Understanding suicide risk among LGBTQ+ youth in Peru: Findings from a nationwide mental health survey.

LGBTQ+ youth globally face increased suicide risk, yet evidence from Latin America, particularly Peru, is limited. Understanding factors influencing suicidality among LGBTQ+ youth in Peru is essential for developing culturally relevant interventions. This study analyzed data from The Trevor Project's 2024 Peru National Survey on the Mental Health of LGBTQ+ Young People (N = 4,643; age 14-24, mean age = 17.34). Logistic regression models examined associations between suicide-related outcomes (lifetime and past-year suicidal ideation, past-year suicide attempts), and positive screens for depressive and anxiety symptoms, mental healthcare desire, sexual orientation "outness" and perceived community acceptance. Approximately 73.5% reported lifetime suicidal ideation, 55.0% past-year ideation and 37.1% past-year attempts. Positive screens for depressive and anxiety symptoms were associated with higher odds of suicidality (aOR range: 1.80-2.88). Compared to youth who did not desire care, both unmet (aOR range: 1.64-2.16) and met (aOR range: 1.26-1.36) mental healthcare desire were associated with higher odds of suicidality, with unmet need showing stronger effects. Higher outness (aOR range: 1.56-1.75), younger age (14-17 years), and gender diversity were associated with higher odds of suicidality. Findings highlight the urgent need for accessible, identity-affirming mental health interventions in Peru, tailored to developmental stages and responsive to the stressors faced by LGBTQ+ youth.