Higher Prevalence of Adverse Childhood Experiences in Transgender Than in Cisgender Individuals: Results from a Single-Center Observational Study

Abstract

Adverse childhood experiences (ACE) have been shown to have a tremendous negative impact on health outcomes later in life. This study presents data on the prevalence of ACEs, psychological distress, and trauma-related symptoms in transgender and gender-diverse (TGD) people compared to cisgender people. TGD adults (n = 35) and a matched sample of nonpsychiatric hospital patients (n = 35) were surveyed between September 2018 and March 2019. Participants completed the Maltreatment and Abuse Chronology of Exposure Scale to assess ACEs, as well as the Brief Symptom Inventory and the Essener Trauma Inventory to assess psychological distress and trauma-related symptoms. TGD patients reported a higher number of ACEs than cisgender patients (0.7 vs. 2.4; p < 0.001; d = 0.94). A total of 28.6% of TGD vs. 5.7% cisgender patients reported four or more ACEs (p < 0.001). The most common forms of ACEs were parental abuse (54.3%) and peer abuse (54.3%). No significantly increased prevalence of sexual abuse was found (p > 0.05). TGD patients also reported a higher prevalence of depression (48.4% vs. 5.7%, p < 0.001), posttraumatic stress disorder symptoms (59.4% vs. 13.8%, p < 0.001), and anxiety (58.1% vs. 28.6%, p = 0.016). Health care providers should be aware of and assess ACEs, especially in vulnerable groups such as TGD people, and create a safe place through open-minded, affirming care.

Characteristics of children and adolescents referred to specialist gender services: a systematic review

“…This review indicates that the majority of studies have not routinely measured or recorded the presence of ACES in the histories and experiences of children and adolescents being referred to paediatric gender services so there is limited data despite the wider research indicating that gender-diverse youth and adults have experienced high rates of childhood adversity. [121][122][123][124][125] It is not possible for this review to speculate as to the relationship between ACES and the experience of gender-related distress in children and adolescents, but the results indicate that this is another important area in which systematic collection of data, at referral and across pathways of care can support care.…”

Care pathways of children and adolescents referred to specialist gender services: a systematic review

“…Many of those referred will experience gender dysphoria, which can cause significant distress 4. Mental health difficulties, neurodevelopmental conditions and psychosocial complexity are higher in referred children and adolescents compared with their peers who do not experience gender incongruence; the relationship between gender dysphoria and these co-occurring conditions is poorly understood 4–9…”

“…4 Mental health difficulties, neurodevelopmental conditions and psychosocial complexity are higher in referred children and adolescents compared with their peers who do not experience gender incongruence; the relationship between gender dysphoria and these co-occurring conditions is poorly understood. [4][5][6][7][8][9] Specialist gender services are evolving to the changing demand for gender-related care by establishing new triage processes, 10 developing multiple care pathways for those presenting with different needs, 11 provision of psychological care by local mental health services 11 12 and expanding provision. 13 14 Uncertainties in the evidence base about the benefits, risks and long-term effects of care pathways and medical interventions for this population are also driving these changes.…”

Adverse childhood experiences among black sexually minoritized men and Black transgender women in Chicago

“…Adverse childhood experiences (ACE) are important predictors of poor mental health outcomes such as depressive symptoms, anxiety, and mental distress in adulthood [ 1 , 2 ]. ACE scores are higher in vulnerable groups such as Sexual and Gender Minorities (SGM) (e.g., Sexually Minoritized Men (SMM) and transgender individuals) compared to heterosexuals and has been hypothesized to mediate the relationship between sexual orientation and mental health [ 1 – 4 ]. It is also known that Black individuals who grew up in underserved communities with higher crime rates and poverty are more likely to endorse ACE items compared to the general populations [ 5 ].…”