---
title: "Suicidality among Vietnamese LGBTQ+ Youth: Prevalence, Correlates, and Service Implications"
id: "plos-one-14-prevalence-and-associated-factors-of-suicidal-ideation-plans-and-attempts-among"
canonical_url: "https://medichelpline.com/clinical-feed/plos-one-14-prevalence-and-associated-factors-of-suicidal-ideation-plans-and-attempts-among"
content_type: "clinical_feed_article"
specialty: "General"
source_name: "PLOS ONE (Medicine)"
source_url: "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357123"
published_at: "2026-08-28T14:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Suicidality among Vietnamese LGBTQ+ Youth: Prevalence, Correlates, and Service Implications
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/plos-one-14-prevalence-and-associated-factors-of-suicidal-ideation-plans-and-attempts-among
- **Specialty:** [General](https://medichelpline.com/clinical-feed/general.md)
- **Primary Source:** PLOS ONE (Medicine)
- **Source URL:** [Original Journal Publication](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0357123)
- **Published At:** 2026-08-28T14:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- This community-based online cross-sectional study surveyed 384 self-identified **LGBTQ+** individuals aged 18–24 living in Vietnam to estimate lifetime and recent prevalence of suicidal ideation, plans, and attempts and to identify associated factors. - Data were collected via convenience sampling through LGBTQ+-led or supportive social media and community networks between 26 February and 10 March 2025 following IRB approval on 7 February 2025; the sample is likely skewed toward urban, internet-connected, and community-linked youth. - Suicidality prevalence was high: lifetime suicidal ideation 56.5%, lifetime suicide planning 32.1%, and lifetime suicide attempts 16.9%; past-12-month prevalences were 5.5% (ideation), 3.6% (plans), and 3.1% (attempts). - Mental health symptoms were measured with the **DASS-21** instrument. In multivariable models, elevated **stress** (AOR 4.52, 95% CI 2.35–8.72) and **anxiety** (AOR 2.12, 95% CI 1.03–4.34) were significantly associated with higher odds of suicidal ideation and planning. - **Anxiety** was the only independent predictor of lifetime suicide attempts in adjusted analysis (AOR 4.30, 95% CI 1.28–14.41). - Higher monthly income (≥ USD 386/month) and rural residence were associated with lower odds of suicidal ideation in multivariable analyses. - Authors interpret findings through Minority Stress Theory, framing measured sociodemographic and DASS-21 variables as downstream correlates rather than direct measures of stigma or discrimination. - Recommendations emphasize routine screening for anxiety and stress, delivery of LGBTQ+-affirming care, and addressing economic vulnerabilities; the study also highlights limited existing data on LGBTQ+ youth mental health in Vietnam. - Data cannot be publicly shared due to participant confidentiality and IRB restrictions; access can be requested from the Hanoi University of Public Health IRB for eligible researchers.
## Clinical Analysis & Structured Key Points
Prevalence and associated factors of suicidal ideation, plans, and attempts among LGBTQ+ individuals: A cross-sectional study in Vietnam | PLOS One Browse Subject Areas ? Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click here . Article Authors Metrics Comments Media Coverage Reader Comments Figures Figures Abstract Background Suicidality is a critical public health concern among LGBTQ+ youth, yet evidence from Vietnam remains limited. This study estimated the prevalence of suicidal ideation, plans, and attempts and examined associated sociodemographic and psychological factors among Vietnamese LGBTQ+ youth. Methods We conducted a community-based, online cross-sectional survey from February to April 2025. Participants included 384 LGBTQ+ individuals aged 18–24 years residing in Vietnam. Participants were recruited through the LGBTQ+ -led or LGBTQ+ -supportive social media and community networks. Suicidality was assessed alongside symptoms of depression, anxiety, and stress using the Depression Anxiety Stress Scales (DASS-21). Monthly income was self-reported and categorized into USD bands. Multivariable logistic regression models were employed to identify factors associated with lifetime suicidal outcomes. Results The lifetime prevalence of suicidal ideation, plans, and attempts was 56.5%, 32.1%, and 16.9%, respectively. Recent (past 12 months) prevalence was 5.5%, 3.6%, and 3.1%. In multivariable analyses, stress [AOR = 4.52 (95% CI: 2.35–8.72)] and anxiety [AOR = 2.12 (95% CI: 1.03–4.34)] were associated with higher odds of suicidal ideation and plans. Anxiety emerged as the sole independent predictor of suicide attempts [AOR = 4.30 (95% CI: 1.28–14.41)]. Conversely, higher income (≥USD 386/month) and rural residence were associated with lower odds of suicidal ideation. Conclusions Suicidality is highly prevalent among this accessible, predominantly urban, and connected subpopulation of LGBTQ+ youth in Vietnam. Anxiety and stress are the most robust proximal correlates of suicidal behaviors. Suicide prevention strategies for this population must incorporate routine screening for anxiety and stress, deliver LGBTQ + -affirming care, and address underlying economic vulnerabilities. Citation: Do MT, Doan T, Pham M, Nguyen B, Hong NND, Vu K-D (2026) Prevalence and associated factors of suicidal ideation, plans, and attempts among LGBTQ+ individuals: A cross-sectional study in Vietnam. PLoS One 21(8): e0357123. https://doi.org/10.1371/journal.pone.0357123 Editor: Daryl Higgins, Australian Catholic University, AUSTRALIA Received: January 20, 2026; Accepted: August 12, 2026; Published: August 28, 2026 Copyright: © 2026 Do et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: Data cannot be shared publicly because of the sensitive nature of the information collected from LGBTQ+ individuals, who are considered a vulnerable population in Vietnam. Public availability of the data would compromise participant confidentiality and safety. The Institutional Review Board (IRB) of the Hanoi University of Public Health has imposed restrictions on data sharing to protect study participants. Data are available from the Institutional Review Board of the Hanoi University of Public Health (contact via qlkh@huph.edu.vn ) for researchers who meet the criteria for access to confidential data. Funding: This work was supported by Grand Challenges Canada awarded to Lighthouse Social Enterprise Co., Ltd (Vietnam). The publication fee is funded by Lighthouse Social Enterprise Co., Ltd. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Introduction Studies across multiple settings have documented that suicidal ideation, suicide planning, and suicide attempts are serious public health concerns among lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) young people globally [ 1 , 2 ]. Evidence consistently shows that sexual and gender minority youth experience higher levels of psychological distress and suicide-related outcomes than their heterosexual and cisgender peers, reflecting the cumulative effects of stigma, discrimination, rejection, concealment, and limited access to affirming support [ 3 , 4 ]. LGBTQ+ populations face pervasive stigma, social rejection, and legal barriers to gender-affirming care, contributing to disproportionately high rates of depression, anxiety, suicidal ideation, and substance use disorders compared with the general population [ 5 – 7 ]. Minority Stress Theory posits that chronic exposure to prejudice, discrimination, and social adversity creates sustained psychological stress, leading to poorer mental health among LGBTQ+ individuals [ 8 ]. Minority Stress Theory provides the conceptual basis for interpreting suicide-related vulnerability among LGBTQ+ youth [ 5 ]. In this study, stigma, discrimination, concealment, rejection, and limited affirming services are understood as upstream minority-stress contexts. The variables available for analysis, including sociodemographic characteristics and DASS-21 depression, anxiety, and stress symptoms, should therefore be interpreted as downstream correlates rather than direct measures of minority stress mechanisms [ 5 , 9 ]. Accordingly, the analysis focuses on observable individual-level and structural factors that may reflect the downstream impacts of minority stress in shaping suicidality [ 10 ]. Empirical evidence from diverse settings supports this conceptual framework, demonstrating disproportionately high levels of suicidality among LGBTQ+ youth exposed to minority stressors. For example, The Trevor Project’s 2021 survey in U.S. found that 40% of LGBTQ+ youth had seriously considered suicide in the past year, with rates reaching 50% among transgender and gender-diverse youth [ 1 ]. Similarly, systematic reviews of contemporary data from developed countries consistently demonstrate a disproportionate burden of psychological distress, bullying, social isolation, and lack of family support among sexual minority youth, who remain significantly more likely to report symptoms of depression and suicidal ideation compared to heterosexual peers [ 2 , 11 ]. Transgender people face this risk nearly four times higher than cisgender people (people whose gender identity matches their sex assigned at birth [ 9 ]. Factors such as family rejection, bullying, and social isolation further exacerbate these risks, often resulting in long-term consequences including chronic depression and post-traumatic stress disorder (PTSD) [ 12 , 13 ]. In East and Southeast Asian contexts, LGBTQ+ individuals often encounter unique challenges stemming from traditional norms, collectivist values, and patriarchal expectations [ 14 ]. In Vietnam, societal stigma regarding gender and sexual diversity remains widespread, driving concealment and internalized negativity [ 15 ]. A 2023 study by Lighthouse Social Enterprise reported that 60% of LGBTQ+ respondents experienced discrimination, and over half exhibited symptoms of prolonged depression [ 16 ]. School-based violence is also prevalent, with over 70% of LGBTQ+ students reporting physical or verbal abuse [ 17 ]. LGBTQ+ youth also face major challenges in limited access to sexual and reproductive health services [ 18 ]. Furthermore, financial dependence on family and low income impede access to mental health and sexual health services [ 19 , 20 ]. Healthcare providers often lack the necessary training and sensitivity to serve this population effectively, with more than 60% reporting limited knowledge and nearly 72% indicating they had never provided care to LGBTQ+ patients [ 21 ]. Despite the increasing visibility of LGBTQ+ issues in Vietnam, there is a paucity of empirical data on the mental health challenges facing this population, particularly among youth who are often excluded from national surveillance systems. To address these gaps, this study aimed to examine the prevalence of lifetime suicidal ideation, plan, attempt, and associated factors among LGBTQ+ youth in Vietnam. Guided by Minority Stress Theory, this study focuses on how proximal psychological distress (depression, anxiety, stress) and distal structural factors (e.g., income, living context) are associated with suicidal outcomes (ideation, plans, and attempts). To our knowledge, this is among the first empirical analyses focusing specifically on suicide-related outcomes among LGBTQ+ young people in Vietnam. Findings from this study will contribute to a context-specific evidence base, informing the design of culturally appropriate interventions and policy advocacy to enhance the well-being of the LGBTQ+ community. Materials and methods Study design and procedure We conducted an online cross-sectional survey using convenience sampling via social media and LGBTQ+ community networks. The Institutional Review Board approved the study protocol on February 7, 2025. Participant recruitment and data collection occurred between 26 February and 10 March, 2025; pre-approval activities were limited to internal questionnaire drafting and platform configuration, with no participant contact prior to IRB approval. Participants were recruited through three principal channels: (i) the Pride MindZ Facebook page (~12,000 followers); (ii) the social media and direct messaging channels of Lighthouse Social Enterprise; and (iii) snowball outreach via partner LGBTQ+ community-based organizations. We acknowledge that this recruitment strategy enabled access to a sensitive and hard-to-reach population but may have introduced selection bias toward participants who were urban, internet-connected, more highly educated, and already connected to LGBTQ+ community networks. Upon accessing the survey link, participants reviewed an information sheet detailing the study’s purpose, voluntary nature, and anonymity. Electronic informed consent was obtained from all participants before the survey began. The self-administered questionnaire took approximately 15–20 minutes to complete. To ensure data quality and prevent duplicate entries in the anonymous online format, a multi-step quality control protocol was implemented. At the platform level, the survey was configured to restrict submissions to one response per IP address and device. Additionally, attention-check items were embedded within the questionnaire to monitor respondent engagement. During data curation, submissions were systematically reviewed and excluded if they met any of the following criteria: duplicate IP addresses, inconsistent demographic responses, implausible completion times (e.g., completing the 15–20 minute survey in under 5 minutes), patterned response sets (e.g., straight-lining), or substantial missing data on primary outcome variables. To further encourage honest reporting on sensitive topics, no personally identifiable information was collected, and strict anonymity was maintained. Participants Eligible participants were individuals aged 18–24 years residing in Vietnam (classified as youth in accordance with the United Nations definition of 15–24 years [ 22 ] and the Vietnam Youth Law 2020 which covers individuals aged 16–30 years [ 23 ]) who self-identified as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, or other sexual/gender minorities). To estimate the required sample size, we conducted an a priori calculation using a single population proportion approach. Based on a lifetime suicidal ideation prevalence of 50.7% among LGBTQI+ people reported in a national survey in Thailand by Moallef et al. (2022) [ 24 ], a 95% confidence level, and an absolute precision of 5%, a minimum sample size of 384 was required. A total of 384 eligible individuals completed the survey and met the inclusion criteria, satisfying this requirement. Study measures Independent variables. Sociodemographic variables included age, sex assigned at birth (female reference), gender identity, sexual orientation, residence (urban/rural), migration status (resident in birthplace vs. migrated), education ( =770 USD per month [ 25 , 26 ]. Outcome variables. The primary outcomes were lifetime suicidal ideation, suicide plans, and suicide attempts. Lifetime was defined as having ever experienced the outcome at any point in one's life. Self-harm was defined as intentional self-injurious behavior without stated suicidal intent, whereas suicide attempts were defined as self-injurious behaviors with the explicit intent to die. Suicidal ideation was assessed by asking whether participants had ever seriously thought about ending their life. Suicide planning was assessed by asking whether participants had ever made a specific plan to end their life. Suicide attempt was assessed by asking whether participants had ever actively attempted to end their life. For descriptive purposes, participants who reported each outcome were further asked about timing, categorized as more than two years ago, within the past two years, within the past 12 months, or within the past three months. These recent categories were mutually exclusive descriptive categories and were not used as the primary regression outcomes because event counts were small. Exact item wording is provided in the S1 Supplementary . While we acknowledge that a validated multi-item assessment would offer greater psychometric precision, the use of a single-item measure was considered appropriate given that the primary aim of this study was prevalence estimation rather than clinical assessment. The single-item measure also is widely supported by established public health surveillance systems, such as the CDC’s Youth Risk Behavior Surveillance System (YRBSS) or the Trevor Project National Survey [ 1 , 27 ]. Additionally, this approach helps minimize participant distress and survey fatigue, and reduce dropout rates, which is a critical consideration in online research on sensitive topics. Psychological distress. Symptoms of depression, anxiety, and stress over the past week were measured using the Vietnamese version of the 21-item Depression Anxiety Stress Scales (DASS-21) [ 28 ]. Participants rated symptom severity over the past week on a 4-point Likert scale (0 = “Did not apply to me at all” to 3 = “Applied to me very much”). The Vietnamese DASS-21 has been validated in Vietnamese adolescents [ 29 ], demonstrating good reliability and a stable factor structure in this age group, which closely aligns with the developmental stage of our study population. While dedicated validation in LGBTQ+ Vietnamese youth has not yet been conducted, the strong internal consistency observed in our sample (Cronbach's α > 0.90 for all three subscales). In this study, it was used as a symptom screening tool rather than a diagnostic instrument. Statistical analysis Descriptive statistics (frequencies, percentages, means, and standard deviations) summarized demographics and mental health indicators. Prevalence rates were reported with 95% confidence intervals (CI). Bivariate analyses (chi-square, Fisher’s exact tests, t-tests) were used to screen for associations. Variables were selected using the Purposeful Selection approach of Hosmer, Lemeshow [ 30 ]. Candidate variables with univariable Wald p 0.10 were considered for removal but were retained if their exclusion changed any remaining coefficient by ≥ 20% (indicating confounding). Variables excluded at the univariable stage were then re-evaluated and re-added if p < 0.10. Multicollinearity was assessed via variance inflation factor (VIF), with VIF ≥ 5 considered moderate and ≥ 10 severe. Model goodness-of-fit was evaluated using the Hosmer–Lemeshow test and Nagelkerke pseudo-R 2 . Model robustness was assessed using the events-per-variable (EPV) ratio, with an EPV ≥ 10 considered optimal. All analyses were conducted using Stata 18.0 software, with a two-tailed p-value of less than 0.05 regarded as statistically significant. Ethical considerations The study protocol was reviewed and approved by the Institutional Review Board of the Hanoi University of Public Health (Decision No. 29/2025/YTCC-HD3, dated February 7, 2025). The study was conducted in accordance with the Declaration of Helsinki. Prior to data collection, all participants were provided with detailed information about the study's purpose, confidentiality, and their rights. Participants provided electronic informed consent by clicking an “I Agree” button before accessing the survey questions. Participation was entirely voluntary, and respondents could withdraw from the survey at any time without consequence. Strict confidentiality and anonymity were maintained throughout the data collection and analysis process. Before proceeding to subsequent sections, participants were asked to answer a check-in question to confirm their willingness and ability to continue with the questionnaire. Because the questionnaire included sensitive questions on self-harm and suicide-related experiences, participants were provided with information on LGBTQ + -affirming mental health support and referral options. Participants who reported distress or suicide-related concerns during study participation were encouraged to seek support from qualified professionals and community-based support services. Participants reporting distress were provided with information on mental health support services and crisis hotlines. No adverse events were reported during the data collection period. Results Demographic characteristics As shown in Table 1 , the study included 384 participants with a mean age of 21.3 years (SD = 1.8). The vast majority resided in urban areas (94.5%) and had a history of migration (66.9%). Regarding education, 71.9% held a university or college degree. In terms of relationships, 65.1% were single, while 33.3% were dating. More than half of the participants lived with family (53.9%). Financially, 53.4% reported a monthly income of less than USD 193, and 18.0% reported insufficient funds for basic expenses. The sample was predominantly assigned female at birth (60.9%). Regarding gender identity, 44.8% identified as cisgender women, 31.8% as cisgender men, and 18.8% as non-binary. Sexual orientation was primarily gay/lesbian (54.7%) or bisexual (29.4%).The sample was predominantly urban, university/college educated, and assigned female at birth. These characteristics should be interpreted as reflecting an online-recruited accessible sample rather than population-level estimates for all LGBTQ+ youth in Vietnam. Download: PNG larger image TIFF original image Table 1. General demographic characteristics (N = 384). https://doi.org/10.1371/journal.pone.0357123.t001 Prevalence of suicidality Lifetime prevalence was 56.5% (95% CI: 51.5–61.5; n = 217) for suicidal ideation, 32.0% (95% CI: 27.4–37.0; n = 123) for suicide plans, and 16.9% (95% CI: 13.4–21.0; n = 65) for suicide attempts. Recency categories were mutually exclusive, with the “past 12
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