I agree with many different factors mentioned so far and there is something else I've noticed and experienced with SI. Although there is limited understanding about it in the US, and the mental health professionals argue about it being attention seeking, it seems more expected or set that this is a behavior only female teenagers engage in. I've known male teenagers who engage in this as well - however if someone engages in this behavior beyond their teenage years, or engages in it as an adult, no one understands that, talks about it, or even acknowledges it - it just makes it that much harder to seek and receive treamtent out of the teenage years.
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