Nonsuicidal self-injury (NSSI) amongst LGBT+ young adults: The role of psychological distress

Rates of nonsuicidal self-injury (NSSI) among lesbian, gay, bisexual, transgender, and other sexual or gender minority (LGBTQ+) young adults are high. Research is needed to elucidate potential mechanisms underpinning this elevated risk. In 2021, young adults in the United Kingdom and United States (n = 1475, aged 18-30) reported their NSSI history and psychological distress (Kessler Psychological Distress Scale) in an online survey. Participants were cisgender heterosexual (CH; n = 1100), cisgender sexual minority (CSM; lesbian, gay, bisexual, asexual) (n = 272), or gender minority (GM; transgender, non-binary) (n = 103). Rates of lifetime NSSI and psychological distress were significantly higher for GM participants than CSM participants (NSSI: OR = 2.68, p < 0.001 | Distress: Coef. = 5.22, p < 0.001), and significantly higher for CSM participants than CH participants (NSSI: OR = 3.39, p < 0.001, | Distress: Coef. = 3.08, p < 0.001). Cross-sectional mediational models (i.e., associational variable analysis) revealed that psychological distress partially accounted for the relationship between identity group and lifetime NSSI in a stepwise fashion, contributing to higher NSSI in the GM group compared to the CSM group, and higher NSSI in the CSM group compared to the CH group. Findings suggest GM young people are at elevated risk of NSSI and psychological distress relative to both CSM and CH peers, and disparities in distress levels may be a key driver of disparities in NSSI rates. While longitudinal mediation models are needed to verify this mechanism, findings support interventions aimed at reducing psychological distress and NSSI among LGBTQ+ young people.