Self-identification by Sexual and Gender Minorities as a Crucial Aspect of Inclusion in a Study of Adverse Childhood Experiences in Haiti

Abstract

Measures of biopsychosocial are inevitably affected by contextual norms, local ideologies, social mores, and self-identification as well as extant policies and laws. Self-identification can is often emotionally laden and can be constrained by fear of reprisal if one’s self-identification departs from acceptable and affirmed norms. Hence, measurement efforts can be hampered and results from established measures can fail to yield accurate and useful data. Adverse Childhood Experiences (ACEs) are understudied in Haiti. We investigated ACEs in Haiti’s urban using the ACE international questionnaire (ACE-IQ). Descriptive statistics permitted exploration of: (1) relationship between participants’ self-identification and sex recorded as observed by interviewers, and (2) prevalence of ACEs by self-reported identity. Roughly half participants self-identified as ’Woman’ (56%; n = 380), 39% as ’Man’ (n = 265), 2% as ’Homosexual’ (n = 13), and 2% as ’Lesbian’ (n =14). Contradictions emerged between participant self-identification and interviewers’ record of sex: 98% self-identified women were observed/recorded as ’Female’, one was observed/recorded as ’Male’, and there was no record for 5. Similarly, 95% self-identified men were observed/recorded as ’Male’, six as ’Female’, two as ’Other’, and there was no record for 5. Although Sexual and Gender Minorities (SGM) constituted a small subsample (n = 27), their responses underscored disproportionate burdens of physical, emotional, sexual abuse, family dysfunction, and interpersonal violence (bullying, community, collective) relative to others. Conducting ACE-IQ studies in Haiti that provide inclusive categories of self-identification may more equitably capture unique ACEs of all Haitians.