Emergency department (ED) visits for suicidal ideation among adolescents have increased over the past two decades, with a higher risk among gender-diverse youth. However, limited evidence describes how these trends vary by race and ethnicity among adolescents with ICD-10 gender identity-related diagnoses in the United States (US). To address this gap, this review aimed to synthesize evidence on ED utilization and suicidality patterns across racial and ethnic groups among gender-diverse adolescents.
We conducted a scoping review using PubMed, Google Scholar, and Scopus for studies published between 2005 and 2025 with terms LGBTQ+, gender identity, suicidality, emergency department, adolescents, and United States. Of 1047 records identified, 272 underwent full-text review after applying inclusion criteria (US-based, English-language, adolescent population, and focus on suicidality or ED use). A total of 29 studies were included and categorized by ED utilization patterns, mental health outcomes, and disparities across gender identity and race/ethnicity.
Findings show elevated suicidality and ED utilization among gender-diverse adolescents, with key themes including higher psychiatric ED use and hospitalization, variability in suicide risk screening, and the impact of social determinants such as discrimination and access to affirming care. Intersectional disparities by race and ethnicity remain underexplored, and inconsistent demographic reporting limits comparability across studies.
Current evidence is limited by heterogeneous methodologies, inconsistent demographic reporting, and retrospective data analysis. Future research should prioritize intersectional, prospective approaches with improved measures to inform equitable policy, resource allocation, and affirming care for gender-diverse youth across racial and ethnic groups.
We conducted a scoping review using PubMed, Google Scholar, and Scopus for studies published between 2005 and 2025 with terms LGBTQ+, gender identity, suicidality, emergency department, adolescents, and United States. Of 1047 records identified, 272 underwent full-text review after applying inclusion criteria (US-based, English-language, adolescent population, and focus on suicidality or ED use). A total of 29 studies were included and categorized by ED utilization patterns, mental health outcomes, and disparities across gender identity and race/ethnicity.
Findings show elevated suicidality and ED utilization among gender-diverse adolescents, with key themes including higher psychiatric ED use and hospitalization, variability in suicide risk screening, and the impact of social determinants such as discrimination and access to affirming care. Intersectional disparities by race and ethnicity remain underexplored, and inconsistent demographic reporting limits comparability across studies.
Current evidence is limited by heterogeneous methodologies, inconsistent demographic reporting, and retrospective data analysis. Future research should prioritize intersectional, prospective approaches with improved measures to inform equitable policy, resource allocation, and affirming care for gender-diverse youth across racial and ethnic groups.