<p>Over the last few decades, self-injury has gained wide visibility in Japanese popular culture from <em>manga</em> (graphic novel), <em>anime</em> (animation), to digital games and fashion. Among the most conspicuous is the emergence of <em>menhera</em> (a portmanteau of “mental health-er”) girls, female characters who exhibit unstable emotionality, obsessive love, and stereotypical self-injurious behaviors such as wrist cutting. Tracing the expansion of this popular cultural slang since 2000, this conceptual article explores three narrative tropes of <em>menhera</em>—the sad girl, the mad woman, and the cutie. Within these <em>menhera</em> narratives, self-injury functions as a self-sufficient signifier of female vulnerability, monstrosity, and desire for agency. These <em>menhera</em> tropes, each with their unique interpretation of self-injury, have evolved symbiotically with traditional gender norms in Japan, while destabilizing long-standing undesirability of sick/detracted female bodies. The <em>menhera</em> narrative tropes mobilize cultural discourses about female madness and subsequently feed back into the social imaginaries, offering those who self-injure symbolic resources for self-interpretation. We argue that popular cultural narratives of self-injury like <em>menhera</em> may exert as powerful an influence as clinical discourses on the way we interpret, make sense of, and experience self-injury. Being attentive to cultural representations of self-injury thus can help clinicians move toward compassionate clinical practice beyond the medical paradigm.</p>