Introduction

Studies highlight the impact of adverse childhood experiences (ACEs) on risk for negative health outcomes in adulthood, including cancer, cardiovascular disease, substance use, and mental health. Lesbian, gay, bisexual, and transgender (LGBT) people report higher rates of ACEs than non-LGBT people, with transgender people at greatest risk.

Objective

This study aims to comprehensively assess the prevalence of ACEs and association with health outcomes among transmasculine individuals.

Participants and setting

A sample of 131 transmasculine individuals enrolled in a clinical trial on preventive cervical cancer screening between March 2015 and September 2016 in the United States were surveyed about ACEs and health outcomes.

Methods

Pearson's chi-squared tests and logistic regression models were used to examine associations between self-reported ACEs prior to age 18 and the risk of various negative health outcomes in adulthood. ACEs were categorized as 0–1 ACEs, 2–3 ACEs, and 4+ ACEs.

Results

Over 90% of the sample (120/131) reported at least 1 ACE; 45% (59/131) reported 4+ ACEs. Report of 4 or more ACEs increased risk for negative health outcomes and risk factors compared to 0–1 ACEs, including: depression (AOR = 5.3, 95%CI = 1.7, 16.2), suicidality (AOR = 5.2, 95%CI = 1.4, 18.8), post-traumatic stress disorder (AOR = 6.0, 95%CI (1.6, 22.8)), intimate partner violence (AOR = 5.3, 95%CI = 1.4, 18.8), and obesity (AOR = 8.2, 95%CI = 1.8, 37.2). Report of 2–3 ACEs was also significantly associated with obesity (AOR = 5.9, 95%CI = 1.3, 26.2).

Conclusions

ACEs are highly prevalent in this sample, and more attention is needed for research and intervention. This exploratory study is the first to comprehensively highlight patterns of physical and mental health risk and victimization associated with report of ACEs among transmasculine individuals. Trauma-informed screening and intervention efforts tailored to the unique needs of this population are needed to provide appropriate and effective care. Clinicians should consider routinely screening for ACEs among transmasculine youth and engage in prevention strategies to reduce health disparities. Further research is warranted to validate these findings among larger, more representative samples to better reflect the diversity of experiences and identities of transmasculine individuals and produce more reliable findings.

中文翻译：

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对跨男性成人的不良童年经历以及与负面身心健康和受害相关的初步调查结果

介绍

研究强调了不良童年经历 (ACE) 对成年期负面健康结果风险的影响，包括癌症、心血管疾病、物质使用和心理健康。女同性恋、男同性恋、双性恋和跨性别 (LGBT) 人群报告的 ACE 发病率高于非 LGBT 人群，其中跨性别人群面临的风险最大。

客观的

本研究旨在全面评估跨男性个体中 ACE 的患病率及其与健康结果的关联。

参与者和设置

对 2015 年 3 月至 2016 年 9 月在美国参加的预防性宫颈癌筛查临床试验的 131 名跨男性个体样本进行了关于 ACE 和健康结果的调查。

方法

Pearson 的卡方检验和逻辑回归模型用于检查 18 岁之前自我报告的 ACE 与成年期各种负面健康结果风险之间的关联。ACE 分为 0-1 ACE、2-3 ACE 和 4+ ACE。

结果

超过 90% 的样本 (120/131) 报告了至少 1 个 ACE；45% (59/131) 报告了 4 个以上的 ACE。与 0-1 次 ACE 相比，报告 4 种或更多 ACE 会增加负面健康结果和风险因素的风险，包括：抑郁症 (AOR = 5.3, 95%CI = 1.7, 16.2)、自杀 (AOR = 5.2, 95%CI = 1.4) , 18.8)、创伤后应激障碍 (AOR = 6.0, 95%CI (1.6, 22.8))、亲密伴侣暴力 (AOR = 5.3, 95%CI = 1.4, 18.8) 和肥胖 (AOR = 8.2, 95% CI = 1.8, 37.2)。2-3 个 ACE 的报告也与肥胖显着相关（AOR = 5.9, 95%CI = 1.3, 26.2）。

结论

ACE 在该样本中非常普遍，需要更多关注研究和干预。这项探索性研究首次全面强调了与跨男性个体中 ACE 报告相关的身心健康风险和受害模式。需要针对这一人群的独特需求量身定制的创伤知情筛查和干预工作，以提供适当和有效的护理。临床医生应考虑在跨男性青年中定期筛查 ACE，并参与预防策略以减少健康差异。需要进一步研究以在更大、更具代表性的样本中验证这些发现，以更好地反映跨男性个体的经历和身份的多样性，并产生更可靠的发现。