To explore the association between mental health status and adverse childhood experiences (ACEs) among sexual minority college students, so as to provide a scientific basis for mental health education and health promotion in universities.

From January to February 2024, convenience and cluster sampling methods were used to select 1 792 college students from 11 colleges in Guangxi. A self-reporting method was applied to identify 476 sexual minority individuals. The Symptom Check-List 90 (SCL-90) and the Simplified Chinese Adverse Childhood Experiences International Questionnaire (SC-ACE-IQ) were employed to assess mental health and ACEs. Multivariate Logistic regression analysis was conducted to examine the associations.

The detection rates of all psychological issues among sexual minority college students in Guangxi were significantly higher than those of non-sexual minority college students (χ²=56.01-91.39, all P < 0.01). Except for physical neglect, bullying, and community violence, sexual minority students exhibited higher reporting rates of other ACEs types compared to non-sexual minority students (χ²=4.52-13.34, all P < 0.05). The total ACEs score for college students was 1.00 (1.00, 2.00), while the SCL-90 total score was 96.00 (113.00, 160.00). Spearman correlation analysis revealed a positive correlation between ACEs total scores and SCL-90 total scores (r=0.29, P < 0.05). Additionally, all ACEs subscales, including emotional neglect, physical neglect, emotional abuse, sexual abuse, parental loss, domestic violence, and community violence were positively correlated with corresponding SCL-90 subscale scores (r=0.05-0.22, all P < 0.05). Multivariate Logistic regression analysis showed that family violence increased the risk of mental health issues for sexual minority students (OR=1.61, 95%CI=1.26-2.09); emotional neglect (OR=1.05, 95%CI=1.00-1.10), physical neglect (OR=1.20, 95%CI=1.06-1.35), sexual abuse (OR=1.49, 95%CI=1.15-1.93) increased mental health risks for non-sexual minority students (all P < 0.05). The cumulative effects of ACEs were all statistically significant in the total sample and both subgroups (all P < 0.05).

Mental health status among sexual minority college students in Guangxi is associated with ACEs, and their well-being requires active attention