- A new study found that the COVID-19 pandemic has exacerbated already existing psychosocial and emotional issues that affect LGBTQIA+ people.
- Experts say the need to remain physically distant during the pandemic has caused disruption to several social coping mechanisms that exist for sex and gender minority communities.
- This includes being cut off from the in-person solace that can come from simply being in an inclusive, LGBTQIA±friendly space where they feel that they’re part of a larger community.
The social isolation brought on by the COVID-19 pandemic has taken its toll on people from all backgrounds throughout the United States and around the world.
We’ve all seen headlines on research that’s highlighted how the pandemic has hurt our mental health, like increases in stress and anxiety across the board.
It’s something relatable to all of us as our lives have been turned upside down over the past year.
Now a new study zeroes in on how the pandemic has exacerbated already existing psychosocial and emotional issues that affect LGBTQIA+ people specifically.
The research, published in the Journal of Homosexuality, examines how adults who are sexual or gender minorities have been disproportionately affected by the pandemic’s abrupt — in some cases seismic — changes to how we live, socialize, and relate to one another.
The impacts of the pandemic
“I think most meaningfully during this time, we have seen the disruption to what are social coping mechanisms that exist for the sex and gender minority communities,” said study author Scott Emory Moore, PhD, an assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University.
“A key part of this: A lot of [sexual or gender minority] identity may surround interactions with people you don’t necessarily talk on the phone, you don’t have regular Zoom calls with. You may gain some sort of solace in being a member of a community,” Moore added.
Essentially, the very pressing public health need for physical distancing and sheltering in place has had an adverse psychological and emotional impact on vulnerable marginalized groups who often seek comfort and support from their greater community.
The in-person solace that can come from an inclusive, LGBTQIA+ friendly bar, community center, or support group has been missing during COVID-19.
For the study, the researchers conducted an online survey of 1,380 U.S. adults. Out of that group, 290 were a sexual or gender minority, while 1,090 weren’t, meaning they were cisgender and heterosexual.
Conducted in the early months of the pandemic — March 23 to June 20, 2020 — the participants were asked about their perceived social support systems as well as any psychological and physical symptoms experienced during the pandemic.
Sexual or gender minority people had more frequent negative physical symptoms and evidence of anxiety and depression symptoms during those first 3 months of the pandemic.
Kelly Wierenga, PhD, an assistant professor at the Indiana University School of Nursing, who is Moore’s research partner and fellow author, said that in the early days of the pandemic, we really didn’t know exactly how the sudden changes brought about my stay-at-home orders and physical distancing would affect people’s overall mental and physical health.
“Maybe it sounded great at first to eat chips and sit in sweatpants for a couple of weeks,” she said.
“But what is needed in order to minimize risk of spreading the virus can potentially negatively influence your health, especially your social and mental health. That is a big focus of what we are looking at here,” Wierenga told Healthline.
A history of disparities in mental and physical health
Disparities in mental health and well-being between cisgender, heterosexual people and LGBTQIA+ people have been well documented in the past.
LGBTQIA+ people are more than twice as likely as heterosexual people to report poor mental health symptoms.
They are also 2.5 times more likely to experience depression, “substance misuse,” and anxiety compared with heterosexual peers.
Additionally, LGBTQIA+ people seek mental health services and support more in general.
Other research has also centered on high rates of substance use disorders among LGBTQIA+ people.
“Substantial prior research has demonstrated that people who identify as LGBTQ+ report poorer mental health outcomes than their heterosexual and cisgender peers, including mood and anxiety disorders, suicidality, and substance use disorders,” said Katie Brooks Biello, PhD, associate professor in the departments of behavioral and social sciences and epidemiology, and the vice chair of the department of behavioral and social sciences, at the Brown University School of Public Health.
“It is theorized, and data supports the hypothesis, that these disproportionate rates of poor mental health outcomes are the downstream impact of multiple forms of discrimination and stigma,” Biello, who was not affiliated with this new study, told Healthline.
Biello said that, while these kinds of disparities are seen across racial and ethnic groups, LGBTQIA+ people of color especially often experience multiple forms of discrimination at once.
She added that this can “exacerbate these disparities further.”
Biello specifically cited the high rates of violence and murder toward Black transgender women in the United States as a particularly pressing problem.
Searching for ‘chosen families’
All of this paints a picture of communities that are uniquely vulnerable to discrimination and major inequities in healthcare and socioeconomic supports — all issues laid bare and magnified by the pandemic.
Biello said that for LGBTQIA+ people, social support in the form of family, school, and community groups, among others, can oftentimes work to partially mitigate the negative effects of these inequities.
In many cases, this support can come in the form of so-called “chosen families,” due to the fact that LGBTQIA+ people might not feel welcomed or accepted by their biological or legal families.
Many LGBTQIA+ people might never “come out” to their families until adulthood, fearing this very rejection.
Biello said that “data has shown that LGBTQ+ older people are more likely to live alone and less likely to have familial connections” in general.
This dynamic of being physically kept away from their chosen communities of support has been particularly damaging during the pandemic.
“As a result, ‘stay-at-home’ orders due to COVID likely forced many LGBTQ+ people to isolate at homes that may be unwelcoming or even unsafe and/or to remain disconnected from their support networks,” Biello said.
“In fact, in a recent large survey conducted at the beginning of the declared national emergency due to COVID, LGBTQ+ individuals reported experiencing significantly less social support than their heterosexual, cisgender peers,” she added.
Jaclyn White Hughto, PhD, MPH, assistant professor of behavioral and social sciences and an assistant professor of epidemiology at the Brown University School of Public Health, told Healthline that being physically alienated from chosen families and community support systems can certainly feed a sense of isolation that can damage a person’s overall health.
Hughto, who’s also not affiliated with the new research, said that while online forums can help bridge the social gaps for people who might feel cut off from their communities, they’re not “an equal replacement for human contact.”
“I’ve seen many community organizations expand support groups to online mechanisms and online counseling, which has been great in many ways. In fact, it should have happened a long time ago with access to telehealth options,” she said.
“But that of course creates inequities when it comes to access to computers, to the internet, to phones, especially in cases of people who are unhoused. Some of the most vulnerable people really lost a lot by not having in-person support groups,” Hughto said.
Addressing these disparities
For their part, Wierenga and Moore said that their study centered on a group that isn’t fully representative of the scope of the LGBTQIA+ experience.
The study group was heavily white, cisgender, and female. It only offered a window to people who had access to the internet.
Moore said that if studies like this reveal how bad this current era has been for “people who live relatively privileged lives,” then consider how challenging it must be for those in more vulnerable positions.
Biello said that the pandemic has particularly shed light on the fact that LGBTQIA+ people experience higher rates of unemployment and lower income than heterosexual and cisgender peers.
“The Williams Institute found in a large, nationally representative survey that LGBTQ+ respondents were more likely to be laid off or furloughed and to report difficulties paying for basic household goods, rent, and/or mortgage as a result of COVID,” Biello said.
“Even more, in the U.S., where racism, particularly anti-Black racism, is the largest driver of wealth and income inequality, it should come as no surprise that LGBTQ+ people of color have suffered even worse economic impacts due to COVID,” she added.
Hughto said that one of the few silver linings of this era is that these inequities have been made more apparent to the public at large.
She explained that with all this new attention, it’s important that governments, support groups, and public resources alike put their “money where their mouth is” to help these communities deal with the health and economic effects of COVID-19.
“I do worry about LGBTQ people and communities of color of all sexual orientations and gender identities who may be living in areas that have a sense of distrust of public health,” she said.
For Hughto, it’s important that resources be dedicated to building better trust, improving testing and vaccination initiatives, and helping bridge these inequities that target vulnerable groups, especially including LGBTQIA+ populations in the United States.
This also brings up the question of allyship. For those who aren’t a part of the greater LGBTQIA+ community, what support should they offer?
Moore said it’s important that people who aren’t part of these communities maintain relationships with their LGBTQIA+ family, friends, and loved ones, but not to make that support “performative” — especially in a social media environment driven by “likes” and personal affirmation.
“For allies, the challenge is to realize that your sex and gender minority friends and family in your life may be experiencing this differently because they’ve lost a large part of their social interactions in a way that you haven’t,” Moore added. “Check in on people and make an effort to maintain that connectivity.”
Moving forward, Wierenga said she’s curious to see what happens “in the next couple of years” to observe the long-range ramifications of these social and economic shifts brought about by the pandemic.
“This likely won’t be the last time there is a health experience that affects people adversely. If we can continue to follow people over time, how are they reengaging? How are they able to find support? What things are helpful? What things are not helpful?” she said.
“There’s so much to learn about caring for people through a crisis that’s maybe not specific to just a pandemic crisis, right?” Wierenga added.
Essentially, Moore and Wierenga said there might be important lessons to learn from studies like theirs that can be applied to nonpandemic times.
“Honestly, 1 year looking back, what are people thinking about to get through this, and how will it change how they will live moving forward?” Moore added.
“As humans, we don’t really have memories about the bad things unless they were traumatic, and for some people, this was a traumatic experience. For others, they may be able to move beyond it,” he said. “It’s necessary to understand that juxtaposition that not one size fits all.”