A common belief about self-injury is that it is engaged predominantly by women, particularly teenage girls. Yet, it is now believed that the gap between male and female self-injury is much smaller, with some studies finding near equal ratios. But some differences remain, for example regarding methods used to inflict injury.
Despite gradual improvement in awareness about mental health and gender inequalities, female self-injury remains a stigmatized and misunderstood behavior.
The difficulty of understanding female self-injury
Self-injury appears to affect women slightly more than men, leading to questions as to why women engage in this behavior more. Many argue that women resort to internal violence by harming themselves to manage their emotions, while men use violence externally, onto others for example1. These outward actions, such as punching walls, can be an act of self-injury misunderstood as external aggressiveness2, 3.
Being female is sometimes classified as a risk factor for self-harm, but this theory is questioned by some researchers who argue that abuse, and not gender per se, can predict self-harm4. Indeed, while factors leading to self-harm are rarely specific to one gender, some causes tend to affect women more than men. This is the case with domestic abuse, which is strongly associated with self-harm and suicidality5, or poverty6.
Yet, research about self-harm in women remains too often focused on gender oppression and domestic or sexual abuse. It lacks deeper investigation, which “leaves unanswered how and why people may come to self-harm in the absence of such experiences” explains psychotherapist Zoi Simopoulou, as well as sociologist and professor Amy Chandler, whom we already mentioned for her role in the Scotland’s Self Harm Strategy and Action Plan. They believe that research tends to take for granted a currently superficial understanding of female self-harm, and do not seek for further meanings nor relationship between self-harm and gender, leading to an “increasingly standardised explanations for self-harm that do not well reflect the complexity of experience and meaning that self-harm can involve.” They add that research contributes to creating flawed stats by focusing on specific methods, such as cutting, or demographic groups, which leads to male self-harm being under-reported1.
As the gap in rates of self-harm between males and females might not be as sharp, self-harm stops being a solely female issue. Naomi Salisbury supports this idea, and suggests it is society’s response to female self-harm, and not self-harm itself, that is a gender issue. Ms. Salisbury is the director of Self injury Support, a UK-based support group which provides resources and training for women and girls who self-harm. “From being told you’re a ‘silly girl’ when seeking treatment for self-harm to being vilified for ‘daring to bare’ long-healed self-harm scars, responses to self-harm in women reflect wider themes for women in today’s society”, she remarks. “Even the language often attached to perceptions of self-harm – attention-seeking, manipulative, hysterical – is overwhelmingly associated with negative traits commonly attributed to women”7.
I feel ashamed not really because I self-harm but because it’s seen as something teenage girls do for attention. I have the impression that people might think it was just a whim. – Sarah, 20*
Female self-harm and the stigma attached to it are being tackled gradually, in a great diversity of fields.
Action
The 1980s and 1990s saw the emergence of women’s health activism. Groups like the Bristol Crisis Service for Women shaped their understanding of mental health issues and self-harm on lived experience. They gave a voice to women who had been treated with judgment by health professionals, listening to them with compassion and acknowledging that oppression and inequalities which affected women could have a role in women’s suffering8. This focus on lived experiences contributed to the demedicalization of self-injury and added a social reading to the previously prevailing medical reading. It also legitimized female self-harm, which faced heavy stigma and stereotypes.
In academia, historians like Sarah Chaney use history to explain stereotypes associated with female self-harm and discredit them. Chaney’s main interests revolve around the history of psychiatry. In 2017, she published a book titled Psyche on the Skin9 which tells the history of self-harm from antiquity to now and illustrates the evolution of social and medical beliefs. “I really wanted to get across the way attitudes to self-harm have related to wider public concerns, in particular contentions about gender. Early definitions tended to focus on men, but in the twentieth century this shifted significantly, with self-injury newly understood as a manipulative or hysterical practice often associated with women” she explained in an interview for the blog The Historian. “Perhaps more importantly, this understanding of self-injury was then used to support ideas about the psychology of women generally – if women self-harm, then women generally must be more deceitful than men. Looking back at these statements can be quite shocking to a modern audience but also, I think, opens our eyes to the way some of these notions remain embedded in our culture and attitudes today”10.
Outside of academia, artists use their talent to raise awareness of issues affecting women. Director Christina Beck directed the movie Perfection11 which tells the story of a woman who self-injures and seeks to raise awareness of self-harm. She explained the origins of her movie in her director statement: “While writing the script for PERFECTION I had an opportunity to be a part of a self-injury support group in Los Angeles. It was from hearing the stories of these women that I knew I had to make a film that would provoke conversation on this isolating, painful and often dangerous disorder that affects so many people”12. She further elaborates in an interview for the website Her Film: “My commitment was to support these other women by telling their stories in one character that could show the pain and private suffering along with the hope of getting to the other side of it”13.
Conclusion
Self-injury and mental health studies amongst women have been harshly stigmatized for years. To compensate for the lack of understanding by society and health professionals, several women spoke up about their experience or organized support groups. Paradoxically, due to the fact that self-injury was assumed to be a female behavior, up until the 21st century research was mainly done on samples of women and girls, meaning that male self-injury is much less understood. Both men and women suffer from gender misconceptions and we need to continue to raise awareness about health and mental health to remove such stigma.
*Name has been changed. All quotes are based on true lived experience.
References
[1] Chandler, A., & Simopoulou, Z. (2021). The Violence of the Cut: Gendering Self-Harm. International Journal of Environmental Research and Public Health, 18(9). https://doi.org/10.3390%2Fijerph18094650
[2] Whitlock, J., Muehlenkamp, J., Purington, A., Eckenrode, J., Barreira, P., Abrams, G. B., Marchell, T., Kress, V., Girard, K., Chin, C., & Knox, K. (2011). Nonsuicidal self-injury in a college population: general trends and sex differences. Journal of American college health, 59(8), 691-698. https://doi.org/10.1080/07448481.2010.529626
[3] Victor, S. E., Muehlenkamp, J. J., Hayes, N. A., Lengel, G. J., Styer, D. M., & Washburn, J. J. (2018). Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults. Compr Psychiatry, 82, 53-60. https://doi.org/10.1016%2Fj.comppsych.2018.01.009
[4] Gómez, J. M., Becker-Blease, K., & Freyd, J. J. (2015). A brief report on predicting self-harm: Is it gender or abuse that matters? Journal of Aggression, Maltreatment & Trauma, 24(2), 203-214. https://psycnet.apa.org/doi/10.1080/10926771.2015.1002651
[5] McManus, S., Walby, S., Barbosa, E. C., Appleby, L., Brugha, T., Bebbington, P. E., Cook, E. A., & Knipe, D. (2022). Intimate partner violence, suicidality, and self-harm: a probability sample survey of the general population in England. Lancet Psychiatry, 9(7), 574-583. https://doi.org/10.1016/s2215-0366(22)00151-1
[6] NatCen & Agenda. (2020). Often Overlooked: Young women, poverty and self-harm. https://www.agendaalliance.org/documents/29/Often_Overlooked_Report.pdf
[7] Salisbury, N. (2018, August 22). Is Self-Harm a Feminist Issue? Self Injury Support. https://www.selfinjurysupport.org.uk/blog/self-harm-a-feminist-issue
[8] Chaney, S., & Copperman, J. (2023). Women Listening to Women: Radical Reflections on Self-Injury Support. The British Journal of Social Work, 53(3), 1742–1750. https://doi.org/10.1093/bjsw/bcad041
[9] Chaney, S. (2017). Psyche on the Skin: A History of Self-Harm. Reaktion Books.
[10] Chaney, S. (2017, May 5). The history of self-harm: An interview with Sarah Chaney – The Historian. QMUL History Projects. https://projects.history.qmul.ac.uk/thehistorian/2017/05/05/the-history-of-self-harm-an-interview-with-sarah-chaney/
[11] Beck, C. (Director). (2012). Perfection [Film]. Ruby Lee productions LLC.
[12] Beck, C. (2011). Pressbook, Director’s statement. https://perfectionthemovie.files.wordpress.com/2011/03/pressbook-9-4.pdf%5B13%5D Her Film. (2012, January 16). PERFECTION: Interview with filmmaker Christina Beck. Her Film Archives. https://web.archive.org/web/20151201053657/https://her-film.com/2012/01/16/christina-beck/
Exploring self-harm 