Changes in Mental Health and Well-Being Are Associated With Living Arrangements With Parents During COVID-19 Among Sexual Minority Young Persons in the U.S

Violence Victimization and Depressive Symptoms Among a Sub-Sample of Sexual and Gender Minority Adults in a Population-Based South African Study

Sexual and gender minority (SGM) adults in South Africa face high levels of violence and poor mental health outcomes. Interventions to prevent these negative health implications are hampered by a lack of representative data among this population. This study aims to quantify the associations between three forms of violent victimization and depressive symptoms in a sub-sample of SGM drawn from a population-based cross-sectional study in Gauteng, South Africa. Data come from the sixth Quality of Life survey conducted in South Africa's Gauteng province. Brief screeners assessed childhood sexual abuse (CSA), past-year intimate partner violence (IPV), non-partner violence, and depressive symptoms. Three survey-weighted logistic regression analyses were fit to model associations between elevated depressive symptoms and CSA, past-year IPV, and past-year non-partner violence, controlling for socio-demographics (age, race, sex, area of residence, education, socioeconomic status, and recent employment). N = 1,328 SGM respondents were included. Over 40% (n = 537) reported depressive symptoms, while 17% (n = 222) reported CSA, 5% (n = 67) reported IPV, and 16% (n = 208) reported non-partner violence. CSA and non-partner violence were associated with significantly higher odds of reporting depressive symptoms (aOR: 1.51, 95% CI [1.03, 2.23]; aOR: 1.84, [1.24, 2.73], respectively). IPV was not associated with elevated depressive symptoms (aOR: 1.17, [0.64, 2.16]). In all models, employment in the past 7 days was associated with significantly lower odds of reporting depressive symptoms. Recent and childhood violence is a major burden that is associated with elevated symptoms of depression among SGM in urban South Africa. Community-tailored interventions and policy-related advocacy related to employment and violence prevention may alleviate depressive symptoms in SGM adults in Gauteng.

An Assessment of Mental Health Challenges of Lesbian, Gay, Bisexual, and Transgender College Students during the COVID-19 Pandemic

INTRODUCTION

Collegiate mental health continues to be a worrisome public health concern among college students in the U.S. The unprecedented COVID-19 pandemic has caused an upward trend of mental health crises, especially among lesbian, gay, bisexual, and transgender (LGBTQ+) college students. The objective of this study was to assess the mental health statuses, attitudes towards disease control and mitigation measures, and coping strategies among this vulnerable group.

METHODS

A web-based survey was conducted at a medium-sized public university in the mid-Atlantic region during the summer and fall of 2021 when COVID-19 was still a major public health concern. The survey was distributed through the listservs of the college and was advertised through campus-wide social media. Descriptive and inferential statistics including a t-test for the differences in group means and a logit regression model for comparing the groups were used.

RESULTS

Our final sample is composed of 611 students with 79% of the respondents identifying as straight, and 20% in the LGBTQ+ group. Our results showed that LGBTQ+ students exhibited higher levels of anxiety and fear compared to the non-LGBTQ+ groups. Also, a large proportion of LGBTQ+ students were negatively impacted by the pandemic as compared to the non-LGBTQ+ groups (p = 0.05), while they generally have more positive views on the public health measures to alleviate the adverse impacts from COVID-19 (p = 0.001).

CONCLUSIONS

Public health emergency management should adopt appropriate strategies and adapt their services to support the mental health needs of LGBTQ+ students. Our study highlighted the need to design tailored health promotion programs and enhance support systems for LGBTQ+ college students during similar emergencies.

Surveying Psychological Wellbeing in a Post-Pandemic World: The Role of Family and Social Support for LGBTQ+ and Cisgender Heterosexual Adults in the UK

Studies have emphasized the importance of social support in mitigating the relationship between psychological distress and mental health effects, with family of origin and family of formation providing key sources of social support over the life course. However, LGBTQ+ people may experience family of origin relationships as a source of distress, while partners and friends may buffer the relationship between minority stress and psychological wellbeing. Through our online survey (March-June 2022), which was conducted when the social restrictions of the COVID-19 pandemic were lifted in the UK, we considered the association between psychological wellbeing and sources of social support by sampling n = 1330 LGBTQ+ and cisgender heterosexual adults. LGBTQ+ adults generally experienced poorer psychological wellbeing outcomes than did cisgender heterosexual people. For LGBTQ+ adults, social support from family of origin, a special person, or friends was not associated with depression, anxiety, or stress levels, but social support from family or a special person was positively associated with higher levels of life satisfaction. Our findings indicate the importance of considering negative as well as positive wellbeing.

"Being Queer, It Was Really Isolating": Stigma and Mental Health Among Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) Young People During COVID-19

Lesbian, Gay, Bisexual, Transgender, Queer, and other sexual and gender minority (LGBTQ+) youth and young adults (YYAs) have poorer mental health outcomes than their cisgender, heterosexual peers in large part due to multilevel stigmatization and minority stress. This was exacerbated by psychological stressors stemming from the COVID-19 pandemic; these experiences intersected with YYA unique developmental stage. Here we explored LGBTQ+ YYA's pandemic-related experiences, focusing on intersections between stigma and belonging, developmental processes, and their relationship to mental health. We conducted qualitative interviews from August to November 2021 with 34 LGBTQ+ YYA ages 14 to 24; interviews were nested within a quantitative study on YYA experiences during COVID-19. Interviews were transcribed and coded using thematic analysis. YYA described how pandemic impacts like quarantine and isolation directly impacted their mental health; these coalesced around four types of thematic shifts: shifts in (1) time, (2) living situations, (3) community supports, and (4) social and political climate. Multilevel stigmatization also created new mechanisms of norm enforcement for LGBTQ+ YYA. Interviews demonstrated how the pandemic also impacted key developmental processes including identity formation and autonomy seeking. The potential consequences of these pandemic-related shifts largely depended on YYA's experiences of stigma and/or belonging throughout the pandemic. Findings suggested that isolation from the COVID-19 pandemic intersected with existing socio-ecological structures in LGBTQ+ young people's lives. Efforts to investigate longitudinal impacts of the pandemic, as well as to intervene to reduce the stigmatization experienced by LGBTQ+ YYA, remain urgent.

Associations between living arrangement and sexual and gender minority stressors among university students since the start of the COVID-19 pandemic

OBJECTIVE

To examine the associations between COVID-19-related living arrangements and sexual and gender minority (SGM)-related stressors (ie, identity concealment and familial rejection).

PARTICIPANTS

N = 478 SGM university students (Mage = 22 years, SD = 4.00).

METHODS

SGM university students were surveyed cross-sectionally between May and August 2020 regarding SGM-related stressors and living arrangements since the start of COVID-19.

RESULTS

Approximately half (48.7%) of the sample reported a living rearrangement to their parents' home due to COVID-19. Living rearrangement to parents' homes was associated with an increased degree of identity concealment (β [95% C.I.] = 0.62 [0.10, 1.15]; p = .020) and familial rejection (β [95% C.I.] = 1.56 [0.72, 2.41]; p < .001) since the start of COVID-19 compared to stably living without parents (34.3%). Stably living with parents (17.0%) was not associated with increased degree of SGM-related stressors compared to experiencing a living rearrangement.

CONCLUSIONS

Stakeholders must consider the unique identity-related vulnerabilities of SGM students living with parents and who experience living rearrangements due to COVID-19.

COVID-19, lockdowns, and the mental wellbeing of LGBTQ people in Australia

LGBTQ communities around the world entered the COVID-19 pandemic with generally high rates of poor mental health and faced additional challenges including stigma, discrimination, and barriers to care. This study sample was drawn from a survey of 3135 LGBTQ adults residing in Australia during the pandemic. Regression analysis was used to explore individual differences in psychological distress and perceived change in mental wellbeing since the onset of the pandemic as well as the impact of lockdowns, by taking advantage of a natural experiment comparing the states that experienced more extensive lockdowns (Victoria and New South Wales) to the rest of Australia. The burden of mental health was found to vary across gender, sexual orientation, age, and area of residence. While no impact of lockdowns on psychological distress was observed, participants living in the states of Victoria (β = -0.15; 95% CI = -0.23, -0.07) and New South Wales (β = -0.13; 95% CI = -0.21, -0.05) self-reported a more negative impact of the pandemic on their mental wellbeing compared to the rest of the country. The findings suggest that the COVID-19 pandemic had a negative impact on the mental wellbeing of LGBTQ populations, particularly among those who experienced extensive lockdowns and highlight the need for increased efforts to enable access to mental health supports during times of crisis.

A quantitative approach to the intersectional study of mental health inequalities during the COVID-19 pandemic in UK young adults

PURPOSE

Mental health inequalities across social identities/positions during the COVID-19 pandemic have been mostly reported independently from each other or in a limited way (e.g., at the intersection between age and sex or gender). We aim to provide an inclusive socio-demographic mapping of different mental health measures in the population using quantitative methods that are consistent with an intersectional perspective.

METHODS

Data included 8,588 participants from two British cohorts (born in 1990 and 2000-2002, respectively), collected in February/March 2021 (during the third UK nationwide lockdown). Measures of anxiety and depressive symptomatology, loneliness, and life satisfaction were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models.

RESULTS

We found evidence of large mental health inequalities across intersectional strata. Large proportions of those inequalities were accounted for by the additive effects of the variables used to define the intersections, with some of the largest gaps associated with sexual orientation (with sexual minority groups showing substantially worse outcomes). Additional inequalities were found by cohort/generation, birth sex, racial/ethnic groups, and socioeconomic position. Intersectional effects were observed mostly in intersections defined by combinations of privileged and marginalised social identities/positions (e.g., lower-than-expected life satisfaction in South Asian men in their thirties from a sexual minority and a disadvantaged childhood social class).

CONCLUSION

We found substantial inequalities largely cutting across intersectional strata defined by multiple co-constituting social identities/positions. The large gaps found by sexual orientation extend the existing evidence that sexual minority groups were disproportionately affected by the pandemic. Study implications and limitations are discussed.

Depression and Anxiety Symptoms Among Cisgender Gay and Bisexual Men During the Onset of the COVID-19 Pandemic: Time Series Analysis of a US National Cohort Study

BACKGROUND

The onset of the COVID-19 pandemic in the United States in March 2020 caused a dramatic change in the way many people lived. Few aspects of daily life were left undisrupted by the pandemic's onset as well as the accompanying policies to control the spread of the disease. Previous research has found that the pandemic may have significantly impacted the mental health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals-potentially more so than other individuals. However, the pandemic did not affect all areas of the United States at the same time, and there may be regional variation in the impact of the onset of the pandemic on depressive symptoms among LGBTQ individuals.

OBJECTIVE

To assess regional variation of the impact of the pandemic, we conducted a time series analysis stratified by US geographic region to examine symptoms of depression and anxiety among a sample of primarily cisgender gay and bisexual men before and after the onset of the COVID-19 pandemic in the United States.

METHODS

In total, 5007 participants completed assessments as part of the Together 5000 study, an ongoing prospective cohort study. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire-4. Patient Health Questionnaire-4 scores were graphed as a function of days from March 15, 2020. Locally estimated scatterplot smoothing trend lines were applied. A sieve-bootstrap Mann-Kendall test for monotonic trend was conducted to assess the presence and direction of trends in the scatterplots. We then compared the observed trends to those observed for 1 year prior (2018-2019) to the pandemic onset using data collected from the same sample.

RESULTS

Significant positive trends were detected for the Northeast (P=.03) and Midwest (P=.01) regions of the United States in the 2020 assessment, indicating that symptoms of anxiety and depression were increasing in the sample in these regions immediately prior to and during the onset of the pandemic. In contrast, these trends were not present in data from the 2018 to 2019 assessment window.

CONCLUSIONS

Symptoms of anxiety and depression increased among the study population in the Northeast and Midwest during the beginning months of the COVID-19 pandemic, but similar increase was not observed in the South and West regions. These trends were also not found for any region in the 2018 to 2019 assessment window. This may indicate region-specific trends in anxiety and depression, potentially driven by the burden of the pandemic and policies that varied from region to region. Future studies should consider geographic variation in COVID-19 spread and policies as well as explore potential mechanisms by which this could influence the mental health of LGBTQ individuals.

Considering the experiences and adjustment of sexual and gender minority youths during the COVID-19 pandemic

Sexual and gender minority (SGM) adolescents and emerging adults experienced social and structural inequities and evinced more psychosocial adjustment difficulties than cisgender, heterosexual youths before the onset of the COVID-19 pandemic. The unique array of stressors confronting SGM youths during the pandemic - including separation from affirming and supportive peers, teachers and communities, and mandated co-residence with potentially rejecting family members - may have exacerbated these discrepancies. Conversely, social distancing and remote learning may have reduced direct exposure to discrimination outside the home, and many SGM youths leveraged their personal and social resources to cope with pandemic-related stressors. This review considers the empirical literature on the academic, psychological, and social consequences of the COVID-19 pandemic for SGM youths.

Problematic Substance Use among Sexual Minority and Heterosexual Young Adults during COVID-19

Sexual minority young adults (SMYAs), compared to heterosexual young adults (HYAs), are a uniquely high-risk population for problematic substance use, a disparity perhaps exacerbated by the COVID-19 pandemic. This study tested whether SMYAs had more problematic substance use than HYAs during the pandemic due to isolation and loneliness as well as lower family closeness. Participants (N = 141) aged 23-29 completed self-report surveys in 2014-2015 as college students and in the summer of 2021 as young adults (59% White, 26% Black/African American, 9% Asian/Middle Eastern, 6% Hispanic/Latino, and <1% American Indian/Alaska Native). Results of multivariate regression and multiple group path analyses did not support hypothesized effects-SMYAs did not have greater increases in problematic substance use compared to HYAs, isolation and loneliness were not significant mediators, and family closeness was not a significant moderator. However, SMYAs experienced a lack of social safety-increased loneliness and decreased family closeness-compared to HYAs. Further research is needed to investigate both the impact and underlying processes of this decreased social safety on SMYA well-being beyond the pandemic to better inform tailored supports and interventions.

Impact of family rejection and racism on sexual and gender minority stress among LGBTQ young people of color during COVID-19

OBJECTIVE

Given the inequitable impact of COVID-19 on sexual and gender minority (SGM) youth and current sociopolitical racial justice concerns in the United States, this study examines the impact of SGM-related family rejection and racism since the start of COVID-19 on SGM-related internalized homophobia and identity concealment among SGM college students of color (SOC).

METHOD

Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study about minority stress and COVID-19 pandemic experiences among SGM college students. Participants completed survey items specifically related to changes in minority stress and racism experiences since the start of COVID-19. Logistic regression models were used to examine the independent and interactive effects of racism and family rejection on identity concealment and internalized homophobia since the start of COVID-19 (adjusting for covariates).

RESULTS

Main effects models revealed that increased racism and family rejection were significantly associated with greater odds of experiencing identity concealment since the start of COVID-19. The interaction of increased racism and family rejection was also significantly associated with greater odds of experiencing identity concealment since the start of COVID-19.

CONCLUSIONS

Study findings suggest that the intersection of racism and family rejection since the start of COVID-19 consequently translates to increased experiences of identity concealment. Such experiences are known to negatively impact mental health across the life course among SGM young people. Public health, medical, mental health, and higher education stakeholders must implement SGM-affirmative and antiracist practices and interventions to support SGM SOC during COVID-19 and beyond its containment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Loneliness in Gender-Diverse and Sexual Orientation-Diverse Adolescents: Measurement Invariance Analyses and Between-Group Comparisons

Youth loneliness is a risk factor for myriad adverse psychosocial outcomes, making it a potentially informative construct for assessment and treatment research. Minority stressors may place LGBTQ+ (lesbian, gay, bisexual, transgender, and queer) youths at high risk of loneliness. However, the prevalence of loneliness across gender and sexual identities cannot be precisely estimated or compared without establishing that common measures assess the construct equivalently across groups. In a preregistered study, we determined the optimal structure of the UCLA Loneliness Scale and investigated whether it showed invariance across gender and sexual identities in a national U.S. sample of adolescents with elevated depressive symptoms (N = 2,431; https://osf.io/52ctd). Results supported strict invariance, indicating that loneliness scores can be meaningfully compared across groups in this sample. Exploratory analyses indicated that loneliness levels and LGBTQ+ identity predicted levels of depression and anxiety. We discuss implications for research on loneliness, health disparities, and psychopathology in high-symptom youths.

Blurred border or safe harbor? Emotional well-being among sexual and gender minority adults working from home during COVID-19

During the COVID-19 pandemic, lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults have experienced pronounced declines in well-being. However, less is known about how changes to daily routines and settings, such as the shift to remote work within many occupations, may be playing a role in well-being outcomes. Drawing on a unique time diary data source (N = 3515 respondents and 7650 episodes) collected between April 2020-July 2021 through online crowdsourcing platforms, we conducted random effects analyses to examine how working from home has been associated with experienced well-being among LGBTQ and cisgender heterosexual workers in the United States during the pandemic. Findings indicate LGBTQ adults felt significantly less stressed and tired while doing paid work at home than while working at a workplace. In addition, working at a workplace, rather than working from home, appeared to be more detrimental to LGBTQ adults' well-being compared to their non-LGBTQ counterparts. Adjusting for work characteristics explained some of the difference, whereas adjusting for family characteristics had little impact on the results. It is possible that for LGBTQ employees, working from home mitigates some of the minority stressors experienced during paid work.

Impact of COVID-19 stress on the psychological health of sexual & gender minority individuals: A systematic review

Introduction

The differential effect of the Covid-19 pandemic on the mental health of the population around the globe is well documented. Social isolation, loss of job, financial crisis, and fear of infection due to the pandemic have widely affected people across countries, and the sexual and gender minority (SGM) group is no exception. However, the additional stressors like stigma, discrimination, rejection, non-acceptance, and violence associated with diverse sexual orientation complicated the situation for the SGM group in the context of the Covid-19 pandemic.

Method

The present study conducted a systematic review of research (n = 16) investigating the impact of Covid-19 stress on the psychological health of SGM individuals. The review had two objectives: (a) to explore the effect of the stress associated with the pandemic on the psychological health of the SGM individuals; and (b) to identify potential stressors associated with the Covid-19 pandemic affecting the mental health of SGM individuals. Studies were selected following a PRISMA protocol and several inclusion criteria.

Results

The review provided new insights into the mental health issues of the SGM individual in the Covid-19 context. The outcome of the review focused on five aspects: (a) depression and anxiety symptoms related to Covid-19 symptoms; (b) perceived social support and Covid-19 stress; (c) family support and psychological distress related to Covid-19; (d) Covid-19 stress and disordered eating, and (e) problem drinking and substance abuse associated with Covid-19 stress.

Discussion

The present review indicated a negative association between Covid-19 stress and psychological distress among sexual and gender minority individuals. The findings have important implications for psychologists and social workers working with this population and policymakers around the globe.

Moving Back to the Parental Home in Times of COVID-19: Consequences for Students' Life Satisfaction

Residential independence from parents is a key marker for young adults' transition to adulthood. Losing this independence by returning to the parental home marks a regression of adult development with negative implications for returnees' subjective wellbeing. This paper investigates how a return to the parental home during the COVID-19 pandemic affects the life satisfaction of university students. We used nationwide survey data from German university students (N = 913) to analyze differences in life satisfaction for those who did or did not return to their parental homes. Our results revealed two main findings. First, university students who moved back to their parental home reported significantly lower life satisfaction than those who remained living independently. Second, the association between moving back and life satisfaction varied by age. A return to the parental home was more detrimental to older students' life satisfaction, while students aged 24 or younger did not experience a significant decrease when moving back to the parental home. We discuss the implications of our findings in the context of young adults' subjective wellbeing during the COVID-19 pandemic.

LGBTQ+ Youth Health: An Unmet Need in Pediatrics

At present, lesbian, gay, bisexual, transgender, queer and intersex people (LGBTQ+) are increasingly being empowered to freely express themselves, particularly young people and rising generations. Although data underline the trend of more open expression of different sexual orientations and gender identities, LGBTQ+ adolescents still suffer discrimination in the health care framework. Inclusive care by providers to look after the health of LGBTQ+ indiviuals is needed. Pediatricians are often the first health care providers for LGBTQ+ youth facing their sexual and gender identities. Unfortunately, pediatricians have limited knowledge about LGBTQ+ issues, which keeps them from fulfilling the specific needs of LGBTQ+ youth. The purpose of this review is to frame the most important aspects of LGBTQ+ youths' lives, including risks, difficulties and needs, that pediatricians should investigate and meet to provide these youth with better and more individualizedassistance regarding their health. A literature analysis showed that pediatricians have insufficient knowledge of and comfort with several items regarding the management of LGBTQ+ youths. Increased awareness and knowledge of the specific and exclusive needs of LGBTQ+ adolescents are mandatory, including dedicated pediatric LGBTQ+ health care training. This would give them the opportunity to forward an inclusive health care system, thus reducing the risks related to stigma, bullying and family rejection and promoting sex education. Further studies are needed to better evaluate the prevalence of LGBTQ+ youths, gender-based medicine in pediatrics and the effects of COVID-19 on the LGBTQ+ younth population due to increased risks of psychosocial suffering, isolation and mental diseases.

Family Rejection During COVID-19: Effects on Sexual and Gender Minority Stress and Mental Health Among LGBTQ University Students

This study examines the relationship between family rejection and moderate to severe psychological distress during COVID-19 among LGBTQ university students. Data were obtained from a national cross-sectional electronic survey of LGBTQ university students (N = 565) collected in the summer of 2020. Hierarchical logistic regression models were used to examine the predictive association between increased family rejection and moderate to severe psychological distress. Respondents who reported increased rejection were more than twice as likely to report moderate to severe psychological distress, with social isolation and LGBTQ identity concealment being significant covariate predictors in the model. These results demonstrate the importance of public health, medical, mental health, and higher education stakeholders understanding the significance of LGBTQ-identity related family rejection when addressing the mental health and well-being of LGBTQ young people.

Young Adults' Perceived Impact of COVID-19 Pandemic on Sleep and Other Functioning: Does It Differ for Sexual/Gender and Racial/Ethnic Minorities?

OBJECTIVES

Since the beginning of the COVID-19 pandemic, there has been concern that the pandemic and associated mitigation efforts would have a particularly adverse effect on communities that are marginalized. This study examined disparities in the perceived impacts of the pandemic on sleep, mental and physical health, social functioning, and substance use among young adults based on sexual/gender minority (SGM) status and race/ethnicity.

METHOD

Participants were 2,411 young adults (mean age = 23.6) surveyed between July 2020-July 2021. A linear regression analysis tested SGM and racial/ethnic group differences on 17 outcomes.

RESULTS

Most young adults reported little-to-no effect of the pandemic on sleep or other indicators of health and functioning. However, SGM young adults reported more adverse effects than non-SGM young adults on their sleep and most other outcomes. Hispanic young adults reported shorter sleep duration - but less pandemic-related depression, loneliness, and relationship problems - compared to non-Hispanic white young adults. We found no evidence that young adults with multiple minority statuses had especially poor pandemic-related outcomes.

CONCLUSIONS

While most young adults did not perceive much impact of the pandemic, results highlight disparities across certain demographic subgroups that may need to be addressed through targeted interventions and close monitoring for long-term effects.

Not All Homes Are Safe: Family Violence Following the Onset of the Covid-19 Pandemic

Evidence from victim service providers suggests the COVID-19 pandemic led to an increase in family violence. However, empirical evidence has been limited. This study uses novel survey data to investigate the occurrence of family violence during the early months of the COVID-19 pandemic in the United States. Data come from the second wave of the Assessing the Social Consequences of COVID-19 study, an online non-probability sample collected in April and May 2020. Family violence is measured using four variables: any violence, physical violence, verbal abuse, and restricted access. The authors use logistic regression and KHB decomposition to examine the prevalence of family violence during the COVID-19 pandemic. We find that sexual minorities, in particular bisexual people, experienced higher rates of family violence than heterosexual respondents. Women were the only group to report an increase in the frequency of family violence. Household income loss is associated with the incidence of verbal violence. Our findings demonstrate the importance of expanding victim services to address the additional barriers victims face within the pandemic context and beyond, including broad contexts of social isolation and financial precarity experienced by individuals at risk of family violence.