Characterising the impact of COVID-19 environment on mental health, gender affirming services and socioeconomic loss in a global sample of transgender and non-binary people: a structural equation modelling

Restar, Arjee; Jin, Hongkui; Jarrett, Brooke A.; Adamson, Tyler; Baral, Stefan; Howell, Sean; Beckham, S. Wilson

doi:10.1136/bmjgh-2020-004424

Cited by 44 publications

(24 citation statements)

References 34 publications

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“…However, our results should be interpreted with some caution as our gender-diverse cohort accounted for only 1% of the sample. Nonetheless, our results are striking and consistent with many other studies focused on gender using larger cohorts [42,43].…”

Section: Discussionsupporting

confidence: 92%

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

Brotto

Chankasingh

Baaske

et al. 2021

Preprint

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The SARS-CoV-2 (COVID-19) pandemic has had profound physical and mental health effects on populations around the world. Limited empirical research has used a gender-based lens to evaluate the mental health impacts of the pandemic, overlooking the impact of public health measures on marginalized groups, such as women, and the gender diverse community. This study used a gender-based analysis to determine the prevalence of psychosocial symptoms and substance use by age, ethnicity, income, rurality, education level, Indigenous status, and sexual orientation. Participants in the study were recruited from previously established cohorts as a part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) study. Those who agreed to participate were asked to self-report symptoms of depression, anxiety, pandemic stress, loneliness, alcohol use, and cannabis use across five phases of the pandemic as well as retrospectively before the pandemic. For all psychosocial outcomes, there was a significant effect of time with all five phases of the pandemic being associated with more psychosocial symptoms relative to pre-COVID levels (p < .0001). Gender was significantly associated with all outcomes (p < .0001) with men exhibiting lower scores (i.e., less symptoms) than women and gender diverse participants, and women exhibiting lower scores than the gender diverse group. Other significant predictors were age (younger populations experiencing more symptoms, p < .0001), ethnicity (Chinese/Taiwanese individuals experiencing less symptoms, p = .005), and Indigenous status (Indigenous individuals experiencing more symptoms, p < .0001). Alcohol use and cannabis use increased relative to pre-pandemic levels, and women reported a greater increase in cannabis use than men (p < .0001). Our findings highlight the need for policy makers and leaders to proactively consider gender when tailoring public health measures for future pandemics.

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Section: Discussionsupporting

confidence: 92%

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

Brotto

Chankasingh

Baaske

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Our findings on the impact of financial change on pandemic depression substantiate previous research showing that income loss during COVID-19 is linked with reduced mental health among TNB people [23] and that pre-pandemic mental health predicts pandemic mental health [24,25,26]. Our results, however, advance the research on these associations and reveal an interaction between pre-pandemic depression and financial loss.…”

Section: Mental Health Of Trans and Non-binary People During Covid-19 14 Of 30supporting

confidence: 90%

Change in Finances, Peer Access, and Mental Health Among Trans and Non-binary People in Canada During COVID-19

Ghabrial

Scheim

Chih

et al. 2021

Preprint

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Purpose COVID-related stressors associated with loss of income and community are compounded with gender minority stress among trans and non-binary people (TNB), which may result in mental health burden. The present study examined the effect of COVID-related change in finances and TNB gathering access on anxiety and depression among TNB people. Methods Participants were 18 years and older (M age = 30) who completed both pre-pandemic baseline (Fall 2019) and pandemic follow-up (Fall 2020) surveys in the Trans PULSE Canada study. Multivariable regression analyses examined associations between change in (1) finances and (2) access to TNB peers and mental health during the pandemic. Results Of 780 participants, 50% reported that COVID had a negative effect on personal income and 58.3% reported loss in access to TNB peer or friend gatherings (in person or online). Depression and anxiety symptoms increased from pre-pandemic to follow-up, and most participants were above measurement cut-offs for clinical levels during the pandemic. Changes in finances and access to peer gatherings were associated with depression symptoms during the pandemic, but effects depended on level of pre-pandemic depression. For participants with high pre-pandemic depression, financial stability was not protective against increased depression at follow-up. Participants experiencing unprecedentedly high levels of depression during COVID may have pursued more TNB gatherings. Neither financial change nor access to TNB gatherings were associated with pandemic anxiety. Conclusion Findings suggest need for a multifaceted approach to mental health programmes and services to address structural barriers, including financial support and meaningful TNB community engagement.

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“…Globally, gender affirming surgeries have been cancelled or postponed for many trans persons ( Streed and Siegel, 2020 ), which can elevate anxiety and depression ( Wang et al, 2020 ). Indeed, in an online global sample of 849 trans and non-binary individuals, reduced access to gender-affirming medical care and supplies, as well as socioeconomic loss, due to the pandemic were associated with poorer mental health ( Restar et al, 2021 ). LGBT individuals, particularly youth, who are isolating with unsupportive family members may be at risk of experiencing violence or distress ( Action International, 2020 ; Ahlenback, 2020 ; OutRight).…”

Section: How Are Gender and Sexual Minorities Impacted By Covid-19?mentioning

confidence: 99%

Beyond a Zero-Sum Game: How Does the Impact of COVID-19 Vary by Gender?

et al. 2021

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Epidemics and pandemics, like COVID-19, are not gender neutral. Much of the current work on gender, sex, and COVID-19, however, has seemed implicitly or explicitly to be attempting to demonstrate that either men or women have been hardest hit, treating differences between women and men as though it is not important to understand how each group is affected by the virus. This approach often leaves out the effect on gender and sexual minorities entirely. Believing that a more nuanced approach is needed now and for the future, we brought together a group of gender experts to answer the question: how are people of different genders impacted by COVID-19 and why? Individuals working in women’s, men’s, and LGBTQ health and wellbeing wrote sections to lay out the different ways that women, men, and gender and sexual minorities are affected by COVID-19. We demonstrate that there is not one group “most affected,” but that many groups are affected, and we need to move beyond a zero-sum game and engage in ways to mutually identify and support marginalized groups.

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Characterising the impact of COVID-19 environment on mental health, gender affirming services and socioeconomic loss in a global sample of transgender and non-binary people: a structural equation modelling

Cited by 44 publications

References 34 publications

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

Change in Finances, Peer Access, and Mental Health Among Trans and Non-binary People in Canada During COVID-19

Beyond a Zero-Sum Game: How Does the Impact of COVID-19 Vary by Gender?

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