The Sexual and Gender Minority Adverse Childhood Experiences Scale

Introduction: Sexual and gender minority (SGM) adverse childhood experiences (ACEs) are iden-tity-based forms of early life adversity. Exposure to SGM ACEs is associated with increased odds of depression, anxiety, and post-traumatic stress disorder in SGM adults. The purpose of this study was to further test a revised version of the measure in a U.S. sample with more robust and clinically relevant mental health outcomes. Methods: In May and June 2022, a national sample of SGM adults (N=4,445) was recruited from a Qualtrics Panel to complete a 20-minute online survey that included questions regarding ACEs, SGM ACEs, depression, anxiety, and post-traumatic stress disorder. Exploratory factor analysis and confirmatory factor analysis were used to examine factor structure. Multivariable regression was used to assess criterion validity, and a sensitivity analysis was conducted. Data were analyzed in February 2023. Results: Respondents indicate that vicarious trauma (81%) and school bullying (67%) were the most common experiences and that all SGM ACEs were frequently occurring before adulthood. Confirmatory factor analysis determined a 1-factor solution. Participants with more SGM adverse childhood experiences exposure had worse anxiety, depression, and post-traumatic stress disorder symptoms (/3=0.16, /3=0.18, /3=0.26, respectively, p<0.0001) after controlling for ACEs exposure and demographic factors. A sensitivity analysis indicated that estimates were similar in terms of magnitude and direction. Conclusions: SGM ACEs commonly and frequently occur before adulthood and impact adult SGM mental health. Overall, the measure had good-to-excellent psychometric properties. Future research should consider integrating SGM ACEs and Minority Stress Theory. Am J Prev Med 2023;65(6):1050-1058. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.

Automated summary

This study examines the impact of sexual and gender minority (SGM) adverse childhood experiences (ACEs) on adult mental health through an online survey. The results show that SGM ACEs commonly and frequently occur before adulthood and are associated with anxiety, depression, and post-traumatic stress disorder. The study also validates the reliability and validity of the measurement tool and suggests integrating SGM ACEs with Minority Stress Theory in future research.