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Impact of the COVID-19 pandemic on the LGBTQ community

Impact of COVID-19 on the LGBTQ+ community

  • 26 min read
  • 7 chapters

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Through COVID-19 pandemic, Human Rights Watch and Amnesty International

Some countries and leaders have been criticized by human rights organizations such as the Human Rights Watch and Amnesty International for using the pandemic as an excuse to abuse or blame minority communities, including members of the LGBTQ+ community.

Background

The United Nations called for all States to urgently take into account the impact of COVID-19 on lesbian, gay, bisexual, transgender and gender diverse (LGBT) persons when designing, implementing and evaluating the measures to combat the pandemic which may affect disproportionately LGBT communities around the world.

A global survey revealed that about 30% of gay men felt unsafe at home during the pandemic. 72% of respondents said they were experiencing anxiety since the pandemic began. A review of the impact of social distancing measures on gay, bisexual, queer, trans, and two-spirit men in Canada concluded that control measures in response to the pandemic had serious potential to impact their mental, social, and sexual health.

Impact on health

COVID-19 has had a significant impact on the health of marginalized communities around the world. LGBTQ+ people are disproportionately affected by medical conditions which would affect their response to a COVID-19 infection. According to the Centers for Disease Control and Prevention (CDC):

When age, sex, and survey year are adjusted, sexual minority persons have higher prevalences than do heterosexual persons of self-reported cancer, kidney disease, chronic obstructive pulmonary disease (COPD), heart disease (including myocardial infarction, angina, or coronary heart disease), obesity, smoking, diabetes, asthma, hypertension, and stroke. Sexual minority adults who are members of racial/ethnic minority groups disproportionately affected by the pandemic also have higher prevalences of several of these health conditions than do racial/ethnic minority adults who are heterosexual.

LGBTQ+ people are less likely to have health insurance. Many reported discrimination, bias, and refusal when attempting to seek healthcare. Discrimination, stigma, or financial barriers in healthcare can cause LGBTQ+ individuals to avoid seeking care. Globally, COVID-19 delays have also further delayed gender-affirming surgeries and gender-affirming care for gender minorities, which is associated with lower mental health outcomes.

Before COVID, disparities of mental health and well-being were prevalent among the LGBTQ community but are heightened even more. A primary population that suffers from COVID-19 and campus closures include those of the LGBTQ community. During COVID, LGBTQ college students face housing insecurity, financial concerns, and, most importantly, a lack of student health insurance. Without the support of student services provided by the university, gender, and sexual minority students face difficulties in acquiring services for their healthcare needs such as hormone replacement therapy and mental health services.

LGBTQ+ people are more likely to be immunocompromised and disabled compared to the general population. Understanding the association of health conditions with marginalized populations is important when addressing the impacts of COVID-19. The Centre for Disease Control and Prevention reported that 90 percent of hospitalized patients were those who had at least one underlying condition before contracting COVID-19. Because LGBTQ+ people are more likely to have pre-existing health conditions, it worsens their chances of survival if they became infected with COVID-19. LGBTQ+ people have elevated rates of depression and substance abuse. Social distancing may worsen these conditions. Being a member of two demographics which both tend to be more economically vulnerable (for example, being both LGBTQ+ and an immigrant, or a racial minority), contributes to health vulnerabilities. LGBTQ+ seniors are more likely to encounter isolation and therefore other health issues.

National health organizations warned that some members of the LGBTQ+ community may be "particularly vulnerable" to the effects of the disease. Reasons for the increased risk include higher rates of cancer, HIV, and smoking, as well as health care discrimination. LGBTQ+ people smoke at rates 50 percent higher than the general population. LGBTQ+ youth have elevated rates of homelessness, and infection is more likely in spaces such as homeless shelters where social distancing is more difficult.

More than 100 LGBT rights organizations signed an open letter asking U.S. public health officials to address this issue. Signatories included GLAAD, the Human Rights Campaign, and Lambda Legal. The letter was organized by the LGBT National Cancer Network with support from GLMA: Health Professionals Advancing LGBTQ Equality, the National Queer Asian Pacific Islander Alliance, the New York Transgender Advocacy Group, Services & Advocacy for GLBT Elders (SAGE), and Whitman-Walker Health.

With added stress, LGBTQ individuals face greater threats to more severe COVID symptoms and higher mortality rate. A disruption to healthcare systems has put a halt to many gender-affirming services and health care treatments. This poses an additional risk factor for those with HIV who will face challenges in communicating with their healthcare provider and obtaining any sort of medications. Transgender people also face the possibility of postponing any surgeries or a halt in their hormone therapies.

Men who have sex with men and trans women are key populations that are vulnerable to HIV. Disruptions to HIV-related services are attributed to travel bans, lack of transportation, and the lack of legislation and policies in implementing further access to such services. Despite hormone and gender-affirming treatments being inaccessible before the pandemic, they have been further postponed or unavailable to transgender individuals. Transgender people as sex workers face a rising challenge in obtaining their sexual and reproductive health rights. As a result of the discrimination and stigma associated with transgender people, they are hesitant to seek medical help.

Impact on social support

Many people felt the impacts of social isolation during lockdowns because of less socialization time with friends and family. Lockdowns limited social support networks in a variety of ways. LGBTQ+ people often identify receiving social support from chosen family, which are people in their social networks they feel safe with and affirmed by. Lockdown restricted the social networks of LGBTQ+ people. Overall, gender and sexual minorities experienced lower perceived social support during the pandemic compared to their heterosexual and cisgender counterparts.

There are also concerns about reduced social support and resources that are available for LGBTQ+ people during COVID-19, particularly those who are homeless and in unsafe family environments. Some students were forced to stay with unsupportive families and were sent home early from campus to families that do not support them, which increased depression and anxiety. COVID-19 has led to an increase in family violence in which LGBTQ+ youth are victimized. During the pandemic, many LGBTQ+ people, especially youth turned to social media for community, affirmation, and support. Online-text based platforms that allowed LGBTQ+ youth to chat helped to increase youth's sense of safety due to not fearing being overhead by family. Also, online text-based platforms offered youth a safe space to connect without the fear of contracting and spreading COVID-19.

The social isolation limited the social support from peers, family, and friends. Those that lack a supportive family connection, are disproportionately affected most with mental health and well-being issues as well as a sense of belonging. Unprecedented times such as these can place a toll on family ties and the already present social support system LGBTQ individuals have. For youth who do not feel safe coming out to their families face an additional toll on their mental and physical health.

Ageist attitudes have been especially prevalent during COVID-19. Seniors and people who are immunocompromised are more vulnerable to severe illness from COVID-19. Many pre-existing barriers and inequities were exacerbated during COVID-19 for older populations. Some older trans people expressed feeling a lack of social support because of experiences of both transphobic discrimination and ageism. For some seniors, connections to LGBTQ+ communities felt severely disconnected because of COVID-19, which restricted access to activities and interactions in queer community. Compared to heterosexual and cisgender seniors, LGBTQ+ older adults are more likely to live alone and experience higher social isolation. Also, about a quarter of seniors feel that they have no one to call in the case of an emergency. As such, some older adults may have less support and access to services during COVID-19. Older LGBTQ+ adults are also more likely to be estranged from biological families and rely more on chosen family supports as they age. During COVID-19, some LGBTQ+ older adults relied more on the help of chosen family than biological family support.

Despite numerous challenges during the pandemic, LGBTQ+ communities have shown resiliency and found ways to adapt through personal strength, community care, and acceptance.

Many LGBTQ+ dating websites have shared ways to prevent coronavirus infections.

Kyle Casey Chu, a writer from San Francisco, documented the ways in which the pandemic, particularly but not exclusively the requirement for people to wear masks when socializing in public, impacted traditional gay sexual behaviours in an August article for Xtra!.

Economic and employment impact

COVID-19 has resulted in job losses and financial insecurities, especially for marginalized populations. Before the pandemic, trans and non-binary people were commonly low-income and underemployed because of systemic discrimination. In addition, members of the LGBTQ+ community tend to be employed in industries which are more likely to have been economically impacted negatively by the COVID-19 pandemic. For example, 40 percent of LGBTQ+ people reported working in person jobs that were highly affected by COVID-19, such as in hospitals or food services. A global study on gay men found that many experienced job losses because of COVID-19 and had issues receiving COVID-19 related funds. In the study, men reported cutting meals and expected their income to decline by 30 percent. LGBTQ+ Americans were slightly more likely to experience job loss due to COVID-19, compared to the general population. Also LGBTQ+ themed organizations, businesses, and communities have been impacted both by COVID-19 itself and its economic impact at disproportionate rates. Gay bars such as the Stonewall Inn have required fundraising to stay afloat, and some without considerable fundraising capability have closed permanently.

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