Toward a social ecological understanding of nonsuicidal self-injury in sexual and gender minority individuals: A scoping review.

Nonsuicidal self-injury (NSSI; i.e., intentional, self-inflicted destruction of body tissue without suicidal intention) is a growing mental health concern in the United States. In 2013, NSSI was reclassified in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) as a condition for further study, external to its previous classification as a symptom of borderline personality disorder. NSSI is stigmatized due to its self-inflicted nature, which may be exacerbated among individuals holding multiply marginalized identities, like sexual and gender minority (SGM) populations. Often evaluated at the individual level, little is understood about the multilevel social factors that shape SGM individuals' vulnerability to NSSI. We conducted a scoping review of articles across five databases. We included all 2013-2023 U.S. studies published in English that evaluated NSSI as a behavioral outcome among SGM populations. We leveraged a social ecological perspective to evaluate studies for the social and behavioral factors linked to NSSI. Our review yielded NSSI correlates at the individual level (e.g., institutional discrimination). The studies mainly had correlates of NSSI concentrated at the individual and interpersonal level. In contrast, there was extremely limited attention given to communal- and societal-level correlates. Prior studies suggest that minority stressors unique to SGM communities (e.g., heterosexism and transphobia) are robust correlates of NSSI. We advocate for a prioritized focus on interventions that combine destigmatizing SGM identities and NSSI while addressing the underlying and intersecting social forces that impact SGM individuals' decisions to engage in these behaviors. (PsycInfo Database Record (c) 2026 APA, all rights reserved).