Women's Health Month: Understanding the Impact of Adverse Childhood Experiences (ACEs)

Women’s Health Month may be commonly associated with annual exams, hormone health, and fitness goals. But it’s also about the invisible experiences many women carry in their nervous systems, often since childhood. One of the most powerful tools we have for understanding those long-term impacts is the Adverse Childhood Experiences (ACE) framework.

If you’ve ever wondered why anxiety won’t quiet down, why relationships feel unsafe even when they’re stable, or why chronic health symptoms seem to follow stress, your ACE score may tell part of that story.

What Are ACEs?

The original Adverse Childhood Experiences study, conducted by the Centers for Disease Control and Prevention, identified 10 categories of childhood adversity, including:

• Physical, emotional, or sexual abuse

• Physical or emotional neglect

• Household dysfunction (substance use, mental illness, domestic violence, incarceration, divorce)

In response to each question, every “yes” adds a point to a person’s ACE score. The higher the score, the greater the statistical risk for long-term health and mental health challenges. But numbers alone don’t tell the full story.

In trauma therapy, we often distinguish between “Big T” and “little t” trauma.

'Big T' Trauma

These are the events that are commonly recognized as traumatic:

• Life-threatening accidents

• Sexual abuse

• Severe physical abuse

• Witnessing domestic violence

Big T trauma overwhelms a person’s ability to cope. When it happens during childhood, it can create lasting changes in brain development, stress regulation, and belief systems about safety and worth.

'Little t' trauma

These equally valid experiences are often minimized or dismissed:

• Chronic criticism

• Emotional neglect

• Parentification (carrying the burden of adult emotions, finances, or responsibilities)

• Bullying

• Growing up with instability

Little t trauma doesn’t always involve a single catastrophic event. Instead, it’s the slow drip of emotional invalidation or unpredictability. Over time, it can shape the nervous system just as profoundly.

Many women I work with say, “My childhood wasn’t that bad.” And yet, their bodies tell a different story — hypervigilance, chronic shame, panic attacks, digestive issues.

Trauma is not defined solely by the event. It is less about what happened to you, and more about how what happened still affects you now.

The Physical Health Impact of High ACE Scores

The ACE study revealed a striking pattern: higher ACE scores are associated with increased risk of:

• Heart disease

• Autoimmune disorders

• Chronic pain

• Obesity

• Diabetes

• Substance use

• Early mortality

Why?

Chronic childhood stress keeps the body in a prolonged fight-flight-freeze state. Elevated cortisol and inflammatory responses become the norm. Over years, that wear-and-tear affects immune, endocrine, and cardiovascular systems.

For women in particular, high ACE scores are linked to:

• Increased risk of reproductive health challenges

• Higher rates of postpartum depression

• Greater vulnerability to intimate partner violence

• Hormonal dysregulation tied to chronic stress

The body remembers what the mind tries to minimize.

The Mental Health Impact

In addition, high ACE scores correlate strongly with:

• Anxiety disorders

• Depression

• PTSD and complex PTSD

• Avoidant, Anxious or Disorganized Attachment in relationships

• Self-harm behaviors

From a therapeutic perspective, what I often see is not “brokenness” but adaptation.

Hyper-independence? A survival skill. People-pleasing? Protection against abandonment. Perfectionism? A strategy to stay safe in chaos. Emotional shutdown? A brilliant nervous system response when feeling wasn’t safe.

However, what helped a child survive can quietly deplete the adult woman she becomes.

Why Women Often Carry This Quietly

Women are frequently socialized to:

• Be caretakers

• Minimize their pain

• Stay loyal to family systems

Many women with high ACE scores don’t seek help until symptoms become unmanageable — burnout, panic, relationship collapse. By then, they often blame themselves. But trauma is not a character flaw. It is an injury. One that deserves care.

Healing Is Possible

Here’s what I want every woman with a high ACE score to hear:

Your nervous system learned to survive. And nervous systems can learn safety.

Trauma therapy, such as EMDR, Internal Family Systems, and somatic experiencing, can help recalibrate the stress response.

Healing often includes:

• Building body awareness

• Learning emotional regulation skills

• Repairing attachment wounds

• Developing self-compassion

• Establishing safe relationships

At your own pace, you can expand your capacity to feel safe and confident in the present.

This Women’s Health Month: A Broader Definition of Health

True women’s health includes mental health, physical health, and relational health.

If your ACE score is high, let that information empower you, not define you. It is a risk indicator, not a life sentence.

And if you’ve never taken the ACE questionnaire but recognize yourself in this post, find it here, or consider exploring it with a trauma-informed provider.

Because healing childhood trauma is not just about feeling better emotionally. It’s about protecting your heart, your immune system, your relationships, and your future.

As a trauma therapist, I have witnessed this truth repeatedly: when women understand their story through the lens of trauma, not shame, transformation begins.

This Women’s Health Month, let’s honor not just women’s bodies, but the stories those bodies have been holding.