Understanding the processes underlying self-harm ideation and behaviors within LGBTQ+ young people: A qualitative study

Abstract

Objective

This study aims to understand the processes underlying self-harmful thoughts and behaviors, with and without suicidal intent, among LGBTQ+ young people.

Method

Nineteen semi-structured interviews took place between October 2019 and May 2020. Participants were aged between 16 and 25 years, had experiences of self-harm ideation and behaviors, and were part of the LGBTQ+ umbrella. A range of sexualities and gender identities were represented: eleven participants were cisgender, six were transgender and two were non-binary. Interviews were transcribed verbatim and anonymised. Thematic analysis and reflective member-checking were used to develop a thematic framework.

Results

Three themes were developed from the interviews and evaluated by four participants who engaged with reflective member-checking. Findings indicated that internal processes and external responses to being LGBTQ+ resulted in self-harmful thoughts and behaviors. Alongside these, additional stressors related to being a young person were led to difficulties with self-harm.

Conclusions

Findings from this study indicate that young people often struggle with accepting their LGBTQ+ identity for a number of reasons, whether this is due to access to a resource or their own feelings about their identity. These negative self-perceptions can be enhanced by poor responses from others and additional life stressors which impact their self-esteem or self-perception.

HIGHLIGHTS

• Understanding and accepting that one is LGBTQ+ is not always a simple process, struggling with these thoughts can influence self-harm.

• Lack of LGBTQ+ terminology hinders self-acceptance and caused young people to engage with self-harm.

• Peers and family members responses to a young people’s LGBTQ+ identity is highly significant and can directly led to self-harmful thoughts and experiences.

Keywords:

• Gender identity
• self-harm
• sexual orientation
• suicide
• thematic analysis

DISCLOSURE STATEMENT

No potential completing interest was reported by the author(s).

AUTHOR NOTES

A. Jess Williams, Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK, Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK. Jon Arcelus, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, UK. Ellen Townsend, Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK, and Maria Michail, Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.

Additional information

Funding

This project was funded as part of an Economic and Social Research Council grant on the Doctoral Training Pathway. The lead author, A. Jess Williams, receives a student stipend from the ESRC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.