Adverse childhood experiences and mental health of sexual and gender minorities in Canada, USA, and Japan.

BACKGROUND

Sexual and gender minorities have an increased risk for adverse childhood experiences (ACEs) and worsening mental health. However, cross-country research on varying levels of social acceptance remains limited. We compared the impact of sexual and gender minority status on ACEs and poor mental health between Canada, USA, and Japan.

METHODS

This cross-sectional study included 50,628 adults in 2022. Sexual and gender minority individuals included those identifying as lesbian, gay, bisexual, transgender, or non-binary. Poor mental health was defined as experiencing not good mental health for ≥ 14 days in the past 30 days in USA, and scoring ≥ 13 on the Kessler 6-item Psychological Distress Scale in Canada and Japan. ACEs included witnessing domestic violence, experiencing physical abuse, and experiencing sexual assault. Social acceptance was assumed high in Canada, moderate in USA, and low in Japan based on Global Acceptance Index 2017-2020.

RESULTS

Sexual and gender minorities reported experiencing sexual assault more frequently (odds ratio = 1.68, 95 % confidence interval = 1.17-2.42). Sexual and gender minorities in USA had a higher risk for sexual assault compared to those in Japan (1.71, 1.06-2.74). After adjusting for presence of ACEs, sexual and gender minorities reported more frequent poor mental health (1.77, 1.40-2.24). Sexual and gender minorities in Canada had a higher risk for poor mental health compared to those in Japan (1.85, 1.21-2.80).

CONCLUSION

Sexual and gender minorities faced a higher risk of ACEs and poor mental health regardless of country. Further research is needed to understand the underlying mechanisms of the increased risk.