Enhancing Classification of Sexual Orientation and Gender Identity Information Among Suicide Decedents Reported in the National Violent Death Reporting System, 2003-2021.

We developed and refined a systematic keyword search process to flag sexual orientation and gender identity indicators in National Violent Death Reporting System suicide narratives (2003-2021). Applying this process to 298 662 records resulted in 2580 records being flagged for review; 1221 (47%) were classified as sexually or gender minoritized (SGM), increasing the sample of identified SGM decedents by 32%. Our findings highlight persistent failures in accurate surveillance, limiting understanding of SGM suicide mortality. Narrative review methods enhance SGM identification and can improve evidence-based suicide prevention and public health policy. (Am J Public Health. Published online ahead of print April 23, 2026:e1-e6. https://doi.org/10.2105/AJPH.2026.308460).