MedicalResearch.com Interview with:
Anna Austin, MPH
UNC Gillings School of Global Public Health
MedicalResearch: What is the background for this study? What are the main findings?
Response: Several studies have examined experiences of childhood abuse among individuals who identify as lesbian, gay, or bisexual (LGB), but there has been relatively little research exploring experiences of other types of childhood trauma, like witnessing domestic violence between parents or growing up with a parent who is an alcoholic, among LGB individuals. We know from the study on adverse childhood experiences (ACEs) conducted by Kaiser Permanente and the Centers for Disease Control and Prevention that the greater number of childhood traumas and adversities an individual experiences, the greater the risk for poor health later in life. There have also been a number of studies that have demonstrated health disparities by sexual orientation, with LGB adults typically having worse health than heterosexual adults. We were interested in the role that multiple types of adverse childhood experiences play in the development of poor adult health outcomes among LGB individuals.
In this study, we captured 8 categories of ACEs. We captured 3 categories of childhood abuse (sexual, physical, and emotional abuse) and 5 categories of household dysfunction (adult mental illness, substance abuse, and domestic violence in the household; incarceration of a household member; and parental divorce or separation). LGB adults were more likely to report each of these 8 categories of ACEs than heterosexuals, with the largest differences found for sexual abuse, adult mental illness in the household, and incarceration of a household member. LGB adults were also more likely to report having experienced multiple ACEs. Forty-two percent of LGB adults compared to 24 percent of heterosexual adults reported having experienced between 3 to 8 ACEs.
We also found that LGB adults were more likely to report poor adult health like smoking, HIV risk behaviors, 14 or more days of poor physical or mental health in the past 30 days, asthma, depression, and disability than heterosexuals. However, after we accounted for the number of ACEs each individual reported, LGB adults were no longer more likely to report smoking, binge drinking, and 14 or more days of poor physical health in the past 30 days.
MedicalResearch: What should clinicians and patients take away from your report?
Response: We know that adverse childhood experiences have an important effect on health and well-being regardless of sexual orientation, but our findings show the importance of directing attention to ACEs among the LGB population. Our findings suggest that ACEs may play a role in the development of poor health outcomes among LGB adults and may contribute to some of the health disparities we see for LGB adults. Policies designed to help prevent children from experiencing ACEs and services intended to help LGB adults recognize and cope with the stress of childhood adversity may help to improve health outcomes and reduce health disparities. In practice, providers should be aware of the potential for a history of exposure to multiple ACEs among LGB individuals and how these experiences may be affecting their health.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Response: In future research, it would be helpful to know the age at which LGB individuals came out, particularly if they came out before the age of 18, so that we could understand how coming out may have affected experiences of ACEs. Future research should also explore why LGB individuals report a higher number of ACEs than heterosexuals and how ACEs interact with other stressors faced by LGB individuals, like discrimination, stigma, and adult experiences of violence, to contribute to health disparities. In addition, research into factors that promote resiliency – the ability to “bounce back” from adversity – among LGB individuals who have experienced ACEs will help to improve wellbeing in this population.
Anna Austin, MPH (2015). Adverse Childhood Experiences Contribute To Poor Health Outcomes in LBG Adults MedicalResearch.com