Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference

ABSTRACTBiological sex is an important factor in mental health, and a non-binary view of how variation in sex and gender influence mental health represents a new research frontier that may yield new insights. The recent acceleration of research into sexual orientation, gender identity, and mental health has generally been conducted without sufficient understanding of the opinions of sexual and gender minorities (SGM) toward this research. We surveyed 768 individuals, with an enrichment of LGBTQ+ stakeholders, for their opinions regarding genetic research of SGM and mental health. We found that the key predictors of attitudes toward genetic research specifically on SGM are 1) general attitudes toward genetic and mental health research 2) tolerance of SGM and associated behaviors 3) non-cisgender stakeholder status and 4) age of the respondent. Non-heterosexual stakeholder status was significantly associated with increased willingness to participate in genetic research if a biological basis for gender identity were discovered. We also found that non-stakeholders with a low tolerance for SGM indicated their SGM views would be positively updated if science showed a biological basis for their behaviors and identities. These findings represent an important first step in understanding and engaging the LGBTQ+ stakeholder community in the context of genetic research.

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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

BMJ Open ◽

10.1136/bmjopen-2021-050092 ◽

2021 ◽

Vol 11 (7) ◽

pp. e050092

Author(s):

Victoria J McGowan ◽

Hayley J Lowther ◽

Catherine Meads

Keyword(s):

Mental Health ◽

Sexual Orientation ◽

Gender Identity ◽

Well Being ◽

Cochrane Library ◽

Gender Minority ◽

Sexual And Gender Minority ◽

And Gender ◽

The Impact ◽

Health And Well Being

ObjectiveTo systematically review all published and unpublished evidence on the impact of the COVID-19 pandemic on the health and well-being of UK sexual and gender minority (LGBT+; lesbian, gay, bisexual, transgender,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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7.I. Workshop: Mental Health Disparities Based on Sexual Orientation and Gender Identity across Europe

European Journal of Public Health ◽

10.1093/eurpub/ckw170.089 ◽

2016 ◽

Vol 26 (suppl_1) ◽

Keyword(s):

Mental Health ◽

Health Disparities ◽

Sexual Orientation ◽

Gender Identity ◽

Mental Health Disparities ◽

And Gender

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The Effects of Sexual Orientation, Gender Identity, and Gender Role on the Mental Health of Women in Taiwan'sT-PoLesbian Community

Journal of Psychology & Human Sexuality ◽

10.1300/j056v15n04_02 ◽

2004 ◽

Vol 15 (4) ◽

pp. 163-184 ◽

Cited By ~ 7

Author(s):

Mei-Fun Kuang ◽

Robin M. Mathy ◽

Helen M. Carol ◽

Kazuhiko Nojima

Keyword(s):

Mental Health ◽

Sexual Orientation ◽

Gender Identity ◽

Gender Role ◽

And Gender

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Depression, Anxiety, and Alcohol Use Among LGBTQ+ People During the COVID-19 Pandemic

American Journal of Public Health ◽

10.2105/ajph.2021.306394 ◽

2021 ◽

pp. e1-e10

Author(s):

Ellesse-Roselee Akré ◽

Andrew Anderson ◽

Kristefer Stojanovski ◽

Kara W. Chung ◽

Nicole A. VanKim ◽

...

Keyword(s):

Mental Health ◽

New York ◽

Sexual Behavior ◽

Sexual Orientation ◽

Los Angeles ◽

Gender Identity ◽

Problem Drinking ◽

Future Research ◽

And Gender ◽

The Impact

Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were “more than usual” during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts. (Am J Public Health. Published online ahead of print August 19, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306394 )

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