# Expanding the sexual and gender minority adverse childhood experiences scale to improve measurement of SGM identity-based early life adversity

> **NIH NIH R01** · UNIVERSITY OF TEXAS AT AUSTIN · 2024 · $792,443

## Abstract

Project Summary
Early life adversity, also known as adverse childhood experiences (ACEs) contribute to poor mental and physical
health outcomes in adulthood in the general population. Research shows that sexual and gender minority (SGM)
adults report more ACEs than heterosexual adults. We argue that it is cisheteronormativity – the societal belief
that everyone is cisgender and heterosexual, that increases risk for exposure to general ACEs, that
cisheteronormativity leads to cisheterosexism – or SGM-identity based discrimination, mistreat and violence
exposure, and that exposure to cisheterosexism in early life should be considered a unique ACE experienced by
SGM populations (SGM-ACEs). In fact, there is some evidence to suggest that exposure to cisheterosexism prior
to adulthood may follow similar biological and neurodevelopmental pathways as exposure to ACEs. We have
developed a first iteration of an SGM-ACEs measure, found that it had good to excellent psychometric properties,
and was associated with proximal and distal minority stress factors in adulthood. However, evidence for SGM-
ACEs impact on mental and physical health outcomes has not been examined rigorously. In addition, our
measure was initially developed from a sample in Bexar County, TX and attention was not given to the potential
differences in experiences at the intersection of sexual and gender identity. To inform future efforts to address
mental and physical health disparities in SGM adults, additional development and testing of SGM-ACEs is
needed, specially using a test-retest design of the measure, more valid and reliable psychological outcome
measures, and an assessment of more objective biomarker measures (e.g., immune function) in adulthood. In
addition, a more thoughtful approach is needed in the development of the next iteration of the measure that
includes identification of the unique experiences of SGM adults outside the geographic boundaries of the original
study, and at the intersection of gender and sexual identity, more specifically across four intersectional SGM
groups: 1. Cisgender monosexuals 2. Gender minority monosexuals 3. Cisgender non-monosexuals 4. Gender
minority (e.g., transgender, non-binary) non-monosexual, and this needs to be followed by an assessment of
measurement equivalence across these four intersectional groups. We propose to: 1. Recruit 15 SGM adults in
each intersectional SGM groups and interview them to identify additional SGM-ACE items related to the
experiences of gender minority individuals, non-monosexual individuals, and SGM adults outside of TX, and to
better understand the perceived impact of SGM-ACEs in early life through adulthood., 2. Use human centered
design methods to co-create SGM-ACEs with community advisory board, and pre-test it with 40 SGM adults and
an expert panel, and 3. Recruit a national sample of 1,844 SGM adults from The PRIDE Study to reach 300
respondents in each the four intersectional SGM groups, use EFA and CFA ...

## Key facts

- **NIH application ID:** 10782353
- **Project number:** 1R01MH136962-01
- **Recipient organization:** UNIVERSITY OF TEXAS AT AUSTIN
- **Principal Investigator:** Phillip W. Schnarrs
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $792,443
- **Award type:** 1
- **Project period:** 2024-04-01 → 2030-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10782353

## Citation

> US National Institutes of Health, RePORTER application 10782353, Expanding the sexual and gender minority adverse childhood experiences scale to improve measurement of SGM identity-based early life adversity (1R01MH136962-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10782353. Licensed CC0.

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