The impacts of adverse childhood experiences on socioeconomic disadvantage by sexual and gender identity in the U.S

Abstract

Background: Adverse childhood experiences (ACEs) predict low education and low income, but this has scarcely been examined by sexual orientation and gender identity.

Objective: We investigated prevalence and associations between ACEs, low income, and low education in sexual and gender diverse (SGD) and cisgender heterosexual (CGH) sub-groups.

Participants and setting: Data came from 14 states in the 2019 Behavioral Risk Factor Surveillance System survey (n = 79,303).

Methods: Chi-square, logistic regression, and moderation analyses were implemented to examine the prevalence and associations between ACEs, low income, and low education. Sample stratification was used to examine differences between SGD and CGH sub-groups.

Results: SGD participants reported higher prevalence of ACEs, low income, and low education compared to CGH participants (p < 0.0001) with the highest proportions in transgender and queer/something else groups. ACEs were associated with low income (AOR 1.084, CI 1.067-1.102) and low education (AOR 1.056, CI 1.041-1.071) in the entire sample. Transgender and queer/something else groups had higher odds of low income (AOR 3.345, CI 1.975-5.665; AOR 1.702, CI 1.096-2.643) and low education (AOR 1.702, CI 1.096-2.643; AOR 3.552, CI 2.842-4.440) and gay/lesbian identity had reduced odds of low education (AOR 0.586, CI 0.457-0.751) compared to CGH males. The strength of associations between ACEs and low income and low education were weaker among SGD compared to CGH sub-groups.

Conclusion: These findings highlight the importance of including categories of sexual identity cross-classified by gender identity in population-based analyses in order to facilitate a comprehensive characterization of the life course outcomes of SGD populations.

Keywords: Adverse childhood experiences; Education; Income inequality; LGBTQ; Minority stress; Sexual and gender minority; Socioeconomic.