ABSTRACT
BACKGROUND: Widespread fear surrounding COVID-19, coupled with physical and social distancing orders, has caused severe adverse mental health outcomes. Little is known, however, about how the COVID-19 crisis has impacted LGBTQ+ youth, who disproportionately experienced a high rate of adverse mental health outcomes before the COVID-19 pandemic. OBJECTIVE: We aimed to address this knowledge gap by harnessing natural language processing methodologies to investigate the evolution of conversation topics in the most popular subreddit for LGBTQ+ youth. METHODS: We generated a data set of all r/LGBTeens subreddit posts (n=39,389) between January 1, 2020 and February 1, 2021 and analyzed meaningful trends in anxiety, anger, and sadness in the posts. Because the distribution of anxiety before widespread social distancing orders was meaningfully different from the distribution after (P<.001), we employed latent Dirichlet allocation to examine topics that provoked this shift in anxiety. RESULTS: We did not find any differences in LGBTQ+ youth anger and sadness before and after government-mandated social distancing; however, anxiety increased significantly (P<.001). Further analysis revealed a list of 10 anxiety-provoking topics discussed during the pandemic: attraction to a friend, coming out, coming out to family, discrimination, education, exploring sexuality, gender pronouns, love and relationship advice, starting a new relationship, and struggling with mental health. CONCLUSIONS: During the COVID-19 pandemic, LGBTQ+ teens increased their reliance on anonymous discussion forums when discussing anxiety-provoking topics. LGBTQ+ teens likely perceived anonymous forums as safe spaces for discussing lifestyle stressors during COVID-19 disruptions (eg, school closures). The list of prevalent anxiety-provoking topics in LGBTQ+ teens' anonymous discussions can inform future mental health interventions in LGBTQ+ youth.