LGBTQ College student health and wellbeing at the onset of the pandemic: additional evidence and lessons learned from COVID-19.

BACKGROUND: The coronavirus (COVID-19) pandemic has killed more than six million people and disrupted health care systems globally. In the United States alone, more than one million people have died from COVID-19 infections. At the start of the pandemic, nearly all aspects of our lives paused to prevent the spread of the novel coronavirus. Many institutions of higher education transitioned to remote learning and enacted social distancing measures. This study examined the health needs and vulnerabilities of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) college students at the start of the COVID-19 pandemic in the United States. METHODS: We fielded a rapid-response online survey between April and June of 2020. We recruited 578 LGBTQ-identifying college students aged 18 years and older by reaching out to LGBTQ-serving organizations on 254 college campuses and via targeted social media advertising. RESULTS: Approximately 40% of LGBTQ college students surveyed were dissatisfied with life at the start of the COVID-19 pandemic, and almost all (90%) were concerned that COVID-19 would threaten their mental health. Moreover, about 40% of LGBTQ college students reported unmet mental health needs, and 28% were worried about seeking care during the pandemic because of their LGBTQ identity. One out of four LGBTQ college students had to go back in the closet because of the pandemic, and approximately 40% were concerned about their finances or personal safety during the COVID-19 pandemic. Some of these adverse outcomes were prominent among younger students, Hispanic/Latinx students, and students with unsupportive families or colleges. CONCLUSIONS: Our study adds novel findings to the large body of research demonstrating that LGBTQ college students experienced distress and elevated mental health needs early in the pandemic. Future research should examine the long-term consequences of the pandemic among LGBTQ and other minoritized college students. Public health policymakers, health care providers, and college and university officials should provide LGBTQ students affirming emotional supports and services to ensure their success as the COVID-19 pandemic transitions to endemic.

The impact of the COVID-19 pandemic on LGBT individuals

The COVID-19 pandemic and the strategies used to cope with the outbreak intensified health, social and economic inequities within society. In particular, psychological problems of different types were experienced by the LGBT community. Previous research has shown that sexual minorities often have more limited access to health care services due to discrimination resulting from lack of cultural responsiveness among health care professionals to the special needs of this sub-group. Pandemic officials failed to recognize the unique needs and concerns of LGBT individuals. As such, it is recommended that, in the future, LGBT persons should be provided with online work, education, and mental health services, as well as mental health services. In particular, emphasis needs to be placed on social support which is a major problem for a minority group during a major crisis affecting a large swath of the population. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Health and access to gender-affirming care during COVID-19: Experiences of transmasculine individuals and men assigned female sex at birth

Since the onset of the COVID-19 pandemic, global research has suggested that the pandemic has negatively affected lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) populations, including by limiting health care access. There is little research on the impact of COVID-19 among transmasculine persons and men assigned female sex at birth (AFAB) in the United States, who face unique health care challenges outside of the pandemic context. Between May and June of 2020, 20 transmasculine individuals and AFAB men who have sex with men participated in semi-structured interviews about their experiences during the early months of the COVID-19 pandemic. Participants were asked how the pandemic affected their access to health care, overall health, and well-being. Interviews were analyzed using an inductive, thematic approach. Participants reported reduced access to in-person health care, which in some cases meant overdue hormone-related bloodwork and unmet health care needs. Most participants reported that they were able to maintain their testosterone regimen, although some were concerned about future access, citing anxiety about potential shortages. Three participants reported canceled or deferred gender-affirming procedures, which they were uncertain would be rescheduled soon. Participants generally reported that the expansion of telehealth improved access to care, particularly for gender-affirming psychotherapy that was otherwise inaccessible or inconvenient prior to the pandemic. Other salient themes include the pandemic's impact on health behaviors and daily routines. Although the COVID-19 pandemic created new challenges for maintaining health, it also expanded access to gender-affirming health care, largely through the expansion of telehealth. Our findings provide new insights for supporting the health of transmasculine individuals and AFAB men. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Understanding the Health and Health-Related Social Needs of Youth Experiencing Homelessness: A Photovoice Study.

PURPOSE: Homelessness is a major public health problem facing millions of youths across the United States (U.S.), with lesbian gay, bisexual, transgender, questioning (LGBTQ+) youths and youths of color being disproportionately at higher risk. This study obtains an understanding of the health and health-related social needs of youths experiencing homelessness during the coronavirus disease (COVID-19) pandemic. METHODS: A total of 14 youths between the ages of 14 and 24 who (a) lived, worked, or attended school in New Britain, Connecticut (CT) and (b) had at least one experience of homelessness or housing insecurity worked with the research team to conduct a needs assessment regarding youth homelessness. Using photovoice, a community-based participatory research method, participants created photo narratives to share their stories and recommendations for community change. The main goals of photovoice are to enable participants to (1) record and represent their everyday realities; (2) promote critical dialogue and knowledge about person and community strengths and concerns; and (3) reach policy makers. RESULTS: Most of the participants identified as youths of color, and half of the participants identified as members of the LGBTQ+ community. Three major themes that appeared in the youths' narratives include the following: mental health and substance use challenges, trouble accessing basic human needs, and lack of a social support system. CONCLUSION: This study uplifts and empowers a vulnerable population to increase visibility around a major public health challenge from their own lived experiences. Despite the challenges that were voiced, many participants shared a sense of hope and resiliency. The major themes endorsed by the youths has the potential of informing practitioners and policy makers of how to better address the needs of youths experiencing homelessness, particularly those most at risk.

Widening mental health and substance use inequities among sexual and gender minority populations: Findings from a repeated cross-sectional monitoring survey during the COVID-19 pandemic in Canada.

This paper examines the mental health and substance use impacts of the COVID-19 pandemic among sexual and gender minority (SGM) populations as compared to non-SGM populations, and identifies risk factors for mental health and substance use impacts among SGM groups. Data were drawn from two rounds of a repeated cross-sectional monitoring survey of 6027 Canadian adults, with Round 1 conducted May 14-19, 2020 and Round 2 conducted September 14-21, 2020. Bivariate cross-tabulations with chi-square tests were utilized to identify differences in mental health and substance use outcomes between SGM and non-SGM groups. Separate multivariable logistic regression models were used to identify risk factors for mental health and substance use outcomes for all SGM respondents. Compared to non-SGM respondents, a greater proportion of SGM participants reported mental health and substance use impacts of the COVID-19 pandemic, including deterioration in mental health, poor coping, suicidal thoughts, self-harm, alcohol and cannabis use, and use of substances to cope. Among SGM respondents, various risk factors, including having a pre-existing mental health condition, were identified as associated with mental health and substance use impacts. These widening inequities demonstrate the need for tailored public mental health actions during and beyond the pandemic.

Latinx Sexual Minority Men's Behavioral, Psychosocial, and Medical Experiences during COVID-19: Differences across Immigration Statuses.

Latinx sexual minority men (LSMM) are at the intersection of two communities disproportionately impacted by COVID-19. To develop and deploy appropriate resources to support LSMM, it is important to understand the behavioral, psychosocial, and medical experiences of this population during COVID-19, as well as for LSMM of different immigration statuses. The current study uses the Pandemic Stress Index (PSI) to describe LSMM's self-reported behavioral, psychosocial, and medical experiences during COVID-19. Logistic and linear regressions compared experiences during COVID-19 among LSMM across different immigration statuses (recent, established, and US-born as the reference group). LSMM's responses to the PSI indicated they experienced anxiety (64.4%), depression (59.0%), alcohol/substance use (27.6%), as well as loneliness (50.1%) and sleep problems (60.4%). Overall, over half reported personal financial loss, the odds of which were 2.75 times greater among LSMM who were recent immigrants compared to US-born LSMM (OR = 2.75, 95% CI: 1.30, 5.82). Nearly 8% reported being diagnosed with COVID-19, with the odds four and a half times greater among established immigrants compared to US-born LSMM (OR = 4.52, 95% CI: 1.60, 12.81). The findings have implications for tailored support resources and public health interventions to reach LSMM in general and LSMM with immigration histories.

Rethinking COVID-19 Vulnerability: A Call for LGTBQ+ Im/migrant Health Equity in the United States During and After a Pandemic.

Public health responses to the coronavirus disease 2019 (COVID-19) pandemic have emphasized older adults' vulnerability, but this obfuscates the social and political root causes of health inequity. To advance health equity during a novel communicable disease outbreak, public health practitioners must continue to be attentive to social and political circumstances that inform poor health. Such efforts are especially needed for populations who are exposed to numerous social and political factors that structure health inequity, such as lesbian, gay, bisexual, transgender, or otherwise-queer identifying (LGBTQ+) populations and im/migrant populations. The COVID-19 outbreak is, therefore, a critical time to emphasize root causes of health inequity.

Mental Health Needs Among Lesbian, Gay, Bisexual, and Transgender College Students During the COVID-19 Pandemic.

PURPOSE: The abrupt closure of universities across the U.S. in March 2020 may have sent some lesbian, gay, bisexual, and transgender (LGBT) college students home to unsafe or unaccepting families and environments. The objective of this study was to examine the mental health needs of LGBT college students in the U.S. during the COVID-19 pandemic. METHODS: We fielded a rapid-response online survey in the spring of 2020. We recruited 477 LGBT-identifying college students aged 18-25 years by contacting LGBT-serving organizations on 254 college campuses and through targeted social media advertising. RESULTS: Nearly half (45.7%) of LGBT college students have immediate families that do not support or know their LGBT identity. Approximately 60% of sampled LGBT college students were experiencing psychological distress, anxiety, and depression during the pandemic. CONCLUSIONS: Health-care providers, college and university administrators, and campus counseling centers should take swift action to ensure that LGBT students receive mental health support during the pandemic.