The mental health and experiences of discrimination of LGBTQ+ people during the COVID-19 pandemic: Initial findings from the Queerantine Study

Objective: To assess mental health status and experiences of discrimination among a sample of Lesbian, Gay, Bisexual, Transgender, Queer people (LGBTQ+, the + including those who don't identify with any such label) during the COVID-19 pandemic. Design: Cross-sectional web-based survey. Setting: Responses were collected during the COVID-19 pandemic between April 27th and July 13th. Participants: 398 LGBTQ+ respondents forming an analytical sample of 310 in the main models. Methods: We used a combined measure of gender identity or expression and sexual orientation as the main explanatory variable. We assessed mental health with the 4-item Perceived Stress Scale (PSS-4), and with the 10-item Center for Epidemiological Studies Depression scale (CES-D-10). We measured experiences of discrimination with a battery of questions that asked respondents whether they had experienced a set of discriminatory experiences because of their LGBTQ+ identity during the coronavirus pandemic. Experiences of discrimination was considered a mediating factor and examined both as an outcome as well as an explanatory variable. Models were adjusted for a range of demographic and socioeconomic variables. Results: The prevalence of depression and stress were both high, with the majority of the sample exhibiting significant depressive symptomology (69%). Around one-in-six respondents reported some form of discrimination since the start of the pandemic because they were LGBTQ+ (16.7%). In regression models, the average score for perceived stress increased by 1.44 (95% Confidence Interval (CI): 0.517-2.354) for those who had experienced an instance of homophobic or transphobic harassment, compared to respondents who had not. Similarly, the odds of exhibiting significant depressive symptomology (CES-D-10 scores of 10 or more) increased three-fold among those who had experienced harassment based on their gender or sexuality compared to those who had not (OR: 3.251; 95% CI: 1.168-9.052). These marked associations remained after adjustment for a number of socioeconomic and demographic covariates. Cis-female respondents who identify as gay or lesbian had the lowest scores for perceived social or depressive symptoms; conversely transgender and gender diverse individuals had the highest scores. Conclusions: We found high levels of stress and depressive symptoms, particularly among younger and transgender and gender diverse respondents. These associations were partially explained by experiences of discrimination which had a large, consistent and pernicious impact on stress and mental health.