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However, little is known about how LGBTQ+ youth seek help when experiencing suicidality. This constructivist grounded theory study examines the help-seeking processes of rural LGBTQ+ youth experiencing suicidality. Drawing on semi-structured interviews with 15 rural-based LGBTQ+ youth (aged 16\u201325) in Quebec, Canada, we inductively developed the Theory Map of Suicidality Help-Seeking among Rural LGBTQ+ Youth. This theory conceptualizes help-seeking as a cyclical and iterative social process shaped by the interplay between constraints and agency. The first thematic process, concealing LGBTQ+ identities and suicidality, showed how rural conservative social norms (particularly cis-heteronormative expectations) led participants to conceal both their LGBTQ+ identity and their suicidal distress, thereby delaying help-seeking. The second process, confronting systemic barriers, captured how participants confronted geographic isolation, limited availability of formal mental health resources, and inconsistent LGBTQ+ competence among providers. The third process, bridging support, highlighted how participants adjusted to navigate community-based strategies, online resources, and trusted adults to bridge informal supports. Taken together, these processes reveal that help-seeking for suicidality among rural LGBTQ+ youth is dynamic and indelibly shaped by social and structural rural contexts. The Theory Map of Suicidality Help-Seeking among Rural LGBTQ+ Youth offers insights to guide tailored suicide prevention interventions that align with and respond to the unique help-seeking experiences of rural LGBTQ+ youth.<\/jats:p>","DOI":"10.1177\/10497323261470619","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:39:02Z","timestamp":1787240342000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Help-Seeking for Suicidality Among Rural LGBTQ+ Youth: A Constructivist Grounded Theory Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1867-8649","authenticated-orcid":false,"given":"Simon","family":"Ouellet","sequence":"first","affiliation":[{"name":"\u00c9cole de sant\u00e9 publique de l'Universit\u00e9 de Montr\u00e9al"},{"name":"Centre de Recherche en Sant\u00e9 Publique, Universit\u00e9 de Montr\u00e9al et Sant\u00e9 Qu\u00e9bec, Centre-Sud-de-l\u2019\u00cele-de-Montr\u00e9al \u2013 Universitaire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-4907","authenticated-orcid":false,"given":"Hannah","family":"Kia","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9029-4003","authenticated-orcid":false,"given":"John L.","family":"Oliffe","sequence":"additional","affiliation":[{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-4757","authenticated-orcid":false,"given":"Olivier","family":"Ferlatte","sequence":"additional","affiliation":[{"name":"\u00c9cole de sant\u00e9 publique de l'Universit\u00e9 de Montr\u00e9al"},{"name":"Centre de Recherche en Sant\u00e9 Publique, Universit\u00e9 de Montr\u00e9al et Sant\u00e9 Qu\u00e9bec, Centre-Sud-de-l\u2019\u00cele-de-Montr\u00e9al \u2013 Universitaire"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/rmh0000068"},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/07067437211053300"},{"key":"e_1_3_7_4_1","volume-title":"LGBTQ+ youth in rural schools and communities","author":"Blackburn M. 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