“There’s Always a Way to Get Around the Guidelines”: Nonsuicidal Self-Injury and Content Moderation on TikTok

The stigmatized nature of nonsuicidal self-injury may render TikTok, a short-form, video-sharing social media platform, appealing to individuals who engage in this behavior. Since this community faces biased scrutiny based on stigmatization surrounding mental health, nonsuicidal self-injury users may turn to TikTok, which offers a space for users to engage in discussions of nonsuicidal self-injury, exchange social support, experience validation with little fear of stigmatization, and facilitate harm reduction strategies. While TikTok’s Community Guidelines permit users to share personal experiences with mental health topics, TikTok explicitly bans content that shows, promotes, or shares plans for self-harm. As such, TikTok may moderate user-generated content, leading to exclusion and marginalization in this digital space. Through semi-structured interviews with 8 TikTok users and a content analysis of 150 TikTok videos, we explore how users with a history of nonsuicidal self-injury experience TikTok’s algorithm to engage with content on nonsuicidal self-injury. Findings demonstrate that users understand how to circumnavigate TikTok’s algorithm through hashtags, signaling, and algospeak to maintain visibility while also circumnavigating algorithmic detection on the platform. Furthermore, findings emphasize that users actively engage in self-surveillance, self-censorship, and self-policing to create a safe online community of care. Content moderation, however, can ultimately hinder progress toward the destigmatization of nonsuicidal self-injury.