Introduction
This study investigated the intersectionality of adverse childhood experiences (ACEs)
among subgroups of sex, race/ethnicity, and sexual orientation.
Methods
Using data from the Behavioral Risk Factor Surveillance Survey across 34 states (N=116,712)
from 2009 to 2018, authors stratified subgroups of sex (male/female), race/ethnicity
(White/Hispanic/Black/multiracial/other), and sexual orientation (heterosexual/bisexual/gay)
to investigate the number of ACEs across groups. Analyses were conducted in 2022.
Results
Stratification resulted in 30 distinct subgroups (e.g., bisexual Black females, straight
multiracial males) with significant post hoc differences per group. Generally, those
identifying as sexual minority individuals had the highest number of ACEs (the top
14 of 30 subgroups), whereas 7 of the top 10 subgroups were female. Surprisingly,
no clear patterns emerged by race/ethnicity, although the 2 largest groups (straight
White females and straight White males) were 27th and 28th of 30, respectively.
Conclusions
Although studies have examined ACEs by individual demographic variables, less is known
about the extent to which ACEs are present in stratified subgroups. Sexual minority
subgroups (particularly female bisexual subgroups) trend toward a higher number of
ACEs, whereas heterosexual subgroups (regardless of sex) comprised the lowest 6 groups
with respect to ACEs. Implications include further examination of bisexual and female
subgroups (including specific ACE domain investigations) to identify the vulnerable
population.
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Published online: March 03, 2023
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