An exploration of psychological distress, employment, and housing among transgender and gender diverse individuals during the COVID-19 pandemic

Transgender and gender diverse (TGD) individuals are faced with various societal factors that contribute to health disparities. As COVID-19 spreads, health disparities that existed prior to the pandemic have become exacerbated. The current study aims to address factors that may be negatively impacting TGD individuals during the COVID-19 pandemic by exploring their experiences related to symptoms of depression, symptoms of anxiety, employment, and housing. TGD participants (N = 342) were recruited from an online participant recruitment platform and answered questions related to their psychological well-being and changes in employment and housing since the start of the pandemic. Adverse changes in employment since the start of the pandemic were reported by almost 1/3 of participants and were associated with higher depression and anxiety. Changes in housing were reported by almost 1/4 of participants and were associated with higher anxiety. Experiencing COVID-19 symptoms or receiving a COVID-19 diagnosis were also associated with higher anxiety. Findings indicate TGD individuals who experienced changes in employment and housing since the start of the COVID-19 pandemic experience greater levels of psychological distress. Findings may inform mental health providers and policymakers on the repercussions the pandemic has had on TGD individuals. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement The current study explored the ways that housing and employment instability brought on by the COVID-19 pandemic contributed to heightened psychological distress among a sample of transgender and gender diverse (TGD) individuals collected using an online survey platform. Our findings indicate that TGD individuals experienced heightened levels of psychological distress directly related to employment and housing instability which is a crucial and timely concern given that TGD individuals experienced greater psychological distress, unemployment, and housing instability relative to the general population prior to the pandemic. Receiving a COVID-19 diagnosis or experiencing symptoms associated with COVID-19 also predicted heightened levels of psychological distress. It is recommended that additional TGD-specific protections be implemented and expanded upon in order to meet the current and impending needs of TGD individuals. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Use of substances to cope during the COVID-19 pandemic among transgender and gender diverse adults.

Background: Studies have found changes in substance use during the COVID-19 pandemic in specific populations. Transgender and gender diverse (TGD) individuals have experienced greater distress compared to cisgender individuals during the pandemic; however, there is little research on substance use among TGD individuals during this sensitive time period.Objectives: The objective of this study is to examine distress from COVID-19 and coping via substance use including alcohol, cannabis, tobacco, and non-medical use of prescription drugs (NMUPD) among TGD adults.Method: An online survey assessing substance use, general psychiatric symptoms, and COVID-19 anxiety was completed by 342 TGD individuals (16.4% transfeminine, 19.6% transmasculine, 64.0% Gender Diverse) in June/July 2020. Chi-square and structural equation modeling (SEM) analyses examined the connections between distress, coping, and substance use.Results: Seventy-one percent of participants reported no changes in substance use since the start of the pandemic and 22% reported an increase in substance use. Increased substance use was associated with alcohol (p < .001), cannabis (p < .001), and combustible tobacco (p < .001) use in the prior three months. SEM showed significant direct effects between distress and substance use coping, substance use coping and recent drug use, and an indirect effect of distress on recent drug use through substance use coping (ß = .31, p = .001).Conclusion: Results highlight the risk of substance use to cope with COVID-19-related stress in a large sample of a minoritized population with mental health disparities. Transmasculine and gender diverse participants were especially likely to report using substances to cope.

Exposure to Childhood Healthcare Discrimination and Healthcare Avoidance among Transgender and Gender Independent Adults during a Global Pandemic.

Transgender and gender-independent individuals (TGI) encounter myriad barriers to accessing affirming healthcare. Healthcare discrimination and erasure exposure among TGI individuals is vital to understanding healthcare accessibility, utilization behaviors, and health disparities in this population. Exposure to gender identity-related healthcare discrimination and erasure in childhood may contribute to TGI adults' healthcare utilization behaviors. The commonality of childhood exposure to gender identity-related healthcare discrimination and its relationship to healthcare avoidance during the early months of the COVID-19 pandemic among TGI adults were explored. TGI adults aged 18 to 59 (N = 342) in the United States were recruited online during the summer of 2020. Among individuals who reported childhood exposure to gender identity-related healthcare discrimination, 51% reported experiencing two or more distinct forms of discrimination. Hierarchical logistic regression indicated that exposure to healthcare discrimination in childhood significantly increased the odds of healthcare avoidance during the early months of the COVID-19 pandemic, after accounting for demographic factors and self-reported COVID-19 symptoms (odds ratio = 1.30, 95% confidence interval = 1.10, 1.54). These findings suggest that childhood exposure to gender identity-related healthcare discrimination is a prominent barrier to the utilization of healthcare for TGI adults, even during a global pandemic.