Exploring Sexual Orientation Disparities Regarding the Interplay of Childhood Sexual Abuse, Self-Reported Diabetes Status, and Depression Among Adults in the United States

ABSTRACT

Previous research has revealed a strong link between the experience of childhood sexual abuse (CSA) and diabetes in adulthood. Moreover, research has shown that sexual minorities (SM) are exposed to adverse childhood experiences (ACEs) (i.e. CSA) and experience depression at higher rates than their heterosexual counterparts. Thus, it is imperative to further investigate the role of depression and the differential associations of exposure to ACEs with diabetes prevalence by sexual orientation. We explored sexual orientation disparities regarding the relationship between CSA and diabetes and examined the moderating role of depression. A total of 29,903 participants from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) were included in this study. Secondary data analysis was conducted using the survey data, and weighted logistic regression and moderation analysis were performed. Heterosexuals who experienced CSA (AOR = 1.25; p < .05) and SM who experienced CSA (AOR = 2.13; p < .05) reported higher odds of having diabetes. Among heterosexuals, depression (AOR = 1.38; p < .001) was significantly associated with having diabetes. Additionally, depression was a significant moderator among heterosexuals with and without CSA. Further understanding of the impact of ACEs on diabetes among specific subgroups of SM should be assessed in future studies.

KEYWORDS:

• Childhood sexual abuse1
• diabetes
• depression
• adverse childhood experience

Acknowledgments

We thank Dr. David Adzrago for his feedback on the study’s conceptualization.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors received financial support from the UTHealth School of Public Health, Department of Health Promotion and Behavioral Sciences for the publication of this article.

Notes on contributors

Sumaita Choudhury

Sumaita Choudhury, MPH, is a PhD Candidate with the Department of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston School of Public Health.

Paul G. Yeh

Paul G. Yeh MD DrPH, is a Faculty Associate with the Department of Management, Policy, and Community Health at the University of Texas Health Science Center at Houston School of Public Health.

Kaitlyn L. Zajack-Garcia

Kaitlyn L. Zajack-Garcia, MS, is a PhD Student with the Department of Health Promotion and Behavioral Sciences at the University of Texas Health Science Center at Houston School of Public Health.

Christine M. Markham

Christine M. Markham PhD is Professor and Department Chair with the Department of Health Promotion and Behavioral Sciences and Deputy Director of the Texas Prevention Research Center at the University of Texas Health Science Center at Houston School of Public Health.