Evidence suggests that sexual minority (SM) and gender minority (GM) youth are more likely to experience self-injurious thoughts and behaviors (SITBs) than heterosexual and cisgender youth. A major barrier to identifying and treating SITBs is nondisclosure. In this study, we explored differences in SITB disclosure patterns between SM and GM youth and their heterosexual and cisgender peers. In this study, we further examined the association between discrimination experiences and SITB disclosure.

Adolescents (N = 931) completed questionnaires assessing demographics, SITBs, disclosure history, disclosure barriers, future intentions to disclose SITBs, and discrimination history.

Few differences in SITB disclosure patterns emerged between SM and GM youth and heterosexual and cisgender youth (P > .05). SM and GM youth endorsed greater rates of fear of disclosure to and worrying parents, two parent-related barriers ( = 8.11, P = .017; = 7.25, P = .027). GM youth reported greater discrimination experiences than SM youth (F = 6.17, P = .002); discrimination experiences impacted their willingness to disclose future SITBs more so than their SM and heterosexual and cisgender peers (F = 11.58, P < .001). Among the full sample, more discrimination experiences were associated with lower previous disclosure honesty to therapists and pediatricians (r = –0.09 to –0.10, P < .05). Among SM and GM youth, discrimination experiences were associated with lesser odds of disclosing suicide attempts in the future (r = –0.12, P < .05).

Minority stress experiences may interfere with SITB disclosure, particularly among GM youth. Targeted interventions should be considered to reduce minority stress and support disclosure.

有证据表明，与异性恋和顺性别青年相比，性少数 (SM) 和性别少数 (GM) 青年更有可能经历自残思想和行为 (SITB)。识别和治疗 SITB 的一个主要障碍是保密。在这项研究中，我们探讨了 SM 和 GM 青年及其异性恋和顺性别同龄人之间 SITB 披露模式的差异。在这项研究中，我们进一步研究了歧视经历与 SITB 披露之间的关联。

青少年 ( N = 931) 完成了评估人口统计、SITB、披露历史、披露障碍、未来披露 SITB 的意图和歧视历史的问卷调查。

SM 和 GM 青年与异性恋和顺性别青年之间的 SITB 披露模式几乎没有差异 ( P > .05)。SM 和 GM 的青年人认为害怕向父母披露和担心父母的比例更高，这是与父母相关的两个障碍（= 8.11，P = .017；= 7.25，P = .027）。GM 青年比 SM 青年报告了更多的歧视经历（F = 6.17，P = .002）；歧视经历对他们披露未来 SITB 的意愿的影响大于他们的 SM、异性恋和顺性别同龄人 (F = 11.58, P < .001)。在全部样本中，更多的歧视经历与较低的先前对治疗师和儿科医生的披露诚实度相关（r = –0.09 至 –0.10，P < .05）。在 SM 和 GM 青年中，歧视经历与未来披露自杀未遂的可能性较小有关（r = –0.12，P < .05）。

少数人的压力经历可能会干扰 SITB 的披露，尤其是在 GM 青年中。应考虑采取有针对性的干预措施，以减少少数群体的压力并支持披露。