Firearm Access and Socio-Structural Factors Related to Suicidality Among Youth With Diverse Sexual, Gender, and Racial Identities.

Objective: Elevated rates of suicidal ideation (SI) and suicide attempts (SA) among youth, particularly multiply marginalized youth, are occurring in the context of youths' access to household firearms. Research examining how perceived access to firearms is related to SI and SA among youth with marginalized identities is limited and often neglects to consider intersectionality. This study explored how intersecting social identities and positions, access to firearms, and socio-structural factors were associated with SI and SA for youth.

Method: The analytic sample (N = 17,794) included 7-12^th grade students who participated in the 2021 Dane County Youth Assessment. Exhaustive CHAID - a decision tree matrix approach - examined all possible combinations of self-reported sociodemographic characteristics (gender identity, sexual identity, racial identity, grade, and firearm access) and socio-structural variables (bias-based bullying, school belongingness, and social pressure) to predict mutually exclusive groups of youth based on past-year SI and SA.

Results: SI and SA was most prevalent among intersectional groups with multiply marginalized identities and access to firearms. Socio-structural factors, including bias-based bullying victimization, lack of school belongingness, and social pressure, were characteristic of groups with higher prevalence of SI and SA.

Conclusions: While the marginalized youth in this sample have lower access to firearms, the prevalence of SI and SA was highest among multiply marginalized youth who reported access to firearms in the context of bias-based bullying, social pressure, and a lack of school belongingness. Youth suicide prevention efforts would be strengthened by policies that address firearm access and improve the school environment.