Cross-Sectional Relationships Between Gender, Disordered Eating Behaviors, and Suicide Among High Schoolers in Colorado

Though transgender and gender diverse (TGD) youth are disproportionately affected by suicide and disordered eating, little research has explored the relationship between the two using state-level data. This exploratory study examined whether disordered eating behaviors moderate the observed relationship between gender and suicide among adolescents. Multivariate logistic regression was performed on the population-based 2023 Healthy Kids Colorado Survey (HKCS) data ( N = 49,989) to test whether the odds of suicide ideation and attempt differed by gender groups, and modeling was carried out to examine the moderation of these relationships by disordered eating behaviors. Additionally, analyses were replicated among only gender minority groups ( n = 2486). Compared to cismale students, the prevalence of disordered eating was higher among all other gender identities. There was a significantly higher risk of suicidal ideation and attempts among transfemale, transmale, nonbinary and gender-questioning students. Disordered eating did not significantly moderate the relationship between gender and suicide outcomes. These findings underscore the heightened vulnerability of TGD youth to disordered eating and suicidal behaviors while suggesting that disordered eating may not be a pathway through which gender relates to suicide outcomes.