Increased adverse health outcomes in sexual minority populations exposed to stressful childhood experiences: a meta-analysis

Background: Within sexual- and gender-diverse populations, stressful childhood experiences (SCEs) impact health outcomes in adulthood. We conducted a meta-analysis of the impact of SCEs on health outcomes among sexual- and gender-minority populations. Methods: We conducted a systematic review and meta-analysis based on preregistered search criteria. The initial search identified 3,067 articles from 2013-2022, narrowed to 64 independent studies following double-reviewer abstract and full-text screening. Seven health outcomes were identified: psychological health (k = 26), suicide and related behaviors (k = 23), substance use (k = 14), sexual health (k = 13), physical health (k = 5), housing instability (k = 3), and adulthood abuse/victimization (k = 3). An individual meta-analysis was conducted for each health outcome. Results: Across all health outcomes, there were increased odds (31 - 132%) for sexual- and gender-diverse-identifying individuals who experienced SCEs before age 18 to develop an adverse health outcome after age 18. Conclusion: Increased odds for the development of an adverse health outcome following SCEs among sexual- and gender-diverse populations highlight the need to assess SCEs in research and clinical practice. This is one of the largest meta-analyses to examine the impacts of SCEs on health outcomes among LGBTQ+ populations. Beyond research and the clinic, these findings have critical policy implications for creating environments that mitigate the impact of SCEs on health outcomes for LGBTQ+ individuals.