Many studies have been conducted to determine risk factors for suicide among adolescents. Population-based research has identified recognized risks for suicide attempts, including gender, race/ethnicity, history of depression, hopelessness, alcohol and other drug use, sexual activity, and violence/victimization.8- 12 Factors that may exacerbate these risks include underlying psychological stresses, such as marginalization, isolation, and rejection.13- 15 Homosexuality has also been suggested as a risk factor for youth suicide.16- 19 Gay, lesbian, bisexual, and not sure (GLBN) youth frequently encounter many of the environmental stresses thought to exacerbate suicidality16- 22; however, studies of suicidality among gay youth have been difficult, because of the social stigma associated with both topics. With one exception, studies examining the relationship of suicide with sexual orientation have been limited to small samples that may not be representative of nonheterosexual youth as a group. Recently, an important population-based study by Remafedi et al22 showed sexual orientation to be a significant risk factor for suicide attempts among youth; however, this 1987 data set lacked the ability to examine the association between sexual orientation and suicide risk within the context of other possible confounding and mediating variables, such as substance use, sexual activity, and violence/victimization.