Associations between suicidality and bullying victimization differ by sex and sexual orientation among U.S. high school students, 2011–2023

INTRODUCTION: Cyberbullying and school bullying among adolescents continues to increase, and is associated with academic difficulties, isolation, anxiety, and depression, and in severe cases, self-harming or suicidal thoughts and behaviors. Yet effects of bullying victimization on suicidality in American youth, especially differences by sex, race and orientation, remain largely unquantified. METHODS: We analyzed Youth Risk Behavior Surveillance System (YRBSS) data from U.S. high school students (N = 94,492), first examining temporal trends in suicidality by bullying exposure from 2011 to 2023, with attention to changes before and after the COVID-19 pandemic. We then examined adjusted associations between cyberbullying, bullying, and suicidality, assessing effect modification by sex, sexual orientation and race. RESULTS: Both cyberbullying and school bullying were significantly associated with increased odds of suicidality. Temporal analysis shows a post-2020 peak in the associations. While females had higher overall suicidality, bullying showed stronger relative effects among males, challenging assumptions about gender vulnerability. Bullying was associated with suicidality across sexual orientation groups, with bisexual students exposed to cyberbullying showing the highest adjusted odds, echoing research on sexual minority youth mental health disparities. Racial and ethnic subgroup analyses also indicated elevated risk among Indigenous and multiracial adolescents. CONCLUSIONS: Cyberbullying is significantly associated with increased suicidality risk among adolescents, highlighting the need for targeted support for vulnerable groups. Findings suggest two key dimensions of risk: persistent effects of bullying and population-level shifts in suicidality risk over time. Addressing both requires intersectional strategies to strengthen school climates and expand access to culturally and developmentally appropriate care.