Socioeconomic Disadvantage: The Global Impacts of Adverse Childhood Experiences By Sexual and Gender Identity

Background/Purpose

In spite of prevailing stereotypes that portray sexual and gender minority (SGM) individuals as more financially stable than their cis-gender, heterosexual counterparts (CGH), current research indicates that SGM individuals face marked disparities in terms of socioeconomic status (SES). SES results from complex interactions between social, structural, health, and educational domains. A growing research base demonstrates an association between Adverse Childhood Experiences (ACEs) and lower SES in the general population. Previous research has found that lesbian, gay, and bisexual individuals may have higher odds of ACEs (ranging from 1.4 to 3.1) than CGH groups. This disproportionate experience of ACEs provides a rationale to investigate the association between ACEs and SES across sexual and gender identities. To our knowledge there has not been a study of population data that examines these associations by sexual and gender identity.

This research aims to delineate the prevalence of ACEs among SGM and CGH individuals. We will also examine the link between ACEs and SES (through poverty status and educational attainment) by sexual and gender identity. This endeavour will contribute to the field by providing a clear assessment of the disparities and associated needs of a population that has often been overlooked.

Methods

Data and sample: The sample consists of participants from the 2019 Behavioral Risk Factor Surveillance System that answered all questions about ACEs and Sexual and Gender Identity (14 states). Participants younger than 29 and older than 65 years were excluded in order to target the years where earning power is expected to be highest (n=55,499).

Measures: 11 types of ACEs were summed. The dependent variable, SES, was calculated in two ways: low income (i.e., below the federal poverty level vs. above) and low education (not a college graduate vs. college graduate). Covariates included race, gender, marital status, and age.

Analysis: We examined the distribution of all variables by sexual and gender identity. Logistic regression was then used to examine the odds of low income and low education (SGM vs. CGH).

Results

37.8% of SGM individuals experienced 4 or more ACEs compared to 16% of CGH individuals. Only 21.4% of the SGM sample experienced 0 ACEs versus 40.5% of the CGH sample. Logistic regression showed that bisexual females had 1.8 times the odds of low income compared to CGH females and transgender individuals had 1.7 times the odds of low income compared to SGM men. Educational outcomes demonstrated that bisexual males had 1.1 times the odds and transgender individuals had 2.7 times the odds of low education compared to CGH males.

Conclusions/Implications

Our findings indicate that SGM individuals face greater risk of ACEs and their deleterious effects, including low SES. These findings point to significant barriers to thriving for a community that has historically faced discrimination and oppression. We recommend that social work researchers conduct further investigation to clarify the pathways between ACEs and low SES in SGM populations. The generation of this knowledge represents a crucial step in the pursuit of equity and justice for SGM individuals, families, and communities.