Risk and Protective Factors Associated with Non-Suicidal Self-Injury in Sexual and Gender Minority Individuals: A Scoping Review.

Non-suicidal self-injury (NSSI) is a significant public health concern, with disproportionately higher prevalence among sexual and gender minority (SGM) populations compared to cisgender heterosexual individuals. While prior research has examined NSSI and related outcomes in SGM groups, evidence on specific risk and protective factors remains limited. This scoping review aimed to systematically map and synthesize risk and protective factors associated with NSSI in SGM populations. A systematic search was conducted in PubMed, Scopus, and Web of Science up to 2 February 2026. A total of 43 studies were included, the majority of which were conducted in the United States and employed cross-sectional designs. Data were charted and synthesized using a minority stress-informed socioecological framework. Findings indicate that NSSI is consistently associated with the co-occurrence of minority stress processes and intrapersonal vulnerabilities. Additional risk factors were identified across family, peer, and community domains. Protective factors were less frequently examined but included social support, family connectedness, school safety, and adaptive coping strategies. Overall, the findings suggest that NSSI among SGM populations is best understood as the result of interacting risk processes across multiple ecological levels. These results support a minority stress-informed, multi-level conceptualization of NSSI in SGM individuals and highlight the need for longitudinal research and greater focus on protective factors.