Adverse Childhood Experiences and Sexual Orientation: An Intersectional Analysis of Nationally Representative Data

Citation

Mersky, Joshua P.; Lee, ChienTi Plummer; & Hami, Davin (2023). Adverse Childhood Experiences and Sexual Orientation: An Intersectional Analysis of Nationally Representative Data. American Journal of Preventive Medicine.

Abstract

Introduction: This study compared the prevalence of adverse childhood experiences (ACEs) across intersections of sexual orientation, gender, race/ethnicity, and economic status. Methods: Data collected between 1994 and 2018 from 12,519 participants in the National Longitudinal Study of Adolescent to Adult Health were analyzed in 2023 to generate ACE prevalence estimates. Unadjusted one-way ANOVAs and multivariate regressions were performed to compare differences in independent and cumulative ACE measures by sexual orientation, gender, race/ethnicity, and poverty status. A multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was conducted to estimate ACE scores across 24 groups that were stratified by sexual orientation, gender, race/ethnicity, and poverty status. Results: Compared to straight participants, adolescents with same-sex attractions and adults who identified with a sexual minority group reported more ACEs overall, though associations varied by ACE type. Strikingly, ACE scores were higher among White than Black youth with same-sex attractions, more economically advantaged than poor bisexual adults, and poor White than poor Black and Hispanic participants, suggesting that the combination of disadvantaged and marginalized statuses does not necessarily correspond with greater childhood adversity. A MAIHDA interaction model showed that sexual orientation and poverty status contributed significant variance to cumulative ACE scores whereas gender and race/ethnicity did not. Conclusions: The results show that ACE disparities can be more fully and accurately represented when sexual orientation and other social identities are modeled as intersectional configurations. Given that ACEs are linked to morbidity and mortality, the findings have salient implications for understanding health disparities that affect population subgroups.

URL

https://doi.org/10.1016/j.amepre.2023.10.015

Keyword(s)

Adverse Childhood Experiences

Reference Type

Journal Article

Journal Title

American Journal of Preventive Medicine

Author(s)

Mersky, Joshua P.
Lee, ChienTi Plummer
Hami, Davin

Year Published

2023

Edition

October 24, 2023

DOI

10.1016/j.amepre.2023.10.015

Reference ID

10148