Suicide-related outcomes are a major public health concern among sexual and gender minority youth globally. Empirical evidence indicates that lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) young people experience disproportionate psychological distress and higher rates of suicidal ideation, planning, and attempts compared with their heterosexual and cisgender peers. This study aimed to estimate the prevalence of lifetime and recent suicidal ideation, suicide plans, and suicide attempts among LGBTQ+ youth aged 18–24 in Vietnam, and to examine associations with sociodemographic characteristics and proximal psychological distress measured by the DASS-21 (Depression Anxiety Stress Scales).
Investigators conducted a community-based, anonymous online cross-sectional survey using convenience sampling. The Institutional Review Board (IRB) approved the study protocol on 7 February 2025. Participant recruitment and data collection occurred between 26 February and 10 March 2025. Recruitment channels included the Pride MindZ Facebook page (approximately 12,000 followers), social media and messaging channels of Lighthouse Social Enterprise, and snowball outreach through partner LGBTQ+ community-based organizations. The survey platform restricted submissions to one response per IP address and device to reduce duplicate entries. Electronic informed consent was obtained before participants began the questionnaire.
Participants were self-identified LGBTQ+ individuals aged 18–24 residing in Vietnam. The survey captured lifetime and past-12-month suicidal ideation, suicide planning, and suicide attempts. Symptoms of depression, anxiety, and stress were assessed using the DASS-21 instrument. Monthly income was self-reported and categorized into US dollar bands; one analytic threshold reported was ≥ USD 386 per month. Multivariable logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations between suicidal outcomes and sociodemographic and psychological variables.
The analytic sample comprised 384 respondents aged 18–24. The study authors recognize that the convenience recruitment strategy likely favored participants who were urban, internet-connected, higher educated, and linked to LGBTQ+ community networks. This accessible subpopulation is therefore not representative of all Vietnamese LGBTQ+ youth but provides evidence from a connected, community-engaged group.
Lifetime prevalence estimates in this sample were high: suicidal ideation 56.5%, suicide planning 32.1%, and suicide attempts 16.9%. Recent (past 12 months) prevalences were lower but nontrivial: 5.5% for ideation, 3.6% for plans, and 3.1% for attempts.
In adjusted analyses, symptoms of psychological distress measured by DASS-21 were the strongest proximal correlates of suicidal outcomes. Elevated stress was associated with markedly higher odds of suicidal ideation and planning (AOR = 4.52, 95% CI: 2.35–8.72). Anxiety symptoms were independently associated with increased odds of ideation and planning (AOR = 2.12, 95% CI: 1.03–4.34) and emerged as the sole independent predictor of lifetime suicide attempts (AOR = 4.30, 95% CI: 1.28–14.41).
Conversely, structural variables showed protective associations in multivariable models. Higher monthly income (defined in analyses as ≥ USD 386/month) and living in a rural area were associated with lower odds of suicidal ideation. The authors interpret these findings as indicators of economic and contextual influences that may modify risk among this sample.
The study frames observed associations through Minority Stress Theory, which posits that chronic exposure to stigma, discrimination, rejection, and limited access to affirming services leads to sustained psychological stress and poorer mental health among LGBTQ+ individuals. In this analysis, measured sociodemographic characteristics and DASS-21 depression, anxiety, and stress scores are treated as downstream correlates that may reflect the impacts of upstream minority-stress processes rather than direct measures of those processes.
Key limitations noted by the authors include convenience sampling and potential selection bias toward urban, internet-connected, and community-linked youth. These sampling constraints limit the generalizability of prevalence estimates to all LGBTQ+ young people in Vietnam. The cross-sectional design precludes causal inference between psychological symptoms and suicidal outcomes. Data cannot be shared publicly because of the sensitive nature of the information and IRB restrictions intended to protect participant confidentiality; researchers who meet IRB criteria may request access from the Hanoi University of Public Health IRB.
Findings underscore high lifetime suicidality within this accessible subgroup of Vietnamese LGBTQ+ youth and identify anxiety and stress as the most robust proximal correlates of suicidal behaviors. The authors recommend routine screening for anxiety and stress, provision of LGBTQ+-affirming mental health care, and interventions to address economic vulnerabilities. The study highlights the need for improved provider training, culturally appropriate services, and inclusion of sexual and gender minority indicators in national surveillance to better inform policy and prevention efforts. Future research should pursue more representative sampling, longitudinal designs to clarify temporal relationships, and direct measures of stigma, discrimination, and social support.
Among 384 community-recruited Vietnamese LGBTQ+ youth aged 18–24, lifetime suicidal ideation, planning, and attempts were highly prevalent. Elevated stress and anxiety symptoms were the strongest correlates of suicidal ideation and planning, with anxiety independently associated with suicide attempts. Higher income and rural residence were associated with lower odds of ideation. The authors call for integrated suicide prevention strategies that include routine screening for anxiety and stress, LGBTQ+-affirming care, and attention to economic and structural determinants of risk.