Prevalence and Correlates of Nonsuicidal Self-Injury Among Transgender People: Results from a U.S. Probability Sample

Nonsuicidal self-injury (NSSI), intentional harm to the body without intent to die, is a major public health concern. Transgender people may be at higher risk for NSSI compared to cisgender peers, but evidence is limited regarding prevalence, demographic correlates, and risk factors. This study is the first to examine NSSI in a probability sample of the U.S. transgender population. We analyzed data from the first U.S. nationally representative sample of transgender people which was recruited through random-digit-dial methods and address-based sampling. Using logistic regression, we examined associations between demographic factors, minority stress processes, early life adversity, and lifetime history of NSSI. The sample consisted of 270 transgender individuals; 144 (53.3%) were transfeminine or nonbinary assigned male at birth and 126 (46.7%) were transmasculine or nonbinary assigned female at birth. The mean age was 34.2 (SD = 17.1, range: 18-81); 68.5% identified as non-Hispanic White and 31.5% as Black, Latino, or multi-race. NSSI was reported by 50% of the sample. Victimization and discrimination, adverse childhood experiences, lower nonconformity in childhood gender expression, and transgender community connectedness were associated with higher odds of NSSI. NSSI is common among transgender people in the U.S. Victimization and discrimination, adverse childhood experiences, and factors related to gender identity development may increase vulnerability to NSSI. Additional research is needed to better understand the relationships between these variables and NSSI. Findings can inform tailored interventions to address specific risk factors that affect this population.