4 - (SYM 129) Gender Acceptance and Congruence as Protective Factors for Non-suicidal Self-injury Among Transgender and Gender Diverse Adults

Transgender and gender diverse (TGD) individuals have high rates of non-suicidal self-injury (NSSI), or the deliberate destruction of one’s own bodily tissue without suicidal intent (Nock et al., 2010). Previous research has found that approximately 40% (Brennan et al., 2017; dickey et al., 2015) to 53% (Jackman et al., 2018) of TGD adults have engaged in NSSI behaviors during their lifetime, which is considerably higher than the lifetime NSSI rate of 5.5% found in the general adult population (Swannell et al., 2014). Previous research on NSSI among TGD people has identified gender dysphoria, or the discomfort/distress experienced when an individual’s gender identity and sex assigned at birth are not aligned (Coleman et al., 2022), as a risk factor for NSSI (Vigny-Pau et al., 2021). However, there is a lack of research on resilience factors associated with one’s TGD identity that may protect against NSSI, including gender congruence (the opposite of gender dysphoria) and gender acceptance. Therefore, the present research examined the association between gender congruence and gender acceptance and NSSI frequency and versatility (i.e., number of NSSI methods), respectively.

Participants were 180 TGD adults recruited from Reddit.com. Participants completed online questionnaires on lifetime NSSI behaviors (Inventory of Statements about Self-Injury; Klonsky & Glenn, 2009) and gender congruence and acceptance over the past two weeks (Transgender Congruence Scale; Kozee et al., 2012). First, two separate linear regressions conducted with the full sample showed that gender congruence and acceptance were not significantly associated with NSSI frequency or versatility (all p’s > .16). Analyses were repeated among just those participants who had a history of engaging in NSSI (n = 160). Gender congruence was associated with increased NSSI versatility, b = -0.16, t = -2.03, p = .045, while gender acceptance was not, b = 0.03, t = 0.38, p = .70. Gender congruence was also associated with increased NSSI frequency, b = -0.20, t = -2.53, p = .01, while gender acceptance was not, b = 0.02, t = 0.20, p = .84.  These findings suggest that, among TGD adults who have engaged in NSSI, increased gender congruence protects against NSSI behaviors. This work has considerable clinical and policy implications, including highlighting the importance of providing gender-affirming care to TGD individuals that facilitates access to desired medical interventions.