No abstract

Emerging evidence suggests that the COVID-19 pandemic is negatively affecting mental health, especially for sexual and gender minority populations. Relatively little is known about the impact of the pandemic on disordered eating behaviors (DEB) for these populations. The aim of this study is to understand changes in DEB across COVID-19 within an LGBTQ+ sample, with a particular focus on differences across sexual and gender identities, and the impact of social support on these outcomes. In a sample of 830 LGBTQ+ adults with a past year history of DEB, most, but not all, participants reported that the frequency of and urge to engage in each DEB increased a little bit or a lot during COVID-19. Contrary to research showing more severe psychopathology and DEB among gender minorities (GM) compared to sexual minorities (SM), changes in DEB severity since COVID-19 were not significantly different between SM and GM participants. There were a few small and significant relationships between changes in average DEB severity and characteristics of interpersonal relationships, average quality of home relationships, and living with someone not affirming of one's identity. Results highlight that COVID-19 may have exacerbated DEB for SGM young adults, that these changes were not different across sexual versus gender minorities, and that these changes are weakly but significantly related to minority stressors.

Youth who are lesbian, gay, bisexual, queer, and questioning (LGBQ PLUS_SPI ) and youth who are a gender distinct from their birth-assigned sex (i.e., transgender and gender diverse), collectively LGBTQIA PLUS_SPI , show nearly triple the risk for self-injurious thoughts and behaviors (SITBs). Research to date highlights that minority stressors across structural, interpersonal, and intrapersonal levels may help to explain this heightened risk. This chapter reviews the research linking stress across each of these levels on LGBTQIA PLUS_SPI SITBs. Moreover, this chapter reviews evidence-based treatments to reduce SITBs in LGBTQIA PLUS_SPI youth, highlighting that interventions that reduce minority stressors and increase coping skills in the context of minority stress appear most effective. In addition to inter- and intrapersonal-level interventions, we argue that major structural changes are needed to meaningfully reduce elevated risk for SITBs in LGBTQIA PLUS_SPI youth.