***CONTENT WARNING: suicide; self-harm; domestic violence***
In the past two years, we have experienced drastic changes in the way we live and interact with one another. COVID-19 has exacerbated issues that disproportionately affected marginalized groups even before the pandemic. One important issue is the prejudice and discrimination targeted towards members of the LGBTQ2S+ community, which has had particularly detrimental effects on mental health and socio-economic status, notably for those with intersectional identities. This blog focuses on the experiences of LGBTQ2S+ youth in particular, who have especially faced the negative impacts of COVID-19; however, we must keep in mind that there are many other forms of intersectionality that intensify the discrimination experienced by those in the LGBTQ2S+ community.
Dismantling Anti-LGBTQ2S+ Prejudice and Fostering Inclusion
In order to promote the well-being and socio-economic inclusion of LGBTQ2S+ individuals in all facets of life, structural and systemic change is required. I propose three steps towards dismantling anti-LGBTQ2S+ prejudice and fostering inclusion.
#1: Implementing Mental Health Services and Restructuring Institutional Policies
Implementing accessible mental health services and restructuring institutional policies is a first step towards addressing the needs of LGBTQ2S+ people. Institutional policies must acknowledge the impact of intersectionality and ensure that those with multiple marginalized identities can access inclusive and identity-affirming services that are specific to their needs. Moreover, clinically and culturally competent services and training for healthcare workers should be implemented; this requires weaving Indigenous and immigrant worldviews towards health and well-being with Western knowledge, and ensuring safe and inclusive spaces for those with various sexual orientations and gender identities to receive the care they require. Healthcare providers[LN1] should also increase the accessibility of online mental health services, and create alternative services for those who face barriers in accessing online care.
Exacerbated by the COVID-19 pandemic, Canada’s health care system is facing increased pressure such as staffing shortages particularly in emergency service and a backlog of procedures, increasing the possibility of patients showing up with more advanced disease conditions. These structural issues require a holistic response and is the responsibility of government, corporate, and social sector as well as healthcare providers.
Homophobia and transphobia often lead to disproportionately negative impacts on the mental health of those identifying as LGBTQ2S+. The Canadian Mental Health Association describes three determinants of positive mental health and well-being: freedom from discrimination and violence, social inclusion and access to economic resources. However, LGBTQ2S+ peoples are often targets of discrimination, sexual and physical assault, hate crimes, and socio-economic exclusion, causing them to experience higher rates of mental health concerns compared to their heterosexual and cisgender counterparts, including depression, anxiety, suicidality, obsessive-compulsive and phobic disorders, self-harm, substance use, and post traumatic stress disorder. For example, in one Ontario-based survey, 77% of transgender respondents reported that they had considered suicide, with 45% reporting having attempted it. Anti-LGBTQ2S+ prejudice and discrimination have a global effect as well; the United Nations Human Rights Commission reports that LGBTQ2S+ peoples around the world are at a greater risk of mental health concerns, including anxiety, depression, self-harm and suicide.
Mental health concerns are exacerbated when those with LGBTQ2S+ identities belong to other marginalized groups, as intersectionality compounds their subordinated identities, heightening the discrimination they experience. For example, racialized and Indigenous peoples battle systemic racism as well as homophobia and transphobia, and mental health issues are particularly prevalent among LGBTQ2S+ youth, who are at a significantly higher risk of suicide and substance use than their heterosexual peers. COVID-19 has worsened the impacts of anti-LGBTQ2S+ prejudice and discrimination, intensifying mental health concerns that existed prior to the pandemic; for instance, individuals identifying as both LGBTQ2S+ and Asian face especially detrimental barriers, due to racial and sexual discrimination being further compounded by anti-Asian hate crimes associated with the pandemic.
COVID-19 has also led to changes in accessing healthcare and social services for those identifying as LGBTQ2S+. While the shift to online care has increased accessibility for some, it has created logistical and privacy concerns for others, as some individuals experience issues with technology or live with unsupportive family members, posing barriers to accessing virtual care. In one study investigating the influence of COVID-19 on LGBTQ2S+ youth in the Greater Toronto Area, around 31% of respondents described severe changes, resulting in an inaccessibility of healthcare and negative impacts on their mental health. The majority of transgender participants reported having to postpone or cancel transition-related appointments or surgeries, increasing depression, anxiety and suicidality. Participants also reported difficulties in accessing counselling, support groups, and alcohol and substance use treatment since the pandemic.
#2: Creating Identity Affirming Communities and Initiatives
LGBTQ2S+-affirming communities and initiatives should be strengthened implemented[LN2] to support those who have suffered heightened discrimination as a result of COVID-19. This can be achieved through more supports for existing organizations (such as GLAAD, Égale, The 519; Pflag Canada) and the creation of Gay-Straight Alliances and Genders and Sexualities Alliances in schools to increase students’ sense of belonging and foster connection.
Additionally, educational workshops and programs in workplaces and communities can aid in dismantling prejudice among co-workers, family members and peers, while faith-based communities may also act as a source of support for those identifying as LGBTQ2S+.[LN3] Employee resource groups (ERG’s) and community groups are some examples of these types of initiatives. Pride At Work Canada, for example, offers “FLOURISH,” an eight-week virtual program that will develop the skills required for 2SLGBTQIA+ Employee Resource Group (ERG)* leaders to be effective and successful in their roles. The Children’s Aid Society of Toronto’s “Out and Proud Program” developed a resource of LGBTQ-Positive Faith Groups and Places of Worship in the Greater Toronto Area (GTA) to support LGBTQ2S+ youth seeking welcome.
Culturally-sensitive awareness-raising campaigns that accurately depict the lived experiences of LGBTQ2S+ peoples and promote their inclusion in all spheres of society may also be beneficial.[LN4] Organizations such as the Alliance for South Asian AIDS Prevention, the Asian Queer Alliance, the Queer South Asian Women's Network, and the Black Coalition for AIDS Prevention provide culturally relevant services and spaces, as well as educational resources.
Individuals who identify as LGBTQ2S+ are often marginalized within their communities, hindering their sense of well-being; LGBTQ2S+ youth in particular frequently experience bullying, physical violence, and social isolation. The pandemic has worsened these feelings of isolation, leading to poorer mental health and increased substance use among youth; in Abramovich et al.’s study, around 81% of participants reported engaging in self-injury and around 36% reported having attempted suicide since the start of COVID-19. Furthermore, around 97% of respondents reported feeling lonelier because of the pandemic, many resorting to alcohol and substance use due to a loss of connection with friends and communities, as well as unemployment, difficult living situations and identity-based discrimination.
#3: Increasing Socio-Economic Support
Lastly, because anti-LGBTQ2S+ discrimination is a global issue, federal and provincial governments must increase financial and social support to members of the LGBTQ2S+ community, particularly immigrants and refugees escaping from persecution in their home countries. This includes increased funding towards affordable and transitional housing, coupled with employment training and social services to enable LGBTQ2S+ peoples to support themselves. Moreover, the funding and provision of public services directed towards those with intersectional identities must be prioritized, such as social assistance for LGBTQ2S+ individuals with disabilities.
Homophobia and transphobia contribute to the socio-economic marginalization of LGBTQ2S+ peoples, particularly when accessing housing, employment, social and health services. For example, transgender individuals are over-represented among low-income Canadians; a study conducted in Ontario in 2008 found that half of transgender people were living on less than $15,000 a year, indicating significant underemployment. Moreover, in a TRANS Pulse report published in 2014, a significant proportion of transgender individuals reported living off of economic assistance; meanwhile, 13% of transgender Ontarians reported being fired for being transgender, 18% were rejected for a job because they were transgender, and 17% declined a job offer because the work environment was not trans-positive or safe. LGBTQ2S+ youth are at an additional disadvantage regarding socio-economic discrimination; Egale Canada reports that Canada has limited specialized housing initiatives for LGBTQ2S+ individuals, particularly youth, who represented twenty-five to forty percent of homeless youth in 2017. Furthermore, LGBTQ2S+ youth are often financially dependent on their families, which can pose additional barriers if they live in discriminatory environments.
The pandemic has intensified socio-economic concerns for LGBTQ2S+ peoples around the world. For example, COVID-19 has made it difficult for undocumented LGBTQ2S+ migrants, refugees and asylum seekers to find employment, as they are unable to work in informal trades that previously supported them nor receive the same benefits as citizens of home countries. Additionally, among those facing the negative socio-economic impacts of COVID-19 are LGBTQ2S+ youth. In Abramovich et al.’s study, participants reported difficulties in securing safe and affordable housing; around 54% of respondents lived with their parents before the pandemic compared to 33% since, and many describe their experiences of living with unsupportive family members, having no physical escape. Participants also reported losing their jobs as a result of the pandemic, with around 28% unemployed pre-pandemic compared to around 56% since, many relying on government assistance as their primary source of income.
COVID-19 has disproportionately impacted LGBTQ2S+ peoples in Canada and around the world, exacerbating mental health issues, and preventing access to housing, employment, healthcare and social services. The pandemic has not only forced us to change how we live, but it has encouraged us to challenge these ways of living, and to consider how structural and systemic inequalities motivated by underlying prejudices cause certain groups to experience the disproportionate costs embedded in our society’s ways of being and doing. Improving the mental health and socio-economic status of LGBTQ2S+ individuals is a national and global concern, which must be addressed by starting at home; we have a duty to uplift and empower LGBTQ2S+ peoples living in Canada in order to provide hope for communities around the world and set a positive example for other states to foster inclusion and dismantle prejudice.
Did You Know?
● LGBTQ2S+ people and those with disabilities often experience poverty; in 2012, 34% of transgender individuals in Ontario had household incomes below the low-income cut-off, and similarly, in 2013, around 20% of persons with disabilities lived below the low-income cut-off. ● A Toronto-based study found significantly higher rates of smoking among LGBT adults (36%) compared to other adults (17%), and some studies suggest that the use of alcohol, tobacco, and other substances is around two to four times higher among LGBT individuals compared to their heterosexual counterparts. ● Racialized LGBTQ2S+ individuals have been found to have mental health needs almost 5% higher compared to non-racialized LGBTQ2S+ individuals, and 16% higher compared to cisgender, heterosexual and non-racialized people. ● One Ontario-based study reported that 47% of transgender youth aged sixteen to twenty-four had considered suicide, with 19% having attempted it. ● Transgender and gender diverse individuals are two times more likely to experience homelessness and poverty than the general population.