# Sex as Self-Injury Among Youth Clinic Visitors in Sweden

## TL;DR

This study explores how some young people in Sweden use sex as a form of self-harm and finds it is linked to other risky behaviors and trauma.

## Contribution

The study provides new insights into the prevalence and risk associations of sex as self-injury among youth clinic visitors in Sweden.

## Key findings

- 12.30% of participants reported experiencing sex as self-injury (SASI).
- SASI was strongly associated with sexual harassment, STI diagnosis, drug use, and experience of violence.

## Abstract

Earlier research has found that sex could be used as a means of self-injury with functions comparable to other self-injurious behaviors such as cutting or burning the skin. A suggested definition for sex as self-injury (SASI) is “a pattern of seeking sexual situations involving psychological or physical harm to themselves.” The research concerning SASI is sparse and the behavior is still in need of further understanding. The aim of this study was to investigate the prevalence of SASI among visitors to youth clinics in Sweden and the associations with sexual risk-taking, drug and alcohol consumption, and experience of violence. The study was based on data collected through the SEXual health Identification Tool (SEXIT) at youth clinics in multiple Swedish cities. A total of 813 participants were included in the study (Median = 19 years, SD 2.52 years, 734 identified as women, 78 as men, and 1 as other). Overall, 12.30% of the participants reported experience of SASI. SASI was most strongly associated with experience of sexual harassment or assault (OR 6.22), ever being diagnosed with a sexually transmitted infection (OR 3.07), drug use (OR 3.02), and experience of physical and/or psychological violence (OR 2.78). In conclusion, SASI is occurring among youth clinic visitors and is associated with factors that endanger young people’s physical and psychological well-being. Healthcare professionals need to have knowledge of SASI to offer proper help and support.

The online version contains supplementary material available at 10.1007/s10508-025-03325-w.