Approximately one million people die by suicide annually worldwide. Yet current suicide prediction and prevention tools are inadequate, and suicide rates are increasing in the United States. Certain populations are known to have especially high rates of suicide, including sexual minority and rural populations. However, little research has examined rural sexual minorities to see if risk may be compounded for this group. The research on sexual minority suicide has identified several factors that may be important mediators and moderators of suicide risk in this group. Specifically, victimization has been identified as a factor that may mediate the risk of suicide among sexual minorities. Additionally, evidence suggests depression may mediate the risk between victimization and suicide among sexual minorities. Finally, studies have demonstrated that social support may act as a protective factor against suicide risk. The current study examined an integrated model of suicide risk among sexual minorities across rural, suburban, and urban settings. The current study suggests that that rurality has an indirect effect on suicidal thoughts through victimization and, subsequently, through depression. The combination of rurality, victimization, and depression also predicts suicide attempts, but they do not exert their influence through the hypothesized path. Further, the models testing whether social support moderated the association between victimization and depression demonstrated poor model fit and could not be interpreted.

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