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Involuntary childhood genital cutting—including female genital mutilation, gender-norming surgery of intersex children, and male circumcision—is painful and traumatic and has been found to permanently alter individuals' sexuality, and to have other lifelong consequences. These early traumas are not yet included on the ACE checklist.
Adverse Childhood Experiences (ACEs) harm children's developing brains. They lead to changing how children respond to stress and damaging their immune systems so profoundly that the effects show up decades later. ACEs cause much of our chronic disease burden, most mental illness, and are at the root of violence.