Hair pulling and skin picking behaviors in gender and sexual minorities assigned female at birth

Introduction Research suggests that gender and sexual minorities report elevated rates of psychiatric disorders, but the clinical correlates of sexual and gender minority status are often lacking or seem contradictory. Existing literature on sexual minorities indicates no significant difference in hair pulling severity between heterosexual and sexual minority individuals, but it does indicate greater severity of skin picking behaviors on some metrics in sexual minorities. No study, however, has examined hair pulling and skin picking in gender minorities. Methods Participants who self-reported hair pulling and skin picking behaviors completed an online survey. Descriptive statistics were derived to determine prevalence of gender and sexual minorities. For each gender minority participant, two cisgender sexual minority participants and two cisgender heterosexual participants were matched on age, sex assigned at birth, and behavior (hair pulling, skin picking, or both). The final sample (mean age=26.2, SD =5.2) consisted of 33 gender minority participants, 66 cisgender sexual minority participants, and 66 cisgender heterosexual participants. All participants were assigned female at birth. All three groups were compared on demographics, pulling and picking characteristics, and comorbidities. Results In the overall survey, 9.0% were gender minorities and 34.8% were cisgender sexual minorities. In the final sample, gender minority participants picked their skin for more days over the past week than cisgender heterosexual participants. Gender minority participants also began picking at a younger age than cisgender heterosexual participants. There were no significant differences in any pulling variables between gender minority and cisgender heterosexual participants. There were no significant differences in pulling or picking variables between cisgender sexual minorities and gender minorities or between cisgender sexual minorities and cisgender heterosexual participants. Conclusions There may be greater representation of gender and sexual minorities in people who engage in excessive hair pulling and skin picking. Moreover, gender and sexual minority status may be associated with more severe picking and an earlier onset of picking behavior.