Archives of Sexual Behavior

, Volume 48, Issue 1, pp 89–111 | Cite as

A Systematic Review and Meta-Analysis of Disparities in the Prevalence of Suicide Ideation and Attempt Among Bisexual Populations

  • Travis SalwayEmail author
  • Lori E. Ross
  • Charles P. Fehr
  • Joseph Burley
  • Shayan Asadi
  • Blake Hawkins
  • Lesley A. Tarasoff
Special Section: Bisexual Health


Sexual minorities are at increased risk of suicide; however, it is unclear whether there are within-sexual minority differences in risk across specific sexual identities—notably between bisexual and lesbian/gay subgroups. We therefore conducted a systematic review and meta-analysis to quantify associations between bisexual identity and self-reported suicide ideation and attempt and the moderation of these associations by gender/sex, age, sampling strategy, and measurement of sexuality. Abstracts and full texts were independently screened by two reviewers, resulting in a total of 46 studies that met inclusion criteria and reported 12-month or lifetime prevalence estimates for suicide ideation or attempt. A consistent gradient was observed across all four outcomes, whereby bisexual respondents reported the highest proportion of suicide ideation or attempt, lesbian/gay respondents the next highest proportion, and heterosexual respondents the lowest proportion. Random-effects meta-analysis comparing bisexual individuals with lesbian/gay individuals yielded odds ratios (ORs) ranging between 1.22–1.52 across the four outcomes examined. Between-study variability in ORs was large. Thirty-one percent of heterogeneity was explained by sample type (e.g., probability vs. non-probability) and 17% by gender/sex. ORs were consistently larger for women (range: 1.48–1.95, all statistically significant at p < .05) than for men (range: 1.00–1.48, all p > .05), suggesting that gender/sex moderates the association between bisexual identity and suicide risk. Within-sexual minority differences in suicide risk may be attributed to structural and interpersonal experiences of monosexism, bisexual erasure and invisibility, or lack of bisexual-affirming social support, each of which may be experienced differently across gender/sex identities.


Suicide Bisexual Sexual orientation Mental health Meta-analysis 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study used secondary data; as such, ethical approval was not required.

Supplementary material

10508_2018_1150_MOESM1_ESM.docx (2 mb)
Supplementary material 1 (DOCX 2010 kb)


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Authors and Affiliations

  1. 1.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  2. 2.Clinical Prevention ServicesBC Centre for Disease ControlVancouverCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada

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