Voice and silence: An exploration of sexual orientation and non-suicidal self-injury

Abstract

Elevated rates of non-suicidal self-injury (NSSI) have been reported among lesbian, gay, bisexual, queer, or questioning (LGBQ) individuals compared to their heterosexual counterparts, but it remains unclear why rates of NSSI may be higher in this population. Using quantitative and qualitative methods, this study explored the role of silencing, a perceived lack of ability to be open and express oneself in social relationships, and how this may be associated with NSSI among LGBQ young adults. Using quantitative data collected from 107 LGBQ young adults with and without a history of NSSI in Part 1, general silencing in relationships was associated with NSSI outcomes through its effect on emotion dysregulation. Silencing specifically pertaining to one’s sexual orientation was associated with the number of NSSI methods through its impact on emotion dysregulation, but was not significantly associated with lifetime NSSI frequency. Results highlight the potential importance of authenticity in social relationships as a way to mitigate NSSI risk and the need to further explore the relation between authenticity in social relationships and emotion dysregulation. Part 2 was conducted with the goal of exploring how one’s sexual identity may or may not be associated with experiences of silence among those with a history of NSSI. Eighty-eight textual narratives provided by LGBQ young adults with a history of NSSI were thematically analyzed using a top-down approach informed by a theoretical framework of voice and silence. Themes of voice (i.e., group identification, acceptance from others, self-acceptance) and silence (i.e., explicit references to silence, fear, shame, sexual prejudice, and the presumption of heterosexuality) were extracted from participants’ self-defining memories relating to their sexual orientation. Analysis of participants’ self-defining memories demonstrated the prevalence of silence as it relates to their sexual orientation and the empowerment that is experienced through voice. Results also highlight the impact of social interactions and the sociocultural environment on the development of one’s sexual identity. Clinically, this research underscores the potential importance of social support in mitigating NSSI risk, safe and accepting spaces in which to explore one’s sexual identity, and points to the possible utility of narratives in the context of therapy.