Members of the LGBTQ+ community are dealing with many unique challenges. They may need to delay gender-affirming surgeries and shelter in place with unsupportive family members, and they may face higher health risks and experience discrimination within the healthcare system,

Pre-Coronavirus Risk Factors

Of the 16 million Americans who identify under the LGBTQ+ umbrella, five million have jobs that are more likely to be impacted by COVID-19. Many lack the paid medical and family leave they need to take time off for themselves or to care for family members. Though the Supreme Court ruled in June 2020 that federal law protects LGBTQ+ individuals from being fired for their identity, that doesn’t necessarily mean all individuals feel comfortable disclosing their identity or that they receive the same benefits and treatments as their non-LGBTQ+ counterparts.  In addition, Kenya Crawford, LMHC, EdM, MA, psychotherapist and clinical supervisor, says, “QTPOC are navigating racism, homophobia, classism, sexism, and an array of other forms of oppression daily. All of these experiences have been magnified in the midst of COVID-19." Though the community, as a whole, is battling unprecedented challenges, some of those being hit the hardest are Black transgender women, transgender sex workers, LGBTQ+ people of color, and immigrant LGBTQ+ individuals. LGBTQ+ youth are also facing many challenges and already have a 120% higher risk of reporting homelessness compared to their heterosexual and cisgender counterparts. “It’s this constant bombarding from every possible angle,” says Kira Hayes MA, MFT, owner and mental health provider at Affirming Pathways Psychotherapy. “COVID filled a cup that was already overflowing.”

Disproportionate Access to Care

At a time when we’re all trying to avoid a virus for which there is no known vaccination or cure, access to affordable, supportive healthcare and mental health care is essential for all. Unfortunately, this country has a long, systematic history of discriminating and denying high-quality care to our minority and marginalized communities. “It’s cruel to target certain groups who are already under-resourced for no other reason than the culture or legal system doesn’t recognize their humanity,” says Louise Newton, MSW, LCSW, SEP at MindPath Care Centers. To cancel a life-affirming surgery after many years of preparation (including hormone therapy, financial preparation, referral letters from mental health professionals, and more) is devastating, especially for those experiencing gender dysphoria. These procedures can be lifesaving and cancelling them puts many individuals at risk of experiencing depression and suicidal ideation. That’s especially true for those who are already experiencing mental health disorders such as anxiety, depression, or substance use disorders due to the overwhelming distress of living in a physical gender body that doesn’t reflect the gender they identify with.

Isolation and the Impact on Identity 

“Our community has truly been struggling during the COVID-19 crisis. We are one of the few, if not the only marginalized populations who don’t have built-in family empathy,” says Elena Joy Thurston, founder of the Pride and Joy Foundation. “Quarantine has meant that we have a lot less face time with the people who affirm our identity and our experience.”  The cancelling of schools, community events, and in-person support groups means spending more time at home, which, for many, isn’t always a safe or comfortable place. Going back into the closet or hiding your identity might be the only way to survive or protect oneself, but that experience can be detrimental to mental health. It is especially problematic for those without a support system who are experiencing gender dysphoria. “Having to hide aspects of one’s identity, one’s life, involves a number of psychological strategies that can ultimately wear upon an individual,” says Konjit V. Page, PhD, chair of the American Psychological Association’s committee on sexual orientation and gender diversity. Even though virtual communities, events, and groups do exist, they aren’t the same as meeting in real life. And not everyone in the LGBTQ+ community feels comfortable joining them, or has the technology to do os. “We often build these chosen families in communal and public spaces, from bars and bathhouses to book clubs and bocce ball groups. During COVID-19, these spaces have largely been closed entirely or are unsafe, which makes meeting up with other [LGBTQ+ members] face-to-face more difficult,” says D. Gilson, PhD, a professor, author, and contributor to The Truth About Insurance. Gilson moved back home with his parents at the start of the pandemic to take care of his father and focus on a career change. “Though a lot of LGBTQ+ folks have found a great deal of camaraderie through virtual events such as drag shows or happy hours,” he adds, “I am one of the people who finds these online events to be anxiety-inducing.” The pandemic, for many, has caused unparalleled feelings of hopelessness, but Newton wants every member of the LGBTQ+ community to remember: “The world needs us to survive. There’s a lot of work that needs to be done.” If you’re battling any number of mental health challenges, from PTSD and substance abuse to depression and suicidal ideation, ask for help. Take advantage of the tools and resources that are available. Now is the time to find supportive care that might not have been available to you pre-pandemic. Organizations like The Trevor Project are worth checking out.

Resiliency in a Crisis 

“While it may seem like the [LGBTQ+] community has come a long way after historical events such as marriage equality, the fight is far from over,” says Crawford. Despite unfair circumstances and insurmountable obstacles, the LGBTQ+ community has proven, time and time again to be incredibly tenacious and resilient. From battling the HIV/AIDS epidemic in the early ’80s to fighting today’s pandemic, this community has shown that mutual compassion in times of crisis isn’t just possible, it’s necessary. We’ve witnessed increasingly large divides in the U.S. in recent years, but Hayes pointed out that in the divide, unification is happening between minority and marginalized populations. “We’ve seen a glimpse of what happens when the world stops,” says Newton, noting that the LGBTQ+ community has the built-in skills and resilience needed to survive this—and any other—crisis. For allies who want to support, speaking up as never been more important. “Allies are the strongest voices and those are the voices that can step in when any kind of stigma is being seen,” says Hayes. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. Allies should consider financial contributions if possible, and if not, attend protests, offer relevant services for free, reach out to LGBTQ+ friends and family members to offer actionable assistance, and at the very least, be a verbal advocate for LGBTQ+ rights.