A QUALITATIVE STUDY OF DELIBERATE SELF-HARM AND CONTROL AMONG SEXUAL AND GENDER MINORTIY PERSONS: NEGOTIATING THE HEALTHCARE SYSTEM

Abstract

Both non-suicidal and suicidal deliberate self-harm (DSH) are a significant cause of death among people of all ages, races, genders, and socioeconomic status. The risk for DSH is known to be particularly elevated among individuals from sexual and gender minority groups, yet potential benefit from contact with the healthcare system may be adversely impacted by a person’s experiences and stigmatization within the healthcare system. Semi-structured, open-ended interviews were conducted with four participants to explore the experiences of gay, lesbian and agender persons and how these experiences may have affected their DSH behaviour and interactions with the healthcare system when seeking treatment. Interviews yielded rich and compelling narratives, which after analysis using Interpretive Phenomenological Analysis were consistently linked back to issues of control, more specifically, a lack of control, struggles to reclaim control and successes in establishing control. Results indicate that participants often felt out of control prior to and/or after engaging in DSH and while interacting with the healthcare system. Participants described feeling stigmatized, misunderstood, and judged by healthcare staff, but also described many successes in managing their and healthcare challenges. Suggestions for improved care include greater education and knowledge of healthcare providers about DSH and sexual and gender minority issues, improved active listening skills of providers and opportunities for peer counseling within this vulnerable group.