Disparities in non-suicidal self-injury by sexual orientation identity: Results from the 2007 Massachusetts Youth Risk Behavior Survey (MYRBS)

Background: Community-based studies have found lesbian, gay, and bisexual (LGB) youth face increased risk for engaging in non-suicidal self-injury (NSSI) relative to their same-age heterosexual peers; however, few population studies have investigated these disparities. Methods: Data were from the 2007 Massachusetts Youth Risk Behavior Survey, with a representative sample of 2,869 high school students (4.9% LGB; 50.4% female; 26.3% racial/ethnic minority; 52.4% grades 9th/10th). Weighted logistic regression models examined differences in NSSI in the past 12 months (single item screening question) by sexual orientation identity and potential protective supports. All models were adjusted for grade-level, sex, race/ethnicity, bullying, binge drinking, regular drug use, and depression. Results: 47.3% of LGB-identified youth engaged in self-harm in the past 12 months compared to 14.7% of heterosexuals (16.3% overall). LGB youth were at increased risk for self-harm (adjusted odds ratio (aOR)=2.4; 95% CI=1.6, 3.7) compared to heterosexuals. Also associated with an increased odds of NSSI (p<0.01) were lower grade-level, female sex, having been bullied, regular drug use, and depression. School (p<0.05) and family support (p<0.0001) were protective factors. Community engagement and participation in sports teams were not significantly protective. No differences were found in self-harm behaviors by race/ethnicity. Conclusion: Significant disparities exist for NSSI by sexual orientation identity. School and family support offer significant protection that attenuate vulnerability for self-harm. Increased awareness of the high prevalence of self-harm behaviors among LGB youth, as well as the protective quality of social support, could lead to better detection and prevention among at-risk adolescents.