Background: Guided by an ecological systems theory (EST) framework, the purpose of the present study was to investigate how multiple micro, mezzo, and macro factors influence the suicidality continuum from suicidal ideation to suicide attempt among Latinx LGB (lesbian, gay, and bisexual) youth living in the United States. Methods: Data for this cross sectional-study included 451 participants who self-identified as Latinx LGB on the 2017-National Youth Risk Behavioral Survey. The analysis explored micro, mezzo, and macro-level factors’ association with three suicidality outcomes (ideation, planning, and attempt) at the bivariate and multivariate level. Since the outcome variables were dichotomized, univariate logistic regressions and backward elimination logistic regressions were used. Results: The most commonly reported suicidal behavior was ideation (n = 173; 40%), followed by planning (n = 150; 34%), and then attempt (n = 64; 21%). Findings from the backward elimination logistic regression on suicidal ideation suggest the best set of independent variables are being bullied at school (odds ratio [OR] = 2.81; CI: 1.61–4.89), experiencing sexual assault (OR = 2.32; CI: 1.32–4.07), experiencing depressive symptoms (OR = 1.99; CI: 1.07– 3.69), being cannabis use (OR = 1.76; CI: 1.08–2.89), and being female (OR = 1.72; CI: 1.01–2.93). For suicide planning the model suggested, experiencing depressive symptoms (OR = 3.21; CI: 1.74–5.91), cannabis use (OR = 2.46; CI: 1.49–4.07), being bullied at school (OR = 2.04; CI: 1.17–3.58), and experiencing sexual assault (OR = 1.88; CI: 1.07–3.31) exhibited the strongest relationships. Suicide attempt was significantly associated with cannabis use (OR = 3.12; CI: 1.60–6.08), experiencing depression (OR= 2.89; CI: 1.30–6.43), experiencing sexual assault (OR = 2.77; CI: 1.34–5.71), and being bullied at school (OR = 2.34; CI: 1.12–4.91). Conclusion: Given the findings of this study, it is essential that tailored suicide prevention efforts be established that uniquely address the intersections of race/ethnicity and sexual orientation and how this intersection influences micro, mezzo, and macro factors associated with suicide ideation, planning, and attempt among Latinx LGB adolescents.

Latino communities in the United States (U.S.) have long endured trauma due to multiple intersecting social and political forces. New restrictive immigration policies since 2016 and the COVID-19 pandemic have each created novel stressors for Latino communities, while escalating the risk of mental health disorders and highlighting the communities' vulnerabilities. The effects of these stressors have been particularly pronounced in southeastern states, such as Tennessee and Georgia, due to their state-level anti-immigrant legislation. Yet, we lack sufficient data to understand how these factors present among Latinos seeking services. To focus attention on the specific experiences of Latino communities living in the U.S. Southeast, the authors analyzed the perspectives of 44 service providers working with these communities in the region using qualitative data collected in an online survey administered during the COVID-19 pandemic and while President Trump's exclusionary immigration policies were in force. Four themes were identified: (1) Latino communities' strengths; (2) impact of the Trump administration on Latino communities; (3) impact of COVID-19's on Latino communities; and (4) strategies to enhance service delivery in Latino communities. Results provide meaningful data to inform micro- and macro-level service delivery in two exclusionary policy states and beyond. Findings suggest future research should include other new immigrant destinations and explore perceptions of Latino community members.