gender differences in reported suicidal ideation and behaviors among U.S. high school students; 2) assess if any initially observed gender differences remain across sexual orientations and among those with previous history of sexual victimization among a nationally representative sample of U.S. high school students using results from the 2015 Youth Risk Behavior Survey (YRBS).

Methods: Data from the 2015 YRBS was used to conduct secondary analyses (N = 15,624). Bivariate and multivariate logistic regressions were performed using SAS 9.4 statistical software to determine if there were significant gender differences in reported suicidal ideation and behaviors (consideration, planning, attempt, injurious attempt).

Results: Sex, sexual orientation and sexual victimization were significantly associated with all four suicide outcomes of interest. Compared to males, heterosexual/straight and gay or lesbian females had significantly increased odds of suicide consideration. Moreover, when compared to males, females that had ever experienced sexual victimization had significantly increased odds of suicide consideration and planning compared to male peers.

Conclusion: There were significant gender differences observed for suicidality when sex alone was considered. Hence, more targeted messaging is necessary to ensure all sub-populations at risk are being effectively reached.