What's Your ACE Score?
ACE stands for Adverse Childhood Experiences — ten categories of childhood adversity that research has linked to later health outcomes. These include abuse (physical, emotional, or sexual), neglect (physical or emotional), and household dysfunction (substance abuse, mental illness, domestic violence, parental separation, or incarceration).
The original CDC-Kaiser study found that the more ACEs someone had, the higher their risk for depression, addiction, heart disease, and early death. Population data shows 64% of people have at least one ACE and 12.5% have four or more.
What's interesting is that sexual minority populations consistently score higher on ACEs compared to their heterosexual peers.
The Finding
Andersen & Blosnich (2013) analyzed data from over 22,000 adults across three states using probability-based sampling from the CDC's Behavioral Risk Factor Surveillance System. The findings:
- Gay/lesbian individuals experienced increased odds of six out of eight ACE categories
- Bisexual individuals experienced increased odds of seven out of eight ACE categories
- Gay/lesbian respondents had 1.66 times the rate of adverse childhood experiences
- Bisexual respondents had 1.58 times the rate
Higher rates showed up across nearly every category: physical abuse, emotional abuse, sexual abuse, household mental illness, household substance abuse, parental separation, and domestic violence exposure.
The ACE Test
While it doesn't capture every possible adverse experience, it identifies ten categories strongly linked to later health outcomes. Here's the test:
Before age 18, did you experience any of the following? Check all that apply:
☐ Physical abuse: A parent or adult in your home hit, beat, kicked, or physically hurt you
☐ Emotional abuse: A parent or adult in your home swore at you, insulted you, or made you fear physical harm
☐ Sexual abuse: An adult or person at least 5 years older touched you sexually or made you touch them
☐ Physical neglect: You didn't have enough to eat, clean clothes, or someone to protect you
☐ Emotional neglect: No one in your family made you feel important, loved, or protected
☐ Household substance abuse: Someone in your home was an alcoholic or used street drugs
☐ Household mental illness: Someone in your home was depressed, mentally ill, or attempted suicide
☐ Domestic violence: Your mother or stepmother was pushed, grabbed, slapped, or threatened
☐ Parental separation/divorce: Your parents were separated or divorced
☐ Incarcerated household member: Someone in your home went to prison
Your score: ___ / 10
My Score — And What I'm Wondering
I scored 3.
Below that critical threshold of 4 where risk really spikes. The original ACE study found that people with 4 or more ACEs have 4-12x higher risk for depression, addiction, and suicide attempts compared to those with zero. They're also 2-4x more likely to report 50+ sexual partners. I did not score as high as you might expect given how much I write about this stuff.
And yet, here I am.
While I do believe there's a connection between childhood wounds and same-sex attraction. But I'm starting to think there's more nuance to it than the word 'trauma' captures.
I've been reflecting on my relationship with my parents. A lot of ex-gay narratives focus on attachment wounds from the same-sex parent, and I've written about my dad in the past. But the truth is, it hasn't been all bad. In some ways, we're very similar. In others, completely different.
Those differences played out over years with little understanding between us. There were bad moments. But by and large it was mostly just a gradual drift. Two people who didn't quite speak the same emotional language, accumulating small ruptures that never fully healed.
The ACE framework captures the big, obvious wounds. But it misses this slower story — the kind that happens when a temperamentally sensitive kid and a well-meaning parent just don't quite connect. Year after year.
That's harder to measure. But it might be just as formative.
I'm curious, what's your ACE score? And have you found the story is more complicated than a checklist can capture?
Andersen, J. P., & Blosnich, J. (2013). Disparities in Adverse Childhood Experiences among Sexual Minority and Heterosexual Adults: Results from a Multi-State Probability-Based Sample. PLOS ONE, 8(1), e54691. https://doi.org/10.1371/journal.pone.0054691
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., ... & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
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