Discrimination as a predictor of poor mental health among LGBTQ+ people during the COVID-19 pandemic: cross-sectional analysis of the online Queerantine study

Kneale, Dylan; Bécares, Laia

doi:10.1136/bmjopen-2021-049405

Cited by 66 publications

(44 citation statements)

References 42 publications

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“…Although mental health inequities existed for SGM before the pandemic, various social and mental health inequities have been exacerbated during the COVID-19 pandemic due to the provincial mandates to physical distancing orders and service closures. Our research aligns with the existing body of literature, which has identified that the mandates for physical distancing and self-isolation have contributed to particular forms of exclusion, social isolation and reduced social support for SGM (Daly et al, 2021; Kneale & Bécares, 2021). The COVID-19 pandemic is particularly concerning for SGM who may have recent and acute experiences of minority stress, and may also be experiencing isolation and separation from affirming persons, resources, social outlets, and supports (Brennan et al, 2020).…”

Section: Discussionsupporting

confidence: 87%

Health Provider and Sexual and Gender Minority Service User Perspectives on Provision of Mental Health Services During the Early Phase of the COVID-19 Pandemic in British Columbia, Canada

Kennedy¹,

Black²,

Watt

et al. 2022

Preprint

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While the COVID-19 pandemic impacted everyone, social determinants of health and structural inequities have had compounding effects that shaped the experiences of some sub-populations during the pandemic. Stigmatization, discrimination, and exclusion contribute to a disproportionately high burden of mental health concerns among sexual minority (i.e., lesbian, gay, bisexual, queer, and other sexually-diverse) and gender minority people. Pre-pandemic, these health inequities are exacerbated by barriers to adequate mental health services including cost, waitlists, and experiences of sexual and gender minority stigma when accessing providers. During the COVID-19 pandemic, these barriers were further complicated by drastic changes in service delivery and access during the pandemic (i.e., a shift to online/virtual provision of care to reduce risk of COVID-19 transmission). To better understand the experiences of sexual and gender minority people accessing mental health services during the first three to nine months of the COVID-19 pandemic, we conducted semi-structured interviews with a purposive sample of 15 health care providers and administrators (summer 2020) and 14 sexual and gender minority individuals interested in accessing mental health services (fall 2020) in British Columbia, Canada. We used interpretive description to inductively analyze interview data. Triangulating between the provider and service user datasets, we examined changes in mental health and coping during the COVID-19 pandemic. We recorded increases in isolation and lack of identity affirmation; inequities in accessing mental health services during the pandemic, perceived opportunities for mental health support, and avenues for reducing mental health inequities through system-level changes that deserve particular attention during the pandemic.

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Section: Discussionsupporting

confidence: 87%

Health Provider and Sexual and Gender Minority Service User Perspectives on Provision of Mental Health Services During the Early Phase of the COVID-19 Pandemic in British Columbia, Canada

Kennedy¹,

Black²,

Watt

et al. 2022

Preprint

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“…measured before and during the crisis, sexual minority men showed higher levels during the crisis compared to heterosexual men, which remained significant after baseline adjustment for depression and sleep quality, meaning that the gap in these measures between sexual minority men and heterosexual men increased during the crisis, even if there was no absolute increase (and even a decrease for depression) in these measures early in the crisis (42). Earlier research had reported the high impact of the COVID-19 crisis on sexual minority men (23)(24)(25)(26)28), but also on the general population (32), it was therefore important to test whether sexual minority men were indeed more affected than heterosexual men. Only relatively few studies mostly based on online convenience samples from the United States of America (9, 33-39), had reported a higher psychological impact of the COVID-19 crisis among sexual minorities compared to heterosexual people.…”

Section: Discussionmentioning

confidence: 92%

“…Overall, these factors may predispose sexual minorities to a worse reaction to the crisis (6,8) and their existing higher addictive behaviors and substance use (14) may also be further exacerbated as a coping mechanism for COVID-19's psychological impact. Recent research has indicated that members of sexual minority groups have suffered a high psychological impact from the crisis (23)(24)(25)(26)(27)(28)(29)(30)(31), but these studies were done in samples of sexual minority people only and, therefore, that impact cannot be compared with the psychological impact suffered by the heterosexual people also affected by the crisis (32). Seven studies with online recruited convenience samples from the United States of America (9,(33)(34)(35)(36)(37)(38) and one online study conducted in Portugal and Brazil (39) comparing sexual minorities and heterosexual persons found that the psychological impacts among members of sexual minorities were greater.…”

Section: Introductionmentioning

confidence: 99%

Sexual Minority Orientation Is Associated With Greater Psychological Impact Due to the COVID-19 Crisis—Evidence From a Longitudinal Cohort Study of Young Swiss Men

Marmet

Wicki

Gmel

et al. 2021

Front. Public Health

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Background: The COVID-19 pandemic and its countermeasures may have had a significant impact on the psychological well-being of specific population subgroups. The present study investigated whether sexual minority men (defined here as attracted partly or exclusively to men) from an ongoing cohort study of young Swiss men experienced different psychological impacts, levels of substance use and addictive behaviors, and to which degree pre-existing vulnerabilities and participants experiences during the crisis might explain these differences.Methods: An ongoing cohort sample based on the general population of young Swiss men (mean age = 29.07 years; SD = 1.27) was assessed before and during the COVID-19 crisis for depression, stress, sleep quality, substance use and addictive behaviors. Additionally, during the crisis, we assessed its impact in form of fear, isolation and traumatic experiences. Potential associations between these outcomes and sexual orientation (sexual minority vs. heterosexual) were tested using linear regression models. It was additionally estimated to which degree these associations were attenuated if adjusted for differences in mental health, personality and socioeconomic status before the crisis, as well as the experience of the COVID-19 crisis (infection with the virus and changes to work situation).Results: Compared to heterosexual men, sexual minority men showed higher levels of psychological trauma (b = 0.37 [0.25, 0.49]), fear (b = 0.18 [0.06, 0.30]) and isolation (b = 0.32 [0.20, 0.44]) due to the COVID-19 pandemic as well as higher levels of depression (b = 0.31 [0.20, 0.41]) and lower sleep quality (b = −0.13 [−0.24, −0.02]) during the crisis. These differences were to a large degree explained by higher pre-crisis levels of mental health problems and the personality dimension of neuroticism-anxiety. Sexual minority men showed higher overall levels of substance use and addictive behaviors, but these differences were already present before the crisis.Conclusion: The COVID-19 crisis may have worsened pre-existing vulnerabilities in sexual minority men, leading to its greater psychological impact on them than on heterosexual men. Reducing minority stress due to sexual orientation may help not only to improve mental health among important proportions of the population but also to reduce their vulnerability to crises. Services offering psychological support to sexual minorities may need to be reinforced during crises.

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“…This could have the consequence of trans populations either being asked inappropriately to shield, or not to have been invited to shield even when this would have been the most appropriate course of action. Evidence on the experience of LGBTQ+ communities during the pandemic to date has mainly been based on data from online convenience samples [14].…”

Section: Introductionmentioning

confidence: 99%

The Health and Healthcare Outcomes of Trans and/or Non-Binary Adults in England: Protocol for an Analysis of Responses to the 2021 GP Patient Survey

Saunders

Lund

Mason

et al. 2022

Sexes

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Background: The large-scale quantitative evidence base to understand and improve health and healthcare outcomes for people who are trans and/or non-binary is still developing, although what research there is suggests that risk of poor health is high, and experiences of healthcare services are often poor. In 2021 the GP Patient Survey, which is carried out annually to measure patient experience in primary care in England, added inclusive questions about gender identity and trans status for the first time. Methods: This protocol paper pre-registers the methods that we will use for this work for a secondary analysis of these data, including both the statistical analysis protocol and early patient and public involvement work, to answer the following three research questions: (1) What are the (a) demographic characteristics, (b) health conditions, and (c) healthcare experiences of trans and/or non-binary adults in England? (2) Was there any difference in whether people who are trans and/or non-binary had been asked to shield during the COVID-19 pandemic or not compared with all other survey responders? (3) Does the relationship between being trans and/or non-binary, and self-reported long-term mental health problems, autism and autistic spectrum disorder and learning disability vary by age, gender, ethnicity, deprivation, sexual orientation or region?

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Discrimination as a predictor of poor mental health among LGBTQ+ people during the COVID-19 pandemic: cross-sectional analysis of the online Queerantine study

Cited by 66 publications

References 42 publications

Health Provider and Sexual and Gender Minority Service User Perspectives on Provision of Mental Health Services During the Early Phase of the COVID-19 Pandemic in British Columbia, Canada

Health Provider and Sexual and Gender Minority Service User Perspectives on Provision of Mental Health Services During the Early Phase of the COVID-19 Pandemic in British Columbia, Canada

Sexual Minority Orientation Is Associated With Greater Psychological Impact Due to the COVID-19 Crisis—Evidence From a Longitudinal Cohort Study of Young Swiss Men

The Health and Healthcare Outcomes of Trans and/or Non-Binary Adults in England: Protocol for an Analysis of Responses to the 2021 GP Patient Survey

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