The Spatial Impacts of COVID-19 Restrictions on LGBTIQ Wellbeing, Visibility, and Belonging in Tasmania, Australia

Self-Disclosure of Loneliness by LGBTQ+ Twitter Users During COVID-19

Mental health in LGBTQ+ community is often challenged by stigma, prejudice, and discrimination. The "social distancing" public health measures during COVID-19 epidemic have exacerbated the trend. During the pandemic, many took to social media as an outlet for sharing their feelings and in search of connection. Social media may help alleviate loneliness-an increasingly prevalent condition associated with both physical and mental health issues. In this study, we examine 147,736 Twitter posts mentioning loneliness by users who self-identify as part of the LGBTQ+ community, posted before and during the COVID-19 lockdowns. We find that, compared to the year before COVID-19, these users posted 67% more loneliness self-disclosures during the first year of COVID-19. Examining the emotional content of these tweets, we find frequent references to depression, dysphoria, and suicidal ideation. During COVID-19, the users mentioned more "pain" and "numbness" in association with the lack of social and physical contact. However, many found Twitter to be a safe space to express these feelings. The replies to these disclosures were rare: only about 29% received one. Using a large dataset of self-disclosures, we reveal quantitatively and qualitatively the disclosure around loneliness by LGBTQ+ users at an unprecedented time of social isolation.

'Being Actively Confident in All Contexts': A Qualitative Exploration of Thriving as an Emerging Adult of Diverse Sexual Orientation

When one thrives, they grow, develop and succeed. For people of diverse sexual orientations (DSO) thriving within one's sexuality is often restricted by heteronormativity, minority stress and poor mental health outcomes. Particularly at risk, are DSO "emerging adults" aged between 18-29 years who seek stability before transitioning to adulthood. Therefore, this qualitative study interviewed 12 participants between the ages of 18-29 years to investigate perceptions of thriving within one's sexuality and factors that may foster or hinder its occurrence. The results indicated participants perceived thriving as a spectrum of states and processes involving a sense of personal safety with high levels of self-acceptance to believe one could exist freely as a person of DSO. The findings suggested thriving within one's sexuality during emerging adulthood is fostered through the factors of seeking personal growth, social representation/visibility, affirming social support and opportunities to support other DSO people. In contrast, identity denial, unsupportive social environments, erasure/tokenism, and experiences of discrimination eroded one's ability to thrive. Psychological interventions focusing on establishing a strong sense of identity, building a social support network and encouragement to seek thriving opportunities, may foster thriving experiences for Australian DSO emerging adults.

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.

Marital status, State policy environment and Foregone healthcare of same-sex families during the COVID-19 period

Sexual minorities in the United States have often reported a higher likelihood of forgoing healthcare than heterosexuals, but whether this occurred during the COVID-19 pandemic remains underexplored. This study applies and extends the Andersen model to examine different-sex and same-sex families' likelihood of forgoing healthcare during the pandemic using nationally representative data from the 2020 (May-October) Current Population Survey (N = 139,636). Results are that during the early stage of the pandemic (1) same-sex families overall are more likely than different-sex families to forgo medical care, (2) cohabitating same-sex families were less likely to forgo healthcare than their married counterparts, and (3) state policy environments will moderate only some of the differences in healthcare utilization by family types. Findings provide partial support for hypotheses and suggest a more careful consideration of the role of partnership and state policy in the Andersen model. Policy implications are also discussed.

"Being Able to Be Yourself": A Qualitative Exploration of How Queer Emerging Adults Experience a Sense of Belonging in Rural Australia

Rural Australians with diverse sexualities (queer) are at higher risk of poor mental health outcomes and suicidal ideation than their heterosexual and urban peers. This is particularly the case for young people aged 18-29 years experiencing a developmental period known as emerging adulthood marked by significant volatility and change. A sense of belonging is a fundamental human need and has been found to function as a protective factor against depression and suicidality in rural, queer, and emerging adult populations. However, studies have not explored how queer emerging adults experience belongingness in rural communities. This paper presents a qualitative, exploratory study of 11 rural queer emerging adult Australians and examines their experiences of belongingness utilizing a four-factor framework of belonging-assessing competencies, opportunities, motivations, and perceptions. The results indicate that negative perceptions of inclusion in rural areas inhibit a sense of belonging from being established, by influencing the individual's motivations to belong and the competencies they apply to belong. Lower levels of perceived social acceptance and queer visibility are two perceptions that repeatedly affect a sense of belonging. Interventions that address perceptions and competencies, and increase queer visibility in rural areas, could increase a sense of belonging for queer emerging adults in rural Australia.

Supporting LGBTIQA+ communities in small rural settings: a case study of health promotion in a community health service

People from LGBTIQA+ communities living in rural areas experience significant disparities across a range of health and wellbeing indicators, high levels of stigma and discrimination, and difficulty accessing inclusive health and support services. This article discusses a targeted health promotion intervention designed to build supportive health and social programs to address these problems. We describe the initial needs assessment undertaken to inform the intervention, the role and activities of the health promotion officer funded through the program, and present evaluation data on program outcomes. The article demonstrates that modest funding for health promotion can make a positive contribution to connecting and supporting individuals in a small regional community, leading to better health and wellbeing outcomes.

Queers in quarantine: Young LGBTQ+ people's experiences during the COVID-19 pandemic in Sweden

The COVID-19 pandemic led to major restrictions of everyday life activities. This worsened the social situation of many people, and marginalized groups have been especially affected. This article explores how LGBTQ+ young adults in Sweden have been affected by the COVID-19 pandemic and the subsequent recommendations and restrictions. Fifteen participants between 20-29 years, who self-identified as lesbian, gay, bisexual, transgender, and queer (LGBTQ+), were interviewed about their experiences. A thematic analysis of the data showed that the participants perceived their psychological wellbeing to have been greatly affected by the pandemic. Several reported symptoms of clinical depression, as well as anxiety, worry, rumination, and a heightened sensitivity to stress. Stressors included fear of the disease itself, and fear of spreading the virus, as well as the negative consequences of adhering to the recommendations of social distancing, which constantly interplayed with the marginalized position of being a young LGBTQ+ person. Most participants experienced a decrease in minority stress in face-to-face interaction with social distancing measures in place, but an increase in minority stress online. Those who faced minority stress at home experienced the isolation as particularly stressful. Limited access to the LGBTQ+ community was a common stressor. For transgender participants, the effects on transgender healthcare, such as prolonged waiting times for gender dysphoria assessment and hormone treatment, were a major challenge. Our results have added valuable knowledge to research indicating how vulnerable young adults were highly affected by the COVID-19 pandemic restrictions.

Examination of eating disorder psychopathology across sexual and gender identities among a Canadian sample

OBJECTIVE

Eating disorders (EDs) disproportionately affect sexual and gender minorities, with majority of research conducted among samples in the United States. The purpose of this study was to examine ED psychopathology among adolescents and young adults in Canada with diverse gender and sexual identities.

METHOD

Data were collected from 2,714 Canadians, aged 16-30 years old, via an online survey at the end of 2021 during the COVID-19 pandemic. Participants responded to sociodemographic questions (including history of EDs) and reported on eating attitudes and behaviors. Descriptive statistics and multiple modified Poisson and linear regressions were conducted.

RESULTS

Over half the sample was heterosexual, 35% were sexual minority cisgender men and women, and 6.5% were transgender and gender non-conforming (TGNC) people. The sample overall reported elevated ED psychopathology based on their eating attitudes and behaviors. TGNC participants reported the most severe ED psychopathology. Generally, sexual minority cisgender women and cisgender men had elevated ED psychopathology compared to their heterosexual counterparts. Regression analyses revealed all gender and sexual minorities reported greater ED psychopathology compared to heterosexual cisgender men.

DISCUSSION

The Canadian sample reported elevated ED psychopathology compared to previous studies among various populations. Additional investigations are now needed to observe how ED psychopathology continues to change after the onset of the pandemic. Further research is needed among cisgender men, TGNC people, and sexual minorities to understand the unique stressors they face that lead to high ED psychopathology, and develop appropriate prevention and treatment tools.

PUBLIC SIGNIFICANCE

EDs affect people of all gender and sexual identities. People who identify as a gender and/or sexual minority often experience problematic eating attitudes and behaviors, particularly transgender and gender non-conforming people of all sexual identities. More research attention is needed among these populations, especially due to a paucity of research among Canadians, to develop effective diagnostic tools, prevention efforts, and treatment programs specific to gender and sexual identities.

Intimate Partner Violence and Openness to Online Counseling Among College Students

Intimate partner violence (IPV) is prevalent and has devastating consequences for college students. Online counseling (OC) may be a way to decrease barriers to help. This study seeks to determine openness to OC compared to face-to-face counseling (F2F) by examining: (1) How openness to OC varies depending on college students' personal and IPV characteristics and (2) How these characteristics vary compared to college non-IPV survivors. Two linear regressions were conducted using a sample from a cross sectional survey. First with the entire sample of college students (N = 1,518) to examine characteristics of those more open to OC and second with only those that identified as experiencing IPV (n = 1,211). The results demonstrated that IPV survivors are less open to OC than to F2F counseling (b = -.23, p < .01). For the model with all college students, those who were significantly more open to OC were female (b = -.39, p < .001), identified as LGBT (b = .23, p < .05), or Asian/Pacific Islander (API) (b = .26, p < .05), and had a physical health issue (b = -.19, p < .05). For the model that only analyzed IPV survivors, the same characteristics were shown to be significantly related to openness to OC. More research is needed to explore why IPV survivors are less open to OC compared to F2F counseling. Exploring why characteristics of female, LGBT, and physical health issues lead to openness to OC could help understand what barriers need to be addressed for wider use.

"Make sure I hear snoring": Adolescent girls, trans, and non-binary youth using sound for sexual wellbeing boundary-making at home during COVID-19

To understand how COVID-19's stay-at-home orders impacted youths' sexual and social development, we conducted five virtual focus groups (n = 34) with adolescent girls', trans', and non-binary youths' aged 16-19 between April-June 2021 in the GTA. We queried experiences of home, privacy, and sexual wellbeing during Canada's third wave. Auto-generated zoom transcripts were coded using an inductive framework with NVivo. Field notes and team discussions on the coded data informed the analysis. This paper explores how sexual wellbeing during the pandemic is practiced in relation to, dependent upon, and negotiated at home. Using intersectionality theory and embodiment theory, this research analyzes how youth's diverse identities shape their understandings and experiences of sexual wellbeing. We found youth needed spaces where they were not only unseen, but importantly, unheard. We argue sound as an important piece of boundary-work that reveals the way youth construct space during precarious times. Youth primarily negotiated sonic privacy through (a) sound-proofing, (b) sound warnings and (c) "silent reassurance", a term we coined to describe the precursor of silence from other household members in order for youth to feel safe enough to practice sexual wellbeing. We found that white youth cited the bedroom as the best space for sexual wellbeing practices, but BIPOC youth felt the bedroom was only their best available option and still found they had to negotiate privacy. Attending to intersectionality theory, we expand on McRobbie and Garber's (1976) bedroom culture concept and widen Hernes' (2004) concept of physical, social and mental boundary-work to include sound as a fourth type, which straddles among them. This research shows how privacy, gender and sexual identities were negotiated at home in times of extreme uncertainty, highlighting how implications of home as a 'place' during the pandemic, constructs sexual wellbeing. Mapping how and where youth practice embodied sexual wellbeing exposes the ways that private and public understandings of identity relate to sexuality and geographies of home. We understand the home as a complex space that can not only determine sexual wellbeing, but where health promoting boundaries can be negotiated. We conclude with suggestions for supporting adolescent sexual wellbeing, inside and outside the home, during and after COVID-19.

Designing for COVID-2x: Reflecting on Future-Proofing Human Habitation for the Inevitable Next Pandemic

The COVID-19 pandemic of 2020–2022 has revealed the vulnerability of modern society to a highly contagious airborne virus. Many spaces in the urban and built environment designed during the late twentieth and early twenty-first century are ill-suited to maintain the level of social distancing required to reduce the probability of virus transmission. Enclosed spaces—in particular, communal circulation spaces such as corridors, elevators and lobbies—have proven loci of transmission, together with circulating reticulated air and lack of proper ventilation. While urban planning needs to incorporate the lessons learnt during COVID-19 in order to future-proof our communities through the provision of well-designed greenspaces, the main burden will fall on architects, who will play an instrumental role in designing buildings that are fit-for purpose. This conceptual paper reviews the status quo and discusses a number of strategies to future-proof human habitation for the inevitable next pandemic.

From Physical Distancing to Social Loneliness among Gay Men and Other Men Having Sex with Men in Belgium: Examining the Disruption of the Social Network and Social Support Structures

Since the start of the SARS-CoV-2 pandemic, levels of loneliness have increased among the general population and especially among sexual minorities, such as gay men and other men who have sex with men, who already experienced more problems with social isolation before the pandemic. We analyzed how the disruption of the social network and social support structures by containment measures impact loneliness among gay and other men having sex with men. Our sample consisted of gay and other men having sex with men who had in person communication with family as well as heterosexual friends and homosexual friends before the lockdown (N = 461). Multivariate regression analyses were performed with social provisions (social interaction and reliable alliance) and loneliness as dependent variables. A change from in-person communication with gay peers before the pandemic to remote-only or no communication with gay peers during the pandemic, mediated by change in social integration, was related to an increased feeling of loneliness during the pandemic compared with before the pandemic. There were some unexpected findings, which should be interpreted in the specific social context of the SARS-CoV-2 pandemic. On average, social integration and reliable alliance among MSM increased during the lockdown, even though in-person communication decreased and loneliness increased. Our results show it is critical to maintain a view of social support and social loneliness as lodged within larger social and cultural contexts that ultimately shape the mechanisms behind them.

The Nexus between Cultural Heritage Management and the Mental Health of Urban Communities

In authorized cultural heritage management discourse, heritage sites can be included in local government heritage registers if their aesthetic, scientific, historic or social values are deemed significant. While notionally providing protection from major alterations and destruction for the benefit of future generations, such listings primarily serve the present generation whose values they reflect. This paper considers the role that cultural heritage places play in terms of community identity and their contribution to a sense of place, to place attachment and, by implication, to personal and community mental health.

Exercising under COVID-2x: Conceptualizing Future Green Spaces in Australia’s Neighborhoods

The COVID-19 pandemic has proven to be a social and economic disruptor on a global scale, severely curtailing people’s ability to travel and engage in many recreation activities. Periodic lockdown and stay-at-home orders have exacerbated the situation. In this social climate, urban green spaces have attained a high significance for the maintenance of the physical and mental health of the population. Given the presence of similar coronaviruses in animal populations, it can be predicted that future epidemics and even pandemics will occur. Urban planning needs to incorporate the lessons learnt during COVID-19 in order to future-proof our communities. This paper reviews the role that urban green spaces played during the COVID-19 pandemic. Based on these observations, the paper discusses a range of options for the provision of pandemic-sensitive spaces for physical exercise and mental recreation. Design concepts for long-term planning adjustments as well as for future ad-hoc solutions are provided. These include the provision of social distancing ‘pods’ embedded in design and landscaping of permanent parks, the design of ad-hoc, socially distanced ‘parklets’ on a quietened street and a rethink of the design of curb-to-boundary setbacks (nature strip) in residential streets.

Experiences of the COVID-19 Pandemic Among African American, Latinx, and White Sexual Minority Women: A Descriptive Phenomenological Study

From a systems perspective, the COVID-19 pandemic has caused global changes impacting the lives of individuals at all levels of interactions. Qualitative in-depth interviews were conducted with a sample of 18 African-American/Black, Hispanic/Latina/Latinx, and White sexual minority women (SMW) to explore experiences and adaptations during the COVID-19 pandemic. Interviews were analyzed using a descriptive phenomenological approach to understand how the complex and changing contexts of the pandemic impacted participants' lives. Analyses revealed participants were impacted in the context of their sexual identity in their experiences of coming out and being visible; creating social bubbles; their connection to the LGBTQ community; and dating. The pandemic, which took place concurrently with major political events including Black Lives Matter demonstrations and protests against police and White supremacist violence against people of color, resulted in additional impacts on Black and Latinx SMW related to safety, dialogues about race, and on-going systemic and cultural racism. Interviews also revealed general challenges in the areas of relationships, including with a partner and family; employment and the workplace; and interactions in public spaces. The findings underscore the importance of understanding the diverse range of experiences and impacts of the pandemic on SMW, including experiences related to their sexual identity and racial/racialized identity, as well as general experiences that may have additional consequences for SMW, and supports needed to help alleviate the negative impacts in the short and long-term.

Introduction to Special Issue: Impacts of the COVID-19 Pandemic on LGBTQ+ Health and Well-Being

This special issue on the impacts of COVID-19 on LGBTQ+ health and well-being reports findings from nine articles with varied study designs, including data from multiple countries and all segments of LGBTQ+ communities. Key findings included the observation that pre-COVID mental health disparities predispose LGBTQ+ people to poorer outcomes; that technological communication aids are essential in maintaining some sense of community; and that substance use is perceived by sexual minority women as a means of coping with fears, stress, loneliness, and boredom. Studies in this special issue also document that community support is still a critical need, particularly among those who are sheltering at home with families of origin. Findings underscore the importance of addressing structural inequities, including advocating for rights; providing financial support for LGBTQ+ community organizations and networks; ensuring access to competent and affirming healthcare; and including vulnerable communities in disaster response and planning.