An Intersectional Modeling of Risk for Nonsuicidal Self-Injury Among LGBTQ Adolescents: Demographics, Bullying Victimization, Mental Health, and IPV

Background and Purpose

Non suicidal self-injury (NSSI) involves the deliberate destruction of one’s own bodily tissue without lethal intent and includes behaviors such as cutting, burning, scratching, and hitting. Between 7-14% of adolescents engage in NSSI, with prevalence varying based on risk factors such as dating violence as well as across demographic groups. LGBT populations are at significantly increased levels of risk compared to their heterosexual peers. Additionally, transgender individuals experience higher rates of NSSI in comparison to other groups within the LGBT community. However, most studies of NSSI combine LGBT respondents into one group or fail to recognize the relationship between the two by treating sexual orientation and gender identity as discrete variables. In this study, we use an intersectional approach predict the likelihood of engaging in NSSI.

Methods

This study uses the 2015 Healthy Kids Colorado Study (N = 10,330), a statewide representative survey, to explore the relationship between bullying and NSSI behavior to determine the likelihood of experiencing NSSI by demographics including the intersection of sexual orientation and gender identity, bullying victimization, and other known risk factors. Logistic regression models are used to predict the likelihood of NSSI (a) by demographics only (age, race/ethnicity, sex assigned at birth), (b) by demographics and the intersection of sexual orientation and gender identity, (c) by adding bullying victimization (face-to-face, online, due to race, due to sexual orientation) to the previous model, (d) by adding known risk and protective factors (recent alcohol use, dating violence, suicide attempt, recent depression), and then finally by including all the above variables.

Results

Results indicate that Latinx and Black students are less likely to engage in NSSI compared to White students. Respondents reporting a male sex assigned at birth are less likely to engage in NSSI compared to respondents assigned female at birth. Compared to cisgender heterosexual respondents, all intersectional sexual and gender minority identity groups have significantly elevated odds of engaging in NSSI ranging from almost two times to nearly nine times as likely to engage in NSSI. Those bullied in school, online, and those bullied due to their sexual orientation were approximately 1.5 times more likely to engage in NSSI. Those with recent depression, recent alcohol use, recent dating violence, and past suicide attempts were more likely to self-harm while those who had a caring adult were half as likely to self-harm.

Conclusion and Implications

These results indicate a need for prevention services focusing on LGBT youth that are culturally competent and targeted at risk and protective factors related to NSSI for this population. In addition, creating protective factors that strengthen connectedness to social supports such as family, teachers, and school safety officers may have an impact in preventing NSSI in the LGBT community. Finally, the results illustrate the importance of an intersectional approach to modeling risk and resilience in the LGBTQ community.