Discrimination as a predictor of poor mental health among LGBTQ+ people during the COVID-19 pandemic: cross-sectional analysis of the online Queerantine study

Abstract

Objectives: To assess the mental health and experiences of discrimination among lesbian, gay, bisexual, transgender, queer (LGBTQ) people at the start of the COVID-19 pandemic.

Design: Data come from a cross-sectional online survey targeted at LGBTQ+ people, which collected data on mental health, experiences of discrimination and a number of other pandemic-related experiences. To examine the association between sexual orientation and gender and mental health and experiences of discrimination, we conducted regression analyses that adjusted for a range of sociodemographic variables.

Setting: A web-based survey was used to collect data between the end of April and mid July 2020.

Participants: An analytical sample of 310 LGBTQ+ respondents aged 18 and above.

Main outcome measures: We assessed mental health with the 4-item Perceived Stress Scale and with the 10-item Center for Epidemiological Studies Depression scale (CES-D-10). We asked respondents about discriminatory experiences because of their LGBTQ+ identity during the coronavirus pandemic.

Results: Perceived stress scores among our LGBTQ+ sample were high (mean: 7.67; SD: 3.22). Based on a score of 10 or more on the CES-D-10, the majority of participants had high levels of depressive symptoms (72%). Around one-in-six respondents reported some form of discrimination since the start of the pandemic because they were LGBTQ+ (16.7%). The average score for perceived stress increased by 1.44 points (95% CI 0.517 to 2.354) for respondents who had experienced discrimination versus those who had not. Similarly, the odds of exhibiting significant depressive symptomology increased threefold among those who had experienced discrimination compared with those who had not (OR: 3.251; 95% CI 1.168 to 9.052).

Conclusions: The LGBTQ+ community exhibited high levels of depression, stress and experienced discrimination during the coronavirus pandemic. High levels of poor mental health were partially explained by experiences of discrimination, which had a large, consistent and pernicious impact on mental health.

Keywords: COVID-19; mental health; social medicine.

Figure 1

Proportion of respondents reporting discrimination by period in the pandemic (numbers at top of column).