Reading Time: 7 minutes Coming out and sharing your authentic self with others is something to be celebrated. But doing so in an unsupportive environment is cause for lots of anxiety. Mentally prepare yourself with these cope-ahead tips.
Reading Time: 5 minutes Find an inclusive community, mentorship programs, and even financial support at the campus diversity office.
Reading Time: 8 minutes Our “sexpert” answers your questions on how to talk to your partner about sexual history, STI/STD status, and having safer (and enjoyable) sex.
Reading Time: 9 minutes A transgender person shares their story about why gender isn’t binary (e.g., boy/girl), and how you can be a supportive ally.
Reading Time: 10 minutes Certain sexual assault survivors may experience marginalization based on their race, ethnicity, nationality, religion, class, sexual orientation, or gender. Keep these strategies in mind as you support your friend through this difficult time.
Reading Time: 12 minutes Sexually transmitted infections (STIs) are increasingly common among young people. Here are seven simple ways you can lower your STI risk.
Reading Time: 13 minutes Is campus safety improving in terms of sexual assault? How can you talk to your partner about sex in a healthy, nonjudgmental way? Our sexual literacy experts answer these and other important questions.
Most of us have supported friends through difficult times, such as a break-up, academic pressure, or family issues. But how do we step up and provide support when friends and loved ones experience sexual assault and other forms of sexual violence? Especially when the person who experienced the assault is male?
Social pressure and stereotypes about gender can make it particularly challenging for men who’ve been assaulted to talk about their experiences. If one of your male friends or loved ones is assaulted, it’s important that you know you’re in a position to help.
Many of the challenges men face reflect social pressure: ideas that sexual assault makes them less masculine, that women can’t assault men, or that “real men” don’t talk about or get help for painful experiences. “Some men fear that they’ll be seen as less of a man,” says Dr. Jim Hopper, a researcher, therapist, and instructor at Harvard Medical School. “If they’re heterosexual, they may fear people will doubt their sexuality. And if they’re gay or bisexual, they may blame the assault on their sexuality in a way that further stigmatizes their being gay or bisexual.”
A common belief is that sexual violence only affects women. In fact, many men have unwanted sexual experiences, as both children and adults. One in six men in the US is sexually assaulted before age 18, according to studies from the 1980s to the early 2000s. In 2015, seven percent of men reported being sexually assaulted while attending college, according to a study by the Washington Post and the Kaiser Family Foundation. Regardless of the targeted man’s sexual orientation, both men and women perpetrate these assaults, according to the Centers for Disease Control and Prevention (CDC) (2013).
“Sex, gender identity, and race can all influence how an experience like this affects someone, but it’s very important you have no presumption about what it feels like to your friend—so listen,” says Dr. Melanie Boyd, assistant dean of student affairs and lecturer in women’s, gender, and sexuality studies at Yale University in Connecticut.
Talking to your friend about what happened
Everyone is different. People’s varying personalities and circumstances affect how they respond to an unwanted sexual experience and what we can do to help. For example, some people want lots of hugs, while some prefer verbal support. The most important thing is to relate to your friend in a way that can help him feel empowered and connected. As a friend, you’re in a great position to do this.
When a friend discloses an experience of violence, it’s normal to feel a wide range of emotions, such as shock, confusion, sadness, or anger. In the moment, keep the conversation focused on your friend’s emotions, not your own.
“Many people who experience sexual violence also experience some degree of self-blame,” says Dr. Boyd. “Partially, that’s just what people do when something bad happens: We go over the events in our head, hunting for things we could have done differently. It’s a way of regaining a sense of control. In the case of sexual violence, though, survivors also have to contend with victim-blaming patterns that run through our culture. So it’s important that friends help them push back against that. Be careful not to say or ask anything that might suggest blame—and affirm for your friend that he did the best he could in a difficult, complicated situation.”
Here are four ways you can be there for your friend
As challenging an experience as a sexual assault may be, it’s not as though your friend has become an entirely different person. The “othering” of people who’ve been assaulted—treating them differently—can be just as dangerous as ignoring or minimizing unwanted sexual experiences, according to researchers Nicola Gavey and Johanna Schmidt (Violence Against Women, 2011). Avoid thinking of the assault as something that cuts your friend off from the rest of the world; in fact, it’s up to you to be supportive and counteract that.
- Because of stereotypes about gender and sexual violence, male survivors may feel particularly othered: They might worry that people won’t take their experiences seriously, or that they’ll be viewed as weak. “It took me almost two years to come to terms with it, and I still feel like the few that I told sort of wrote it off because I’m a male,” said Chris*, a second-year undergraduate at the University of Kansas. To avoid othering, you can demonstrate that you take your friend’s experience seriously by using phrases like “that wasn’t okay” or “that sounds really messed up.”
- While it’s important to give your friend opportunities to talk about his experience of violence (if he chooses to), remember to maintain the other parts of your friendship too. It may be a relief to your friend to spend some time on normal activities that he enjoys. You can try statements like, “I’m happy to talk more about this if you want, but it’s also fine if you want to take a break from processing and go for a run together.”
Make sure to listen and focus on your friend’s feelings. “Pay attention to their specific issues,” says Dr. Boyd.
- Avoid pushing your own ideas. “Allow them to talk without being interrupted, and especially don’t put any more pressure on them (e.g., telling them that you think they need the police or a therapist),” says Tom*, a third-year undergraduate at Ripon College in Wisconsin. “Ask what you can do to help.”
- Don’t try to investigate the situation. It’s not important for you to find out exactly what happened or to delve into the details beyond what your friend wants to share.
- Avoid questions that might feel blaming (e.g., “Were you drunk?” or “Did you say no?”). “Being reminded that I wasn’t the one at fault felt reassuring,” said Taylor*, a second-year undergraduate at Wake Technical Community College in North Carolina.
- Don’t speculate about what you would have done in the situation (e.g., “If someone tried to do that to me, I’d fight them off”) or project emotions onto your friend (e.g., “You must feel like a whole different person”). Let your friend lead the conversation, and respect what he’s feeling.
Try statements like…
Avoid pronouns that assume the gender of the perpetrator or that make other assumptions about the experience. “I think one of the most important issues is breaking down the stereotype that only women are abused,” said Lena*, a second-year undergraduate at Tarrant County College in Texas.
- Make clear that you’re not making presumptions about your friend’s experience based on his identity. In particular, avoid assumptions about your friend’s sexual orientation or gender identity. “Drop in phrases or words that don’t put them on the spot but that signal your openness to hearing a more complex narrative, about, for example, ‘people of all genders,’” says Dr. Boyd. “Pay attention to what’s going on for the person in front of you.”
- It’s not your role to define the experience for your friend. Some people don’t use the word “rape” or “assault” to describe what may seem to you to be sexual violence, or relate to the terms “victim” or “survivor.” “You want them to feel like you’re connecting with their experience, not trying to impose your views or language on them,” says Dr. Hopper.
“As a friend, you want to relate to them in a way that gives them power, including by giving them choices and respecting whatever choices they make on whatever timeline,” says Dr. Hopper.
- Your friend might be interested in working with the police, pursuing disciplinary action, or working with other university resources. It’s up to him to decide. While it’s not your job to steer him to the police or school administrators, providing information about his options can be a great way to help. Figure out what resources your school has, such as hotlines, therapists, heath care providers, disciplinary processes, chaplains, or survivor advocates. “Since I was assaulted, I have learned that it wasn’t my fault and that therapy does help,” said Josh*, a second-year undergraduate at the College of the Desert in California.
- Talk with your friend about what makes him feel empowered and safe. Everyone’s different, so whether your friend feels like watching TV, working out, or flirting with someone at a party, you should ask and see how you can help. Sometimes people want to spend time on their own, sometimes people want to be social. It’s not your job to judge, but to be supportive.
Look after yourself
“Supporting someone through the healing process can be stressful, hard, and exhausting. That’s why it’s important for supports to take of themselves,” says Bella Alarcon, a bilingual clinician at the Boston Area Rape Crisis Center who facilitates a support group for partners, friends, and family of people who’ve experienced sexual violence. Paying attention to your own needs isn’t selfish. “If you’re exhausted and overwhelmed, you’re not going to be able to support the survivor,” says Alarcon.
Be mindful of your own needs, and make sure that you’re getting support.
- “It’s okay to set limits and boundaries. If you need a break, it’s okay,” says Alarcon. If you’re finding a conversation with your friend overwhelming, say so. Try language like, “I really want to be here for you, but I’m finding it hard to handle this conversation. I want to be able to support you as well as I can, and I think I can do that better if I take a break for a few minutes.”
- Reach out to university resources for support. Consider speaking to a trusted mentor, a dean, a survivor advocate, or a health professional about how you’re doing. Respect your friend’s privacy by not sharing their story with peers or classmates.
- “Be kind to yourself and take care of yourself: Take a bath, go to the gym, have a cup of tea, go out with friends, have fun, have a good cry, take a deep breath, or get your own counseling,” says Alarcon.
*Names changedGet help or find out more
Bella Alarcon, bilingual clinician, Boston Area Rape Crisis Center, Massachusetts.
Melanie Boyd, PhD, assistant dean in student affairs; lecturer in women’s, gender, and sexuality studies, Yale University, Connecticut.
Jim Hopper, PhD, independent consultant and clinical instructor in psychology, Department of Psychiatry, Harvard Medical School, Massachusetts.
1in6. (n.d.). Sorting it out for himself. Retrieved from https://1in6.org/family-and-friends/sorting-it-out-for-himself/
Abelson, M. J. (2014). Dangerous privilege: Trans men, masculinities, and changing perceptions of safety. Sociological Forum, 29(3), 549–570. https://doi.org/10.1111/socf.12103
Anderson, N., & Clement, S. (2015, June 12). Poll shows that 20 percent of women are sexually assaulted in college. Washington Post. Retrieved from https://www.washingtonpost.com/sf/local/2015/06/12/1-in-5-women-say-they-were-violated/
Anderson, S. S., Hendrix, S., Anderson, N., & Brown, E. (2015, June 12). Male survivors of sex assaults often fear they won’t be taken seriously. Washington Post. Retrieved from https://www.washingtonpost.com/local/education/male-victims-often-fear-they-wont-be-taken-seriously/2015/06/12/e780794a-f8fe-11e4-9030-b4732caefe81_story.html
Beres, M. A. (2014). Rethinking the concept of consent for anti-sexual violence activism and education. Feminism & Psychology, 24(3), 373–389.
Beres, M. A., Herold, E., & Maitland, S. B. (2004). Sexual consent behaviors in same-sex relationships. Archives of Sexual Behavior, 33(5), 475–486.
Brenner, A. (2013). Transforming campus culture to prevent rape: The possibility and promise of restorative justice as a response to campus sexual violence. Harvard Journal of Law and Gender. Retrieved from https://harvardjlg.com/2013/10/transforming-campus-culture-to-prevent-rape-the-possibility-and-promise-of-restorative-justice-as-a-response-to-campus-sexual-violence/
Carmody, M. (2003). Sexual ethics and violence prevention. Social & Legal Studies, 12(2), 199–216. https://doi.org/10.1177/0964663903012002003
Catalano, S. (2013). Intimate partner violence: Attributes of victimization, 1993–2011. Bureau of Justice Statistics (BJS). Retrieved from https://www.bjs.gov/index.cfm?ty=pbdetail&iid=4801
Colorado State University. (n.d.). A Guide for supporting survivors of sexual assault. Retreived from https://wgac.colostate.edu/supporting-survivors
Crome, S. (2006). Male survivors of sexual assault and rape. Australian Institute of Family Studies. Retrieved from https://aifs.gov.au/publications/male-survivors-sexual-assault-and-rape
Crome, S. A., & McCabe, M. P. (2001). Adult rape scripting within a victimological perspective. Aggression and Violent Behavior, 6(4), 395–413.
Davies, M., Gilston, J., & Rogers, P. (2012). Examining the relationship between male rape myth acceptance, female rape myth acceptance, victim blame, homophobia, gender roles, and ambivalent sexism. Journal of Interpersonal Violence, 27(14), 2807–2823.
Davies, M., & Rogers, P. (2006). Perceptions of male victims in depicted sexual assaults: A review of the literature. Aggression and Violent Behavior, 11(4), 367–377.
Dube, S. R., Anda, R. F., Whitfield, C. L., Brown, D. W., et al. (2005). Long-term consequences of childhood sexual abuse by gender of victim. American Journal of Preventive Medicine, 28(5), 430–438. https://doi.org/10.1016/j.amepre.2005.01.015
Gavey, N., & Schmidt, J. (2011). “Trauma of rape” discourse: A double-edged template for everyday understandings of the impact of rape? Violence Against Women, 17(4), 433–456.
Gavey, N., Schmidt, J., Braun, V., Fenaughty, J., et al. (2009). Unsafe, unwanted: Sexual coercion as a barrier to safer sex among men who have sex with men. Journal of Health Psychology, 14(7), 1021–1026.
Graham, R. (2006). Male rape and the careful construction of the male victim. Social & Legal Studies, 15(2), 187–208.
Grand Rapids Community College. (n.d). Step-by-step. Retrieved from
Harrell, M. C., Castaneda, L. W., Adelson, M., Gaillot, S., et al. (2009). A compendium of sexual assault research. RAND Corporation. Retrieved from https://www.rand.org/content/dam/rand/pubs/technical_reports/2009/RAND_TR617.pdf
Hopper, J. W. (2015, June 23). Why many rape victims don’t fight or yell. Washington Post. Retrieved from https://www.washingtonpost.com/news/grade-point/wp/2015/06/23/why-many-rape-victims-dont-fight-or-yell/
Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the defense cascade: Clinical implications and management. Harvard Review of Psychiatry, 23(4), 263–287.
Maine Coalition Against Sexual Violence. (n.d.). Sexual violence against LGBTQQI populations. Retrieved from https://www.mecasa.org/index.php/special-projects/lgbtqqi
Masters, N. T. (2010). “My strength is not for hurting”: Men’s anti-rape websites and their construction of masculinity and male sexuality. Sexualities, 13(1), 33–46.
Monk-Turner, E., & Light, D. (2010). Male sexual assault and rape: Who seeks counseling? Sexual Abuse: A Journal of Research and Treatment, 22(3), 255–265.
Paulk, L. (2014, April 30). Sexual assault in the LGBT community. National Center for Lesbian Rights. Retrieved from https://www.nclrights.org/sexual-assault-in-the-lgbt-community/
RAND Office of Media Relations. (n.d.). Complete results from major survey of US military sexual assault, harassment released. Retrieved from https://www.rand.org/news/press/2015/05/01.html
Rothman, E. F., Exner, D., & Baughman, A. L. (2011). The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: A systematic review. Trauma, Violence & Abuse, 12(2), 55–66.
Sleath, E., & Bull, R. (2010). Male rape victim and perpetrator blaming. Journal of Interpersonal Violence, 25(6), 969–988.
Stanko, E. A., & Hobdell, K. (1993). Assault on men: Masculinity and male victimization. British Journal of Criminology, 33(3), 400–415.
Strauss, V. (2014, August 29). Does “restorative justice” in campus sexual assault cases make sense? Washington Post. Retrieved from https://www.washingtonpost.com/blogs/answer-sheet/wp/2014/08/29/does-restorative-justice-in-campus-sexual-assault-cases-make-sense/
Walters, M. L., Chen, J., & Breiding, M. J. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 findings on victimization by sexual orientation. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/pdf/nisvs_sofindings.pdf
Weiss, K. G. (2010). Male sexual victimization examining men’s experiences of rape and sexual assault. Men and Masculinities, 12(3), 275–298.
Willis, D. G. (2009). Male-on-male rape of an adult man: A case review and implications for interventions. Journal of the American Psychiatric Nurses Association, 14(6), 454–461.
Rate this article and enter to win
Deliberately hurting oneself is among those human behaviors that seem baffling and counter-intuitive from the outside. A student who parties, gets depressed, and ends up cutting himself may fear that his peers just wouldn’t get it. A student who realizes that a friend pulls out her own hair may have no idea how to help. While most college students do not deliberately harm or injure themselves, it’s certainly happening on campuses, studies show.
“Self-injury tends to go through jags,” says Dr. Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery at Cornell University, New York. “It’s not uncommon for someone to not injure for a year and then start again in college when they get triggered by a variety of stressors—everything from academic to romantic problems.” Understanding self-injury can help clue us in to the complexities of our own and others’ experience, and lead us to healthy ways to handle the stresses of school, however they manifest.
What is self-injury?
When people intentionally cause harm, pain, or damage to their own body, without the intent to die, it’s called non-suicidal self-injury (or self-harm). We tend to think of self-injury as cutting. In reality, it can be any type of behavior that intentionally causes tissue damage to the body, so it could involve burning, pulling out hair, or some acts of externalized aggression, such as punching walls. Self-injury may happen under the influence of drugs or alcohol (though using alcohol or drugs is not itself considered self-injury). Self-injury is different from suicidal self-harm, which is motivated by the intent to die and includes suicidal thinking. That said, people who self-injure are more likely than others to consider suicide (see: What raises the risk for self-injury?).
- Self-injury is not necessarily used as a way to get attention from others. However, some people may self-injure because they haven’t yet learned how to ask for what they need in healthier ways. If someone needs attention, take it seriously.
- Self-injury may co-occur with other issues, such as depression or anxiety, but it is not itself a disorder, diagnosis, or disease. Self-injury is a symptom.
- Eating disorders, such as anorexia or bulimia nervosa, are different from self-injury, though people with eating disorders are at higher risk of self-injury compared to the general population, according to a 2015 meta-analysis by the Cornell Research Program on Self-Injury and Recovery.
- Tattoos and piercings are not considered self-injury, unless someone is seeking out pain as a substitute for healthier ways to handle distress.
- Heavy drinking or drug abuse is not technically a form of self-injury, though the behaviors are often related. A 2011 study in the Journal of American College Health found that almost one in five students who self-injured did so when under the influence of alcohol or other substances.
- Self-injury is not the same as BDSM, erotic practices that involve submission and dominance, which may include consensual behaviors that cause physical pain. Self-injury is about seeking emotional release, while consensual BDSM practices are about sexual pleasure.
- Self-injury may be a means by which some people feel more in control of how and when they experience pain.
Why do some people self-injure?
Self-injury can happen as a result of not being able to cope with certain stressors or emotions. “The behavior is seen a lot in college because the pressures during this timeframe—like grades, relationships, and jobs—increase,” says Dr. Retta Evans, associate professor of Community Health and Human Services at the University of Alabama at Birmingham.
Self-injury is more common in young adults who are also experiencing depression or anxiety, sexual abuse or trauma, eating disorders, or substance abuse. People who are LGBTQ are also at relatively high risk, perhaps because of the stress of social judgment. “Self-injury was a way to release inner pain that I didn’t know how to talk about,” says a third-year undergraduate at St. Clair College, Ontario.
People self-injure for a variety of reasons. Sometimes those reasons evolve over time. In our survey, many students referred to self-injury as a temporary behavior that they had managed to move past. “When I was in foster care I began to self-injure. I had recently been removed from a very dangerous situation and was dealing with what I had survived. I stopped harming myself when I was ready; I meditated a lot and worked through my issues,” said a fourth-year undergraduate at Portland State University, Oregon.
These are among the most common reasons for self-injuring:
1 To experience emotions differently
“I have severe anxiety attacks. Self-injury is a form of manifesting the emotional pain into physical pain. By doing this, I tell myself my pain is real.”
—Second-year undergraduate, Portland State University, Oregon
2 To “take away” or escape from unwanted feelings or thoughts
“Self-injury to me meant an escape from emotional pain that I did not understand and did not want my family to see. It happened because I did not want to be seen as weak in my family’s eyes; I was supposed to be a role model.”
—Fourth-year undergraduate, Dominican University, California
3 To bring recognition to their problems
“For me, it was a cry for attention. I was not getting the help I needed and had no real coping mechanisms.”
—First-year undergraduate, East Tennessee State University
4 To avoid taking anger out on someone else
“I got so angry that I hurt myself because I couldn’t hurt the other person. I am a nice person, but when people do mean things toward me, I hurt myself instead. It’s the only way I can vent.”
—Fourth-year graduate student, Berea College, Kentucky
5 To punish yourself or help you deal with a failure
“For me, self-injury was my way of punishing myself for who I was. I hated myself for things I did and the way I was. I hated who I was and thought I didn’t deserve happiness.”
—Fourth-year undergraduate, California State University, Stanislaus
6 To continue the habit
“Self-injury was a form of punishing myself for perceived ‘stupidity’ when it began. But it’s currently a compulsion when I experience severe frustration or stress.”
—Second-year graduate student, University of Rhode Island
Most people who self-injure start as teens—but self-injury is not a problem that goes away when they graduate high school. It can continue into college, restart when pressure builds, or begin later, experts say. “It’s very episodic, for a lot a people,” says Dr. Janis Whitlock, director of the Cornell Research Program on Self-Injury and Recovery at Cornell University, New York.
People don’t talk much about self-injuring, so it’s hard to know how commonly it happens. In a 2011 study, 15 percent of college students said they had self-injured at some point, and 7 percent had in the past year (Journal of American College Health), though estimates vary. In surveys, more women tend to report self-injury than men. On campuses, however, women and men may self-injure at similar rates. Most people who self-injure don’t seek support, research shows.
What raises the risk for self-injury?
- Most people who self-injure start in their early to mid-teens, according to the Cornell Research Program on Self-Injury and Recovery.
- However, two studies found that close to 40 percent of participants who self-injured first did so at age 17 or later (Journal of Mental Health Counseling, 2008).
- Most self-injurers (80 percent) stop within five years, research shows.
2 Depression and anxiety
- In a 2009 study, participants with depression, anxiety, and perfectionist personality traits were significantly more vulnerable to self-injury, according to Suicide and Life-Threatening Behavior.
- People who self-injure are more likely than others to consider or attempt suicide, research suggests. This may be because “people who have practice hurting their bodies may find it easier to hurt themselves lethally,” researchers say (Cornell Research Program on Self-Injury and Recovery website).
3 Child abuse and trauma
- Adolescents who had been abused as children were significantly more likely to self-injure than their peers who had not been abused—especially if they had been abused by more than one individual, a 2015 study in the journal PLOS One found.
- Even exposure to childhood abuse—for example, witnessing a sibling being abused—increases the later risk of self-harm, the researchers found.
4 Eating disorders
- A large cohort of people who self-injure—54–61 percent—also have some form of eating disorder, such as anorexia or bulimia, according to a 2007 meta-analysis in Suicide and Life-Threatening Behavior.
- Bulimia is more likely than other eating disorders to co-occur with self-injury, according to the Journal of Adolescent Health (2011).
- Women with eating disorders are more likely to also self-injure than men with eating disorders, according to the same study.
5 Substance abuse
- Drug use and frequent heavy drinking are associated with higher rates of self-injury, according to a 2010 study of almost 6,000 students in the Journal of Addictive Behaviors.
- The researchers also found that self-injurers who used drugs were more depressed (another risk factor for self-injury) than those who didn’t use drugs.
6 Minority sexual or gender identity
- Lesbian and gay adolescents are over twice as likely to self-injure as their heterosexual peers, according to a 2011 study in the Journal of American College Health.
- People who identify as bisexual have the highest rates of self-injury. The same study found that bisexual adolescents were over three times as likely to self-injure as their heterosexual peers.
- The higher rates of self-injury among the LGB community may be due to societal judgment about their identity, the stress of coming out, and the lack of belonging (especially among those who identify as bisexual), the researchers speculated.
- Self-injury is relatively common among trans youths, especially those with higher levels of transphobia (conflict about their own identity) and interpersonal tensions, according to the Journal of Sexual Medicine (2016).
Research is currently mixed on this issue. Girls and women seem to self-injure more commonly than boys and men do. But some studies suggest that during young adulthood, men and women may self-injure at similar rates. For example, the 2011 study of college students found that women were more likely than men to report that they had ever self-injured, but women and men were equally likely to say they had self-injured within the past year (Journal of American College Health). (The student comments in this article come from men and women.)
Researchers have two main theories that may help explain the perceived gender differences in self-injury:
- Women are more likely to speak up about self-injury; perhaps societal gender stereotypes make it easier for women than men to talk about emotional health issues.
- Men’s self-harming behavior may be brushed aside as “typical male aggression.”
“In some ways, men are better at hiding it than women [perhaps due to traditional gender roles]. If we see wounds on a guy’s knuckles we [might] assume he’s been working on a car or in a fight,” says Dr. Whitlock. “To an outsider, it looks like they’re trying to cause someone else pain, but the underlying motivation is often to cause themselves pain. For women, the telltale cuts on arms or ankles might be more obvious.”
“My self-injury involved punching walls and seeking out fights to vent anger and frustration. Usually under the influence of alcohol.”
—Fifth-year undergraduate (male), University of New Brunswick
“For many years I cut my thighs. They are horribly scarred now. I chose my thighs because I was embarrassed and didn’t want it to be obvious. I did it to cope and calm down because it always cleared my head. I was in a dark place, but I hid it from my friends and family
—just like the scars.” —Fourth-year undergraduate (female), University of New Brunswick
How to help yourself or a friend who self-injures
Usually, when people learn how to cope with their emotions and talk about how they feel, they experience less of an urge to hurt themselves. Simple techniques and skills can decrease the intensity of emotions and make them more manageable. “Finding a different outlet [for distress] was the key to my recovery,” says a second-year undergraduate at SAIT Polytechnic, Alberta. These three approaches can help you or a friend:
1 Reach out and talk
If you are self-injuring, reach out. Talk to a friend, mentor, RA, professor, member of your religious community, or member of your support group (in person or online). Ask for their support, and spend time with people who make you feel good.
If you’re concerned that someone else may be self-injuring, check in with them. “Let your friend know you care,” says Dr. Lance Swenson, associate professor in psychology at Suffolk University, Massachusetts. “Remind your friend you are there to listen. Tell them you can help them get help. Most people who self-injure are not consciously aware of why they are [doing it], at least not in the moment.” Seek out support for yourself too, so that you’re in a strong position to be there for your friend.
“Let your friend know you care,” says Dr. Lance Swenson, an associate professor in the psychology department at Suffolk University, Massachusetts. “Remind your friend you are there to listen. Tell them you can help them get help. Most people who self-injure are not consciously aware of why they are [doing it], at least not in the moment. They shouldn’t feel like they have to face it alone.”
That said, it’s not on you to solve this. “The roots of self-injurious behavior are likely very complicated. No matter how much you care about a friend, and how hard you try to help, they may continue this behavior despite your best efforts to help them,” says Dr. Davis Smith, a physician at the University of Connecticut.
How to talk to a friend you are concerned about:
- Ask straightforward, direct questions in a calm manner, such as, “Are you thinking about hurting yourself?”
- Actively listen—focus on what they’re saying—then offer support.
- Take your friend seriously. If your friend mentions any thoughts about suicide, especially a plan or method, call 911 or speak to a dean or campus counselor.
- Encourage your friend to talk to a trusted mentor, RA, professor, coach, or member of their religious community; be there for them, but do not take on the full burden yourself.
- Encourage your friend to consider seeking help from a licensed mental health professional (for example, a psychologist, social worker, or counselor—ask at your campus health center or counseling center).
2 Test coping strategies and figure out what works
If you’re concerned about a friend, you may be able to help them explore these techniques. If you’re self-injuring, test these strategies and take note of what helps. “Distress tolerance skills” can be used in place of self-injury. See Get help or find out more (below) for more info.
1 Do the opposite of what you feel:
For example, listen to your favorite upbeat song, or watch a funny YouTube video. Look in the mirror and smile—watch as your expression changes.
2 Exercise hard and fast:
Do 25 jumping jacks, go for a jog, or dance around the room. Research shows that cardio exercise can reduce your stress and improve your mood. Regular physical activity can be protective.
3 Use your five senses:
This helps you connect with what is going on around you and anchor yourself in the present moment. For example, sink your heels into the floor or ground and focus on how it feels beneath your body. Hold something soft or fuzzy. Squeeze a stress ball. Place a cool, wet washcloth on your face. Light a scented candle and breathe in deeply. Cook and/or eat your favorite food and really allow yourself to enjoy the flavor. Go for a walk or drive and take in the sights and smells. Take ice from the freezer and hold it tightly in your hand. Get into warm water (take a shower or bath).
4 Take slow, deep breaths:
Imagine you are blowing up a balloon. When you inhale deeply, your lower belly should expand. Count to three on each inhale and each exhale.
5 Think about your emotions:
Face them instead of pushing them away. Labeling an emotion (e.g., “My heart is racing and I’m feeling anxious”) can often help you figure out why you’re feeling that way (e.g., “I have a big exam coming up next week and I’m anxious about studying for it”). Write down how you’re feeling in a notebook or journal.
6 Focus on your heart:
Put your hand on your heart so you can feel your heartbeat and count the beats per minute. Try to slow down your heart rate by taking slow, deep breaths.
7 Actively cherish what you have:
Look at pictures on your phone or computer that make you smile. Make a list of all of the things you are grateful for or happy about in your life.
8 Actively cherish who you are:
Make a list of your accomplishments—e.g., “I do pretty well in school,” “I am a caring friend,” “I take excellent care of my dog.”
9 Sink into something else:
Read a book, story, or article. Listen to your favorite music, play an instrument, or sing (even if you have no musical talent!). Engage in your favorite hobby or master a skill, such as gardening, cooking, baking, playing a video game, knitting, painting, or drawing.
10 Prioritize sleep:
Get up as close to the same time every day as possible; this will help you go to bed at a more regular time too. Your bed is for sleeping only (no electronics or social networking). Relish it.
3 Consider seeking professional support
Checking in with a counselor can relieve some of the pressure and help you find strategies and resources you wouldn’t otherwise know about—whether it’s you who’s self-injuring or your friend. Your student health center or counseling center may be able to help directly or refer you to an expert medical provider. Certain therapeutic techniques—such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy—are designed to build healthy coping skills directly. If you ever feel suicidal, call 911, go to the nearest emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-8255.
“I did not want to feel hopeless and alone anymore,” says a first-year undergraduate at California State University, Channel Islands. “I decided go to counseling to cope with my self-injuring tendencies. Every session I attended helped me gain the confidence to be myself, and most importantly, to love myself. Don’t be afraid to seek help.”
Find out here Fourth-year undergraduate, Portland State University, Oregon “Resisting the urge to self-injure as a coping mechanism can be a constant struggle for many. Calm Harm is designed to manage that urge and direct users to safer and more effective ways of managing stressors.” USEFUL? FUN? EFFECTIVE?
Based on dialectical behavioral therapy (worth looking into on its own), the app provides options for what you can do instead of hurting yourself when you’re feeling negative emotions. While clicking through menus is tedious at times, the techniques were actually helpful (which was my main concern).
Helpful and appropriate, definitely. But something like this isn’t really ever going to be “fun”—the question is whether it works.
No app will “solve” the problem outright, but this has real potential to help. Calm Harm does what it sets out to do: provide alternatives to self-harm in the short term so that more definitive treatment can be sought/have time to work.
Fourth-year undergraduate, Portland State University, Oregon
“Resisting the urge to self-injure as a coping mechanism can be a constant struggle for many. Calm Harm is designed to manage that urge and direct users to safer and more effective ways of managing stressors.”
[school_resource category='counsellingservices, suicideprevention']
Retta R. Evans, PhD, MCHES, associate professor, program coordinator, Community Health & Human Services, University of Alabama at Birmingham.
Michelle M. Seliner, MSW, LCSW, chief operating officer, S.A.F.E. Alternatives.
Lance P. Swenson, PhD, associate professor, Suffolk University, Boston, Massachusetts.
Janis Whitlock, PhD., director, Cornell Research Center on Self-Injury and Recovery, Cornell University, New York.
Andover, M. S., Morris, B. W., Wren, A., & Bruzzese, M. E. (2012). The co-occurrence of non-suicidal self-injury among adolescents: Distinguishing risk factors and psychosocial correlates. Child and Adolescent Psychiatry and Mental Health, 6, 11–17. doi: 10.1186/1753-2000-6-11
Arcelus, J., Claes, L., Witcomb, G. L., Marshall, E., et al. (2016). Risk factors for non-suicidal self-injury among trans youth. Journal of Sexual Medicine, 13(3), 402–412.
Batejan, K. L., Jarvi, S. M., & Swenson, L. P. (2015). Relations between sexual orientation and non-suicidal self-injury: A meta-analytic review. Archives of Suicide Research, 19(2), 131–150. doi: 10.1080/13811118.2014.957450
Cornell Research Program on Self-Injury and Recovery. (n.d.). Self-injury. Retrieved from https://www.selfinjury.bctr.cornell.edu/perch/resources/siinfo-2.pdf
Ernhout, C., Babington, P., & Childs, M. (2015). What’s the relationship? Non-suicidal self-injury and eating disorders. The Information Brief Series, Cornell Research Program on Self-Injury and Recovery. Cornell University, Ithaca, NY.
Favazza, A. (1987). Bodies under siege: Self-mutilation in culture and psychiatry. Baltimore, MD: Johns Hopkins University Press.
Heath, N. L., Toste, J. R., Nedecheva, T., & Charlebois, A. (2008). An examination of non-suicidal self-injury among college students. Journal of Mental Health Counseling, 30(2), 137–156.
Hoff, E. R., & Muehlenkamp, J. J. (2009). Nonsuicidal self-injury in college students: The role of perfectionism and rumination. Suicide and Life Threatening Behavior, 39(6), 576–587.
Jacobson, C. M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11, 129–147.
Jacobson, C. M., Muehlenkamp, J. J., Miller, A., & Turner, J. B. (2008). Psychiatric impairment among adolescents engaging in different types of deliberate self-harm. Journal of Clinical Child & Adolescent Psychology, 37(2), 363–375.
Linehan, M. M. (2014). Dialectical behavioral therapy skills training manual: Second edition. New York, NY: Guilford Press.
Lloyd-Richardson, E., Perrine, N., Dierker, L., & Kelley, M. L. (2007). Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine, 37(8), 1183–1192.
Nock, M., Joiner Jr., T., Gordon, K., Lloyd-Richardson, E. E., et al. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144(1), 65–72.
Nock, M., & Prinstein, M. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Counseling and Clinical Psychology, 72(5), 885–890.
Nock M., & Prinstein, M. (2005). Contextual features and behavioral functions of self-mutilation among adolescents. Journal of Abnormal Psychology, 114(1), 140–146.
Nock, M., Prinstein, M., & Sterba, S. (2009). Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults. Journal of Abnormal Psychology, 118(4), 816–827.
Peebles, R., Wilson, J. L., & Lock, J. D. (2011). Self-injury in adolescents with eating disorders: Correlates and provider bias. Journal of Adolescent Health, 48(3), 310–313.
Serras, A., Saules, K. K., Cranford, J. A., & Eisenberg, D. (2010). Self-injury, substance use, and associated risk factors in a multi-campus probability sample of college students. Psychology of Addictive Behaviors, 24(1), 119–128.
Svirko, E., & Hawton, K. (2007). Self-injurious behavior and eating disorders: The extent and nature of the association. Suicide and Life Threatening Behavior, 37(4), 409–421.
Swannell, S. V., Martin, G. E., Page, A., Hasking, P., et al. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis, and meta-regression. Suicide and Life Threatening Behavior, 44(3), 273–303.
Sweet, M., & Whitlock, J. (2010). Therapy: Myths & misconceptions. Cornell Research Program Self-Injury and Recovery. Retrieved from https://www.selfinjury.bctr.cornell.edu/perch/resources/therapy-myths-and-misconceptions-pm.pdf
Whitlock, J. L., & Selekman, M. (2014). Non-suicidal self-injury (NSSI) across the lifespan. In Oxford Handbook of Suicide and Self-Injury, edited by M. Nock. Oxford Library of Psychology, Oxford University Press.
Whitlock, J. L., Muehlenkamp, J., Purington, A., Eckenrode, J., et al. (2011). Nonsuicidal self-injury in a college population: General trends and sex differences. Journal of American College Health, 59(8), 691–698.
Yates, T., Carlson, E., & Egeland, B. (2008). A prospective study of child maltreatment and self-injurious behavior in a community sample. Development and Psychopathology, 20(2), 651–671.
Rate this article and enter to win
Gabe Murchison is senior research manager at Human Rights Campaign, the largest LGBTQ advocacy organization in the US. He focuses on research that “helps us understand the unique challenges that LGBTQ people deal with and the resources we have for tackling them.”
Murchison has a master’s in public health from Yale University. As an undergraduate, he spent three years with Yale’s sexual violence prevention program, Communication and Consent Educators. His master’s thesis examines sexual assault risk factors affecting LGBTQ people and how to make our communities safer.
Why did you do this research?
“To prevent sexual violence, we have to understand how it happens, and while we know a bit about how sexual violence against straight, cisgender women tends to look, there’s very little research on violence against LGBTQ students. As a result, most prevention efforts are designed for straight, cisgender women. There’s very little research telling us whether they serve LGBTQ students equally or at all.
“Overall, our data suggests that LGBTQ students’ unwanted sexual experiences (coercion or assault) are similar to what we know about heterosexual, cisgender women’s. For instance, in the research we conducted, many of the perpetrators were friends, romantic partners, exes, or hookups, and coercion and alcohol incapacitation were more common tactics than physical force.
“However, students with more internalized homophobia were more likely to have experienced sexual assault and coercion, while students with a stronger sense of LGBTQ community were less likely to have had those experiences. We found that 82 percent of perpetrators were male—surprisingly, that number was similar regardless of the survivor’s gender.”
This list is adapted from the Glossary of Terms published by the Human Rights Campaign. Terminology relating to gender and sexual identity is variable (e.g., a non-cisgender person may identify as transgender, gender non-conforming, non-binary, queer, or genderqueer). Always respect individuals’ preferences.
Asexual The person does not experience sexual attraction or desire for other people.
Bisexual The person is emotionally, romantically, or sexually attracted to more than one sex, gender, or gender identity.
Cisgender A person’s gender identity aligns with the sex assigned to them at birth.
Gay The person is emotionally, romantically, or sexually attracted to people of the same gender.
Gender identity A person’s innermost concept of self as male, female, a blend of both, or neither; how individuals perceive themselves, and what they call themselves.
Gender non-conforming The person does not behave in a way that conforms to the traditional expectations of their gender, or their gender expression does not fit neatly into a category; also termed “non-binary.”
Genderqueer The person rejects static categories of gender and embraces a fluidity of gender identity (and often, though not always, sexual orientation); may see themselves as being both male and female, neither male nor female, or outside these categories.
Homophobia The fear and hatred of, or discomfort with, people who are attracted to those of the same sex.
Lesbian The woman is emotionally, romantically, or sexually attracted to other women.
LGBT An acronym for “lesbian, gay, bisexual, and transgender.”
Queer Fluid gender identity and/or sexual orientation; often used interchangeably with “LGBT.”
Transgender The person’s gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth; transgender people may identify as straight, gay, lesbian, bisexual, etc.
Transphobia The fear and hatred of, or discomfort with, transgender people.
“I use transgender to refer to people who identify with a different gender than they were assigned at birth. I use gender non-conforming to refer to people who consistently and noticeably express themselves outside of the norms for their gender.
“Like anyone else, a transgender person could be gender-conforming or non-conforming after they transition. Some transgender men dress and act in stereotypically masculine ways, while others are more feminine than the average man, and the same is true of transgender women.
“There are also many transgender people who don’t identify exclusively as men or women, but as neither, or a combination of both. I use the umbrella term ‘non-binary’ for these identities, because they are outside of the male-female ‘gender binary.’
“Many health researchers use the umbrella term ‘gender minorities’ to describe transgender and gender non-conforming people. In the study we’re discussing, I didn’t ask participants about being gender non-conforming, so I can only talk about transgender students’ experiences. Other research has found that LGBTQ youth who are gender non-conforming have different experiences than those who are gender-conforming—for instance, they are more likely to be bullied in school. Whether being gender non-conforming affects the likelihood of experiencing sexual violence is an important question for future research.”
“Living in a culture that stigmatizes one or more of your identities—your race, status, sexual orientation, or many others—can affect your health negatively. One way is through internalized stigma: when you come to consciously or unconsciously believe the negative cultural ideas about yourself. Internalized homophobia is internalized stigma about being lesbian, gay, bisexual, or queer.
“Absorbing negative beliefs about one’s LGBTQ identity can cause a range of problems, like making someone more prone to depression or anxiety, or affecting their sexuality and relationships.
“For instance, it appears that some abusers take advantage of internalized homophobia to control their partners. When we were planning our research, we thought that sexual aggressors could do something similar, and there was some qualitative research (interviews with LGBTQ people about their unwanted sexual experiences) backing that up.
“It’s important to note that internalized stigma is not something to be ashamed of. It’s an almost unavoidable consequence of having any stigmatized identity, but most people find positive ways to cope with it.”
For research references, see Sources.
Internalized transphobia may occur at a higher rate than internalized homophobia, research suggests. In a 2016 study, transgender participants reported higher rates of discrimination, depression symptoms, and suicide attempts than cisgender LGB participants. Among transgender people, depression symptoms were associated with a lack of self-acceptance around identity, researchers wrote (Transgender Health).
Transgender, gender nonconforming, and genderqueer people experience pressure from multiple sources. “According to research, stressors include being bullied at school and work, reduced access to housing, loss of friends and family, physical violence, harassment and assault, and reduced medical access,” says Joleen Nevers, sexuality educator at the University of Connecticut.
“Trans students report facing more discrimination on campus than their cisgender LGBQ peers. Trans students deal with a number of challenges that don’t affect cisgender LGB students, like difficulty accessing housing and restrooms that match their gender. School policies may have a serious impact: Transgender people denied access to these facilities are more likely to have attempted suicide.
“On average, trans students also seem to have a weaker sense of community on campus, even though they’re equally involved in groups and leadership activities.”
For research references, see Sources.
“We surveyed about 700 LGBQ college students at hundreds of colleges and universities, using questions that measured their levels of internalized homophobia and their sense of LGBTQ community on campus. We also asked them about some things that are related to sexual violence risk among heterosexual women, including how many romantic and sexual partners they’d had during college. Finally, we asked them about different types of unwanted sexual experiences they may have had, and about how and with whom those experiences happened. We used this data to look at three big questions:
- “First, is sexual violence against LGBTQ undergraduates basically similar to what heterosexual, cisgender women tend to experience? While those women’s experiences vary, common themes include assault while incapacitated by alcohol or drugs; assault or coercion by a dating partner; and initially consensual hookups that end in assault. I guessed that LGBTQ students would report similar experiences, but many people assume that ‘hate crime’ attacks play a big role, so it was an open question.
- “Second, do LGBTQ students have unique experiences that affect their risk of sexual violence?
- “Third, we knew very little about gender: Do LBQ women tend to be assaulted by men, women, or both? What about GBQ men? And what about people with a non-binary gender? That would help us understand whether this violence tends to take place within LGBTQ relationships or communities, or whether it’s mostly perpetrated by heterosexuals.”
How different is trans students’ experience?
“Technically, our study was about sexual orientation, not gender. However, many transgender students are also LGBQ. In my sample and another recent study by the Asssociation of American Universities, transgender students experienced the highest rates of sexual assault and coercion.
“Trans students report facing more discrimination on campus than non-trans LGBQ peers. Some students are even targeted for sexual assault because they are trans. On average, trans students also seem to have a weaker sense of community on campus. We don’t know how transgender stigma on campus relates to sexual assault and coercion, but given the high rates of both discrimination and sexual violence, the question deserves more attention.”
How can we support LGBTQ students?
“We researched how feeling that you belong to a community affects the incidence of sexual assault. A strong sense of LGBTQ community is beneficial, potentially because it helps people deal with internalized homophobia and transphobia.
“The peer education program I worked with in college is based on the idea that changing how students think about sexuality, sexual pressure, and even ‘going out’ can make sexually aggressive behavior harder to get away with and help all students feel more empowered.”
“Campus programming sets the tone for LGBTQ students and straight, cisgender students,” says Gabe Murchison. The following approaches can help build an inclusive community, he says:
- Health services should use inclusive language—like “students who need a Pap test” instead of “women who need a Pap test,” since some transgender students will need that service as well.
- All programming should include LGBTQ students among its examples.
- Health, sexuality, and sexual violence workshops should feature characters with gender-neutral names and point out that both consensual sex and sexual violence can occur in any gender combination.
“It’s important to have friends who support your sexual orientation or the fact that you’re transgender—but that doesn’t mean they have to be LGBTQ. Many LGBTQ students make their closest friends through athletics, Greek life, arts, religious organizations, or housing assignments. For some, most or all of those friends are straight and cisgender.
“Since LGBTQ people are just as diverse as any other group, it’s very likely that you’ll meet like-minded LGBTQ friends throughout your life, even if you don’t fit in with the LGBTQ students you’ve met on campus.”
“There are not a ton of data on LGBTQ undergraduates specifically. From what exists, it appears that:
- “Gay, bi, and queer men are at higher risk than other men (but still at lower risk than women).
- “Lesbian, bi, and queer women seem to be at similar or slightly higher risk compared to other women.
- “Transgender students, particularly those with non-binary gender identities (not exclusively male or female), seem to be at higher risk than cisgender students.”
For research references, see Sources.
“‘Queer’ is how respondents self-identified. Thirteen percent of my sample described their sexual orientation as queer. The term has been adopted by the major US advocacy organizations and is used in some (not all) research on this population.”
What cultural problems did you identify in your peer work?
“Some students who wanted to make friends with other LGBTQ people felt like the only way to do that was to be part of a hookup scene. That led to them having consensual sex they didn’t really want and sometimes made them targets for coercion. Also, some people talked about experiencing sexual aggression when they were newly out and thinking maybe that was normal or acceptable among LGBTQ people—because they didn’t yet have many LGBTQ friends to discuss it with.”
How did you aim to build a safer culture?
Create nonsexual spaces and conversations
“We decided that building a stronger sense of community could help. First, we got LGBTQ student leaders on board to help change the way people in their circles talked about hooking up, and also to be intentionally welcoming to younger students. Second, we started hosting LGBTQ events that were not at all sexualized—like a fantastic pie-baking event that’s become an annual tradition. Third, we made sure that the more sexualized spaces were still low-pressure. For example, after an LGBTQ dance, we showed Mean Girls until 3 a.m. People loved it, and it showed that you can go out and dance without ending the night in someone’s bed.”
How can all students reach out to LGBTQ peers?
Check in with friends and younger students
“Checking in is really valuable. If someone is in an intense relationship and you’re not sure if it’s good-intense or bad-intense, you can ask some open-ended questions like, ‘How are things with Ryan?’ Even if everything is fine, they’ll feel supported. Reaching out to younger or newly out students can be especially effective. They may be particularly vulnerable to sexual assault, or just plain loneliness.”
Pay attention to who seems left out
“Some students don’t participate in the LGBTQ community because they feel excluded—most visible LGBTQ social groups might be mostly white, mostly a particular gender, mostly secular. Also, not all LGBTQ communities are great at supporting transgender, non-binary, or bisexual students. Set an example by learning more about being bi- and trans-inclusive, and asking your friends to do the same.”
“Do your best not to assume someone is heterosexual or cisgender. My college had a dance where first-year students set up dates for the people they live with. Some people made a point of asking each suitemate about their gender preferences for the date. For some LGBQ people, that was the first time they felt comfortable coming out to the people they lived with.
“Be an advocate. Student affairs staff often take students’ opinions seriously. These staff can affect the decision-making process on issues that affect LGBTQ students, like funding an LGBTQ center or creating mixed-gender housing options. If you know LGBTQ students on your campus are advocating for this type of goal, you can write or talk to student affairs staff and explain why you feel it’s important.
“Speak up. If an LGBTQ person (or anyone else) hears stigmatizing comments all the time, they may be too afraid or frustrated to address them. Try to respectfully but firmly shoot down any anti-LGBTQ remarks you hear.”
Sexual assault is never the fault of the survivor. Become familiar with your campus and community resources. Campus resources for survivors of coercion and/or sexual assault include the counseling center, student health center, women’s center, and sexual assault center. Community resources include rape or sexual assault crisis centers and hotlines.
Gabe Murchison, senior research manager, Human Rights Campaign. Murchison’s master’s thesis (not yet published) was advised by Melanie Boyd, PhD, assistant dean of student affairs at Yale University, and John Pachankis, PhD, associate professor of epidemiology at Yale School of Public Health.
Joleen Nevers, MA Ed, CHES, AASECT Certified Secondary Education, sexuality educator, health education coordinator, University of Connecticut.
Association of American Universities. (2015). AAU Campus Survey of Sexual Assault and Sexual Misconduct. Retrieved from https://www.aau.edu/Climate-Survey.aspx?id=16525
Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., et al. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103(5), 943–951. Retrieved from https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301241
Braun, V., Schmidt, J., Gavey, N., & Fenaughty, J. (2009). Sexual coercion among gay and bisexual men in Aotearoa/New Zealand. Journal of Homosexuality, 56(3), 336-360
Centers for Disease Control. (2010). National Intimate Partner and Sexual Violence Survey: An overview of 2010 findings on victimization by sexual orientation. Retrieved from https://www.cdc.gov/violenceprevention/pdf/cdc_nisvs_victimization_final-a.pdf
D’Augelli, A. R., Grossman, A. H., & Starks, M. T. (2006). Childhood gender atypicality, victimization, and PTSD among lesbian, gay, and bisexual youth. Journal of Interpersonal Violence, 21(11), 1462–1482.
Dugan, J. P., Kusel, M., L., & Simounet, D. M. (2012). Transgender college students: An exploratory study of perceptions, engagement, and educational outcomes. Journal of College Student Development, 53(5), 719–736.
Edwards, K. M., Sylaska, K. M., Barry, J. E., Moynihan, M. M., et al. (2015). Physical dating violence, sexual violence, and unwanted pursuit victimization: A comparison of incidence rates among sexual-minority and heterosexual college students. Journal of Interpersonal Violence, 30(4), 580-600.
Grant, J. M., Mottet, L. A., & Tanis, J. (2011). Injustice at every turn: A report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force. Retrieved from https://www.thetaskforce.org/static_html/downloads/reports/reports/ntds_full.pdf
Haas, A. P., & Rodgers, P. L. (2014). Suicide attempts among transgender and gender non-conforming adults: Findings of the National Transgender Discrimination Survey. American Foundation for Suicide Prevention; Williams Institute, UCLA School of Law.
Hines, D. A., Armstrong, J. L., Reed, K. P., & Cameron, A. Y. (2012). Gender differences in sexual assault victimization among college students. Violence and Victims, 27(6), 922-940.
Karlsen, S., & Nazroo, J. Y. (2002). The relation between racial discrimination, social class, and health among ethnic minority groups. American Journal Public Health, 92(4), 624–631. Retrieved from https://www.aleciashepherd.com/writings/articles/other/Relation%20between%20racial%20discrimination%20social%20class.pdf
Martin, S. L., Fisher, B. S., Warner, T. D., Krebs, C. P., et al. (2011). Women’s sexual orientations and their experiences of sexual assault before and during university. Women’s Health Issues, 21(3), 199-205.
Menning, C. L., & Holtzman, M. (2013). Processes and patterns in gay, lesbian, and bisexual sexual assault: A multimethodological assessment. Journal of Interpersonal Violence, 0886260513506056.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. Retrieved from https://psycnet.apa.org/index.cfm?fa=search.displayRecord&uid=2003-99991-002
Student Health 101 survey, February 2016.
Su, D., Irwin, J. A., Fisher, C., Ramos, A., et al. (2016). Mental health disparities within the LGBT population: A comparison between transgender and nontransgender individuals. Transgender Health, 1(1), 12–20. Retrieved from https://online.liebertpub.com/doi/full/10.1089/trgh.2015.0001
Williamson, I. R. (2000). Internalized homophobia and health issues affecting lesbians and gay men. Health Education Research, 15(1), 97–107. Retrieved from https://her.oxfordjournals.org/content/15/1/97.full
Rate this article and enter to win
What’s your sexual identity: straight, gay, bi, or something else? Next question: Were you born that way? You have probably heard that the answer is yes. But what if that message doesn’t fit with your experience? What if your sexual identity has changed?
Increasingly, young adults are embracing the concept of sexual fluidity and acknowledging that their patterns of attraction can shift. Labels—e.g., straight, lesbian, or asexual (lacking sexual desire)—do not tell the whole story. “A predominantly heterosexual woman might, at some point in time, become attracted to a woman, just as a predominantly lesbian woman might at some point become attracted to a man,” writes Dr. Lisa Diamond, a leading researcher in sexual identity, in Sexual Fluidity (Harvard University Press, 2009). Sexual fluidity appears to be more common for women than men, for reasons that may be both biological and cultural, according to Dr. Diamond. Nevertheless, men’s sexuality is also looking more fluid than previously believed, writes Dr. Jane Ward in Not Gay: Sex Between Straight White Men (NYU Press, 2015).
You get that it’s complicated
Many students recognize sexual fluidity as normal. In a recent survey for Student Health 101, 71 percent of students said, “My sexual identity feels clear and fixed and I don’t see it changing.” The rest—29 percent—have experienced some form of sexual fluidity.
- In our survey, 13 percent have experimented outside of their “usual” sexual orientation. Six percent said that their sexual identity “depends on the situation.”
- Two in three students in our survey believe that sexual identity can change over a lifetime.
- Seven out of ten students in our survey agree that human sexuality has varied across different places and times; this implies that you recognize the role of cultural influences.
- Nationally, 31 percent of Americans under 30 consider themselves something other than exclusively heterosexual, according to a 2015 survey by YouGov. The full survey findings suggest young adults are more flexible in their sexual identity than are older adults.
How does sexual identity shift?
Sexuality can be fluid in three main ways, says Dr. Diamond, an assistant professor of developmental psychology at the University of Utah:
- A person may become interested in people outside of their usual sexual orientation (e.g., a man who identifies as straight might be attracted to another man).
- A person may find that their sexual orientation itself seems to shift over time (e.g., a woman who identifies as a lesbian might become attracted to men, or to people of other genders).
- A person may consider gender and sexual identity irrelevant and avoid labels altogether: They may be attracted to “the person, not the gender,” says Dr. Diamond. (Those who like labels may refer to this orientation as pansexual.)
Andi, 27, a musician in Texas, used to identify as bisexual. “As far back as I can remember, I have had crushes and sexual feelings for men and women and people in between.” However, until fairly recently, they dated only men (“they” is Andi’s preferred pronoun). After breaking off their engagement with a man, Andi found they had little interest in dating other men and started identifying as gay or queer.
The shift has been confusing. “Things were much simpler when I was just bisexual. I felt like I understood myself better and was better able to trust my feelings,” they say. The LGBT communities at college were not helpful, but Andi found support and understanding among like-minded LGBTQ people on Facebook and Tumblr. “I ended up having a solid community. Having people to talk to about my changing sexuality, who could validate my feelings and be nonjudgmental, was very helpful.”
“I’ve seen too many people think, ‘No no no no, I am definitely [insert sexual label],’ and try to force themselves to fit rather than embracing their feelings,” says Andi. “My hope is that others who experience this are given the chance to just let it happen and see where it takes them.”
Steve, 35, was 19 when he met Craig. They worked together, shared hobbies, and saw each other almost daily. “He was one of those incredibly rare friends that you could talk about literally anything with,” says Steve. When Steve discovered that his then-fiancée was cheating on him, he turned to Craig for support.
One day, after an argument with his fiancée, “I saw Craig and we just started laughing for no reason at all, and then I was seized by an almost overwhelming urge to grab his hand, pull him close, and kiss him,” Steve says. He didn’t—he was so surprised by the impulse that he didn’t know what to do. At the time, Steve was still uncomfortable with the idea of same-sex attraction and did not know how to understand these feelings.
Years later, he says, “I realized that I had actually been very much romantically and sexually attracted to him. If I could have accepted that part of myself at the time, I would definitely have left my fiancée for him in a heartbeat.” Steve has never had any feelings like that for men since, and he still identifies as heterosexual.
Why does sexual identity shift?
Sexual identity, orientation, and behavior are influenced by a mix of biological and social factors, researchers say. Although people cannot choose to change their sexuality, sometimes life events change it for them. For example:
- Platonic love with a close friend may transform into romantic love or sexual attraction.
- Moving to a new environment—e.g., a more diverse or accepting community—may enable people to see and experience themselves and others differently.
Misha, a third-year undergraduate at Stanford University, California, used to identify as straight and asexual. (Asexuality is on a continuum, similarly to other orientations. For example, it can range from some sexual desire to no sexual desire. The definition and use of the term varies.) After an abusive relationship in which Misha’s asexuality was used against them, their interests shifted and they began to identify as bisexual. (“They” is Misha’s preferred pronoun.)
Misha has found community with other asexual LGBTQ people and has started identifying as agender. Their identity shift remains difficult to talk about. “When I do [discuss it], I hear the same things I heard from straight people: that I’m actually straight and just not recovered enough to live up to myself,” Misha says. Those people seem to assume that recovering from trauma will enable Misha to revert to a straight identity.
Sexuality activists have often resisted the idea that non-heterosexual identities are the result of traumatic experiences involving someone of the opposite sex. Some people may dismiss those identities as invalid, temporary, or pathological. But identities shaped in part by trauma are as valid as those that aren’t.
In addition, sexual fluidity may mean that your patterns of attraction change more than once. “You can change your labels frequently, and no matter what led to the change, you aren’t faking,” Misha says. “It’s okay to want to go back or not.”
Some shifts in sexual identity take place when the person discovers a different part of their sexual orientation, which may be wider than they previously thought. See: What’s the difference between sexual identity, orientation, behavior, and capacity?
We can think about human sexuality as having four dimensions: identities, orientations, behaviors, and capacities.
Our sexual identity is who we feel we are, the definition that we feel fits us best. It’s something we consider definitional; if other people don’t know this about us, we feel they don’t know us well. We can identify as gay, for instance, even if our orientation (who we are attracted to) is more bisexual or pansexual (not limited by biological sex or gender).
Our sexual orientation is about who we are attracted to. We may have a straight sexual orientation for most of our young lives, and then mid-life we may realize that we are more bi- or pansexual in how we experience attraction. Orientation is often more stable than how we identify ourselves.
Our sexual behaviors are simply what we do. A lesbian can have a fling with a man, for instance. She identifies as lesbian, and her primary orientation is gay, but she’s decided to experiment and have another type of experience. She’s still gay, but some of her behaviors are not.
Capacity is a term I often use when talking about people in polyamorous or open relationships, though it can be used in other ways as well. Someone can have the capacity to love multiple people at once; she might identify as polyamorous, even if she is not currently in any relationships. (Polyamory can also be seen as an identity or an orientation.) Many people seem to develop the capacity to be polyamorous, and then never lose that even if they go back to monogamy.
By Dr. Rosalyn Dischiavo, EdD, MA, CSE, CSEC, sexologist, professor, author, and former therapist. Dr. Dischiavo founded the Institute for Sexuality Education & Enlightenment in Connecticut, an AASECT-approved professional training program for sex educators, counselors, and therapists.
Undermining the cause?
Historically, some LGBTQ groups and communities have struggled with the notion of sexual fluidity. For a long time, “born this way” was the only accepted narrative about gay and lesbian sexuality, says Laura Haave, director of the Gender and Sexuality Center at Carleton College, Minnesota. “Politically, it was necessary to say, ‘This is something that can’t be changed’ and because it’s not fluid, gay and lesbian people deserve civil rights.” When she was younger, Haave says, “it was almost like you didn’t want to talk about fluidity because that undermined your cause.”
But it is not true that fluidity is equivalent to choice, writes Dr. Diamond in Sexual Fluidity: “These assumptions are illogical, unscientific, and plain wrong. Individuals undergo plenty of drastic psychological changes that they did not choose and over which they have little control.”
Think your sexuality may be fluid?
“Recognize that everyone’s experience of their own sexuality is different, and that’s OK,” says Haave.
Explore the language of sexuality: “Try on new labels, identities, or philosophies that seem to fit you, and know that it’s OK to embrace these or reject them whenever you feel like it,” says Haave. “If you don’t find any labels, identities, or philosophies that seem to fit you, it’s OK not to have any of these and just be yourself.”
Students experiencing sexual fluidity may have unique needs when it comes to student health services. “It can be difficult for students to seek health care because they may be concerned about being judged or having to explain themselves to a health care provider,” says Joleen Nevers, sexuality educator and health education coordinator at the University of Connecticut.
In subtle ways, campus services can accidentally make these students feel unwelcome. For example, if you are asked to fill out a form in which your sexual identity isn’t listed as an option, you may get the implicit message that you’re not welcome or recognized, potentially contributing to stress-related issues. “We’ve got to recognize that we need to stop patting ourselves on the back for including gay, lesbian, bisexual, or other,” says Laura Haave, director of the Gender and Sexuality Center at Carleton College, Minnesota.
Providers should use “reflective language that the student provides to us,” says Nevers. For example, if a male student refers to himself as an MSM (a man who has sex with men), providers should refer to him that way, and not as “gay” or “bi.” If a person who identifies as nonbinary (not male or female) nevertheless uses the label “lesbian,” providers should echo that.
- Campus LGBTQ groups Although not all sexually fluid students feel welcome in their schools’ LGBTQ groups, growing awareness of sexual fluidity among young people means that more of these groups are becoming inclusive of those who are fluid. Try it. If you feel unsupported or unwelcome, it is always OK to leave.
- Online communities Platforms like Tumblr have active communities of LGBTQ young people, many of whom are accepting of sexual fluidity. Many online groups include anyone who is interested in people of the same gender, regardless of labels or orientation. For example, Actual Lesbians, a Reddit group, welcomes all non-straight women, including those who are “bicurious,” and provides a space to get advice and find support.
- Setting boundaries If someone is asking intrusive questions or insisting that you should identify differently than you do, it is your right to set boundaries. Tell them that you’re uncomfortable discussing this or that you need them to accept your self-identification.
- Screen therapists and health care providers If you are concerned that a therapist or doctor will not be understanding and supportive of your identity, ask them up front about their views on sexual fluidity and whether or not they are familiar with the relevant research. If your doctor or therapist believes that sexual orientation is rigid and that choosing (and sticking with) a label is a necessary part of healthy development, it may be a good idea to find a different provider.
“Contact your local LGBTQ Resource Center to find out if they have a list of providers. Usually if a provider is LGBTQ-friendly, they will also be open and inclusive of those who identify as sexually fluid,” says Tara Schuster, coordinator of health promotion at Rensselaer Polytechnic Institute, New York.
- Affirm people who change their labels If a person who used to identify with a particular label now uses another one, believe them, and use their preferred label. It doesn’t mean they’re confused or that they were wrong about their identity before. Sometimes identities shift.
- Include people who do not use labels Questionnaires and intake forms often force people to identify themselves as gay, straight, lesbian, or bisexual. This can exclude those who choose not to use labels. No term can be perfect and inclusive of everyone, but varying the language you use can help you reach people who may have felt excluded before.
- If you have a role in collecting this sort of information, allow participants to fill in their own label or select “none.”
- If you have a role in planning campus events or creating relevant resources, try using terms like “women who date women” or “people who have sex with men.”
- Avoid telling others how to identify Sexually fluid people who explore “outside” their sexual orientation often face others telling them that they are “actually gay,” “actually bi,” and so on. This can feel very invalidating. Sexual fluidity means that, for many people, occasionally stepping outside the boundaries of their usual patterns of attraction is healthy and normal. Let people tell you how they identify, and let others know how you identify too.