Associations with LGBTQ+ mental health disparities during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has created tremendous, and unequal, burdens on mental and physical health throughout the United States. Prior work suggests that LGBTQ+ individuals have experienced disproportionate harms due to the COVID-19 pandemic, but potential mechanisms underlying these disparities remain unclear. In a large (N = 893) sample of U.S. LGBTQ+ adults, we examined four theoretically derived risk factors as potential contributors to depression, anxiety, and suicidal ideation during the summer of 2020. Stressors and disruptions due to the COVID-19 pandemic were common, with over 25% of participants experiencing changes in their living situation, 40% reporting interruptions in health care access, and high levels stress due to social isolation, financial concerns, and increased mental health symptoms. We found that social disconnection, disruptions in health care, financial strain, and efforts to avoid disclosing one’s sexual orientation or gender identity at home were each associated with poorer mental health, with the largest effects evident for identity disclosure avoidance. Transgender and gender diverse adults reported poorer mental health overall, but gender identity did not moderate the effects of other tested risk factors. Results highlight the importance of considering LGBTQ+ mental health in the context of minority-specific stress processes, in addition to more general social determinants of health.