Life under COVID-19 for LGBT+ people in the UK: systematic review of UK research on the impact of COVID-19 on sexual and gender minority populations

ObjectiveTo systematically review all published and unpublished evidence on the impact of the COVID-19 pandemic on the health and well-being of UK sexual and gender minority (LGBT+; lesbian, gay, bisexual, transgender, non-binary, intersex and queer) people.MethodsAny relevant studies with or without comparator were included, with outcomes of: COVID-19 incidence, hospitalisation rates, illness severity, death rates, other health and well-being. Six databases (platforms) were searched—CINAHL Plus (Ovid), Cochrane Central (Cochrane Library), Medline (Ovid), Embase (Ovid), Science Citation Index (Web of Science) and Scopus between 2019 and 2020 in December 2020, using synonyms for sexual and gender minorities and COVID-19 search terms. Data extraction and quality assessment (using the relevant Joanna Briggs checklist) were in duplicate with differences resolved through discussion. Results were tabulated and synthesis was through narrative description.ResultsNo published research was found on any outcomes. Eleven grey literature reports found to be of low quality were included, mostly conducted by small LGBT+ charities. Only four had heterosexual/cisgender comparators. Mental health and well-being, health behaviours, safety, social connectedness and access to routine healthcare all showed poorer or worse outcomes than comparators.ConclusionsLack of research gives significant concern, given pre-existing health inequities. Social and structural factors may have contributed to poorer outcomes (mental health, well-being and access to healthcare). Paucity of evidence is driven by lack of routinely collected sexual orientation and gender identity data, possibly resulting from institutional homophobia/transphobia which needs to be addressed. Men are more at risk of serious illness from COVID-19 than women, so using data from trans women and men might have started to answer questions around whether higher rates were due to sex hormone or chromosomal effects. Routine data collection on sexual orientation and gender identity is required to examine the extent to which COVID-19 is widening pre-existing health inequalities.PROSPERO registration numberCRD42020224304.

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Sexual and Gender Minority Stress Amid the COVID-19 Pandemic: Implications for LGBTQ Young Persons’ Mental Health and Well-Being

Public Health Reports ◽

10.1177/0033354920954511 ◽

2020 ◽

Vol 135 (6) ◽

pp. 721-727

Author(s):

John P. Salerno ◽

Jackson Devadas ◽

M Pease ◽

Bryanna Nketia ◽

Jessica N. Fish

Keyword(s):

Mental Health ◽

Minority Stress ◽

Well Being ◽

Gender Minority ◽

Sexual And Gender Minority ◽

And Gender ◽

Health And Well Being

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A Mixed-Methods Examination of the Unique Associations of Gender-Sexuality Alliance Involvement and Family Support on Bravery in Sexual and Gender Minority Youth

Journal of Adolescent Research ◽

10.1177/0743558420933226 ◽

2020 ◽

pp. 074355842093322

Author(s):

Christopher J. Ceccolini ◽

V. Paul Poteat ◽

Jerel P. Calzo ◽

Hirokazu Yoshikawa ◽

Kasey Meyer

Keyword(s):

Sexual Orientation ◽

Mixed Methods ◽

Gender Identity ◽

Family Support ◽

Well Being ◽

Minority Youth ◽

Gender Minority ◽

Sexual And Gender Minority ◽

And Gender ◽

Heterosexual Youth

Research among sexual and gender minority (SGM) youth has suggested associations between Gender-Sexuality Alliance (GSA) involvement and better health. Emergent research has similarly demonstrated associations between family support and general well-being among SGM youth. However, the trait of bravery has received little attention in this literature, despite its relevance for youth in marginalized positions. We examined the association between level of GSA involvement, family support, and bravery among GSA members ( n = 295; Mage = 16.07), and whether those associations differed based on sexual orientation or gender identity. We then conducted one-on-one interviews with SGM youth ( n = 10), to understand how they understood bravery and experienced support in both GSA and family contexts. Greater GSA involvement significantly predicted greater bravery for all youth, whereas greater family support predicted greater bravery only for heterosexual youth. No significant moderation was found for gender minority youth. Our qualitative findings clarified how SGM youth conceptualized bravery and how they experienced it within their GSA and family settings. GSAs were associated with more frequent displays of explicit support for SGM identity, while families were perceived as providing less explicit support.

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Experiences with sexual orientation and gender identity conversion therapy practices among sexual minority men in Canada, 2019–2020

PLoS ONE ◽

10.1371/journal.pone.0252539 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252539

Author(s):

Travis Salway ◽

Stephen Juwono ◽

Ben Klassen ◽

Olivier Ferlatte ◽

Aidan Ablona ◽

...

Keyword(s):

Sexual Orientation ◽

Gender Identity ◽

Ethnic Minorities ◽

Demographic Data ◽

Conversion Therapy ◽

Gender Minority ◽

Sexual And Gender Minority ◽

Minority Men ◽

And Gender ◽

Racial Ethnic

Background “Conversion therapy” practices (CTP) are organized and sustained efforts to avoid the adoption of non-heterosexual sexual orientations and/or of gender identities not assigned at birth. Few data are available to inform the contemporary prevalence of CTP. The aim of this study is to quantify the prevalence of CTP among Canadian sexual and gender minority men, including details regarding the setting, age of initiation, and duration of CTP exposure. Methods Sexual and gender minority men, including transmen and non-binary individuals, aged ≥ 15, living in Canada were recruited via social media and networking applications and websites, November 2019—February 2020. Participants provided demographic data and detailed information about their experiences with CTP. Results 21% of respondents (N = 9,214) indicated that they or any person with authority (e.g., parent, caregiver) ever tried to change their sexual orientation or gender identity, and 10% had experienced CTP. CTP experience was highest among non-binary (20%) and transgender respondents (19%), those aged 15–19 years (13%), immigrants (15%), and racial/ethnic minorities (11–22%, with variability by identity). Among the n = 910 participants who experienced CTP, most experienced CTP in religious/faith-based settings (67%) or licensed healthcare provider offices (20%). 72% of those who experienced CTP first attended before the age of 20 years, 24% attended for one year or longer, and 31% attended more than five sessions. Interpretation CTP remains prevalent in Canada and is most prevalent among younger cohorts, transgender people, immigrants, and racial/ethnic minorities. Legislation, policy, and education are needed that target both religious and healthcare settings.

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Sexual Orientation and Gender Identity Change Efforts and Suicide Morbidity Among Sexual and Gender Minority Adults in Colombia

LGBT Health ◽

10.1089/lgbt.2020.0490 ◽

2021 ◽

Author(s):

Ana María del Río-González ◽

Maria Cecilia Zea ◽

Jennifer Flórez-Donado ◽

Prince Torres-Salazar ◽

Daniela Abello-Luque ◽

...

Keyword(s):

Sexual Orientation ◽

Gender Identity ◽

Identity Change ◽

Gender Minority ◽

Sexual And Gender Minority ◽

And Gender ◽

Change Efforts

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The US Supreme Court and the Future of Sexual and Gender Minority Health

American Journal of Public Health ◽

10.2105/ajph.2021.306302 ◽

2021 ◽

pp. e1-e3

Author(s):

Michael Liu ◽

Jack L. Turban ◽

Kenneth H. Mayer

Keyword(s):

United States ◽

Sexual Orientation ◽

Civil Rights ◽

Gender Identity ◽

Supreme Court ◽

The United States ◽

Physical And Mental Health ◽

Gender Minority ◽

Sexual And Gender Minority ◽

And Gender

Over the past decade, the United States has made substantial progress in advancing the rights of sexual and gender minority (SGM) people. In 2015, the Supreme Court of the United States (SCOTUS) decision in Obergefell v. Hodges provided same-sex couples the fundamental right to marry across the United States.1 In 2020, the landmark Bostock v. Clayton County decision extended the interpretation of “on the basis of sex” under title VII of the 1964 Civil Rights Act to prohibit workplace discrimination on the basis of sexual orientation and gender identity.2 This sweeping decision sets the precedent that other sex-based antidiscrimination laws should be interpreted to include SGM people. However, explicit and broad protections based on sexual orientation and gender identity are not common features of federal laws, and existing SGM protections remain tenuous, as they rely on judicial interpretation. With recent shifts in the composition of SCOTUS, there is the increasing possibility that the hard-earned protections for SGM people in the United States will be reversed through recently argued and upcoming cases. Based on the available empirical evidence, we are concerned about the possible physical and mental health sequelae. (Am J Public Health. Published online ahead of print May 20, 2021: e1–e3. https://doi.org/10.2105/AJPH.2021.306302 )

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Women Mental Health and Well-being: A New Paradigm

International Journal of Indian Psychology ◽

10.25215/0402.102 ◽

2017 ◽

Vol 4 (2) ◽

Author(s):

Mrs. Ashwini. R ◽

Dr. Vijay Prasad. B

Keyword(s):

Mental Health ◽

Mental Illness ◽

Well Being ◽

New Paradigm ◽

The Family ◽

Stigma Of Mental Illness ◽

Gender Perspectives ◽

And Gender ◽

The Impact ◽

Health And Well Being

This paper reviews literature on the determinants of women’s mental health through a stigma of mental illness and gender perspectives. This approach stresses that women’s particular health needs have been neglected in a male-centred models of health, and argues for the importance of addressing these needs in a way that views women and their lives holistically. A woman in social context is seen as parents and their roles have been demonstrated from their life within the family and society as well. This article draws attention to the women and physical health instead of looking at mental illness alone. The impact of violence against women, in particular, the effects of childhood sexual abuse, domestic violence and rape has been illustrated in western and Indian perspectives. In recommendations initiatives in mental health services especially, for women mental health has been emphasized broadly.

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City-Level Structural Stigma and Patient Sexual Orientation and Gender Identity Data Collection at US Health Centers, 2018

American Journal of Public Health ◽

10.2105/ajph.2021.306414 ◽

2021 ◽

pp. e1-e5

Author(s):

Anthony N. Almazan ◽

Dana King ◽

Chris Grasso ◽

Sean Cahill ◽

Micah Lattanner ◽

...

Keyword(s):

Sexual Orientation ◽

Data Collection ◽

Gender Identity ◽

Health Centers ◽

Orientation Data ◽

Gender Minority ◽

Patient Demographics ◽

Sexual And Gender Minority ◽

And Gender ◽

The Relationship

Objectives. To examine the relationship between city-level structural stigma pertaining to sexual orientation and gender identity (SOGI) and completeness of patient SOGI data collection at US federally qualified health centers (FQHCs). Methods. We used the Human Rights Campaign’s Municipal Equality Index to quantify city-level structural stigma against sexual and gender minority people in 506 US cities across 49 states. We ascertained the completeness of SOGI data collection at FQHCs from the 2018 Uniform Data System, which describes FQHC patient demographics and service utilization. We included FQHCs in cities captured by the structural stigma index in multinomial generalized linear mixed models to examine the relationship between city-level structural stigma and SOGI data completeness. Results. FQHCs in cities with more protective sexual orientation nondiscrimination policies reported more complete patient sexual orientation data (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.2, 2.1). This association was also found for gender identity nondiscrimination policies and gender identity data collection (AOR = 1.7; 95% CI = 1.3, 2.2). Conclusions. Municipal sexual and gender minority nondiscrimination laws are associated with social and municipal environments that facilitate patient SOGI data collection. (Am J Public Health. Published online ahead of print September 9, 2021:e1–e5. https://doi.org/10.2105/AJPH.2021.306414 )

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What Oncologists Should Know About Treating Sexual and Gender Minority Patients With Cancer

JCO Oncology Practice ◽

10.1200/op.20.00036 ◽

2020 ◽

Vol 16 (6) ◽

pp. 309-316

Author(s):

Gwendolyn P. Quinn ◽

Ash B. Alpert ◽

Megan Sutter ◽

Matthew B. Schabath

Keyword(s):

Health Disparities ◽

Sexual Orientation ◽

Gender Identity ◽

Clinical Encounter ◽

Gender Minority ◽

Patients With Cancer ◽

Sexual Orientations ◽

Sexual And Gender Minority ◽

And Gender

Sexual and gender minority (SGM) individuals encompass a broad spectrum of sexual orientations and gender identities. Although SGM is a research term, this population is often known as lesbian, gay, bisexual, transgender, queer (LGBTQ). Typically, LGB refers to sexual orientation, T refers to gender identity, and Q may refer to either. Although each group is distinct, they share the common bond of experiencing health disparities that may be caused, in part, by stigma and discrimination, as well as by the oncology provider’s lack of knowledge and, therefore, lack of comfort in treating this population. One challenge in improving the quality of care for SGM patients with cancer is the lack of collection of sexual orientation and gender identity (SOGI) data in the medical record. Furthermore, national studies suggest that many oncologists are unsure of what to do with this information, even when it is collected, and some are uncertain as to why they would need to know the SOGI of their patients. This clinical review offers insight into the health disparities experienced by SGM individuals and strategies for improving the clinical encounter and creating a welcoming environment.

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An Analysis of the Impact of Sexual Orientation on Longitudinal Depression

Innovation in Aging ◽

10.1093/geroni/igaa057.3314 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 900-900

Author(s):

Anna Thompson ◽

Britney Wardecker

Keyword(s):

Mental Health ◽

United States ◽

Sexual Orientation ◽

Repeated Measures ◽

Well Being ◽

The United States ◽

Repeated Measures Anova ◽

The Impact ◽

Health And Well Being ◽

Over Time

Abstract Research suggests that mental health and well-being improve as we age, and this trend is dubbed “the paradox of aging” (Charles & Carstensen, 2010). However, little is known about whether this trend happens for individuals who may experience lifelong disadvantage, such as those who identify as lesbian, gay, or bisexual. We used data from the Midlife in the United States Study (MIDUS) to examine lesbian/gay, bisexual, and heterosexual adults’ changes in depression from 1995 to 2014. Participants identified as lesbian/gay (n = 46), bisexual (n = 37), and heterosexual (n = 3030) and 45.1% identified as female. Participants’ ages ranged from 20-74 years (M = 45.61, SD = 11.41) in 1995 and 39-93 years (M = 63.64, SD = 11.35) in 2014. We analyzed our data using a repeated measures ANOVA and our results indicate that depression decreased on average from 1995 to 2014 for heterosexual [Wilk’s Lamda = .996, F (1, 3029) = 12.23, p < .001] and lesbian/gay adults [Wilk’s Lamda = .848, F (1, 45) = 8.08, p = .007]. However, bisexual adults did not experience this decrease in depression [Wilk’s Lamda = .990, F (1, 36) = 0.36, p = .550] and their depression remained relatively stable. Our results are consistent with previous studies that indicate bisexuals experience poorer mental health when compared to lesbian/gay and heterosexual adults (Bostwick, Hughes, & Everett, 2015). The current research highlights depression as a condition that may not decrease universally over time. We discuss implications for bisexuals’ health and well-being.

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