Lisa Westerson, LCSW
Director of Residential Services, Mountainside Treatment Center
The negative mental health outcomes brought about by COVID-19 have been written about at length, but the pandemic’s impact on the LGBTQ+ community has received considerably less attention. Pre-pandemic, the marginalization of this population led to greater levels of mental distress and substance abuse. Now, this community needs additional support as the country recovers from one of the worst health crises in recent memory.
Prior to the pandemic, gay and bisexual men as well as lesbian and bisexual women were more likely to experience significant mental distress and depression compared to the general population, according to the Journal of Community Health. Similarly, a 2019 report found that the rate of anxiety disorders among transgender people was more than five times higher than that of the general population, while depressive disorders among transgender people were more than six times more prevalent. During COVID-19, researchers from the University of Maryland discovered that a whopping 65 percent of LGBTQ+ individuals experienced “moderate or severe psychological distress.”
Shame and isolation
Mainstream, heteronormative values can cause LGBTQ+ people to feel guilty or embarrassed about their sexual orientation. As a result, LGBTQ+ individuals are more likely to experience internalized heterosexism, which can lead to substance use and other destructive behaviors.
Additionally, recommendations for social distancing during the pandemic have left many feeling alone and disconnected from their circles. LGBTQ+ individuals in particular may have struggled with feelings of loneliness even prior to the pandemic, and now face additional difficulties finding community during COVID-19, as many in-person support groups have been replaced with virtual ones as a precautionary measure. Forming and maintaining personal connections through a virtual format has proven challenging for those in recovery.
Those identifying as LGBTQ+ may also face pushback from family members. This not only reinforces feelings of shame and isolation but can also result in LGBTQ+ individuals being displaced from their homes.
Furthermore, a February 2021 study from the UCLA School of Law found that members of the LGBTQ+ community face a heightened risk of layoffs (12.4 percent versus 7.8 percent) and furloughs (14.1 percent versus 9.7 percent) compared to non-LGBTQ+ individuals. The same report revealed that LGBTQ+ people were more likely to encounter other financial stressors, such as trouble affording their rent.
Links to addiction
The challenges faced by LGBTQ+ people also increase the risk of alcohol and drug addiction. Studies conducted before the pandemic have shown that substance use is more prevalent in the LGBTQ+ community than the general population, very likely due to stigma and greater exposure to drugs and alcohol when socializing with peers. One report from the Substance Abuse and Mental Health Services Administration (SAMHSA) found that sexual minority adults were more than twice as likely to report a past-year substance use disorder than sexual majority adults.
After COVID-19 struck, 13 percent of the general population reported starting or upping their substance use, per findings from the Centers for Disease Control and Prevention (CDC). By comparison, 32 percent of LGBTQ+ students said that they increased their alcohol consumption and 22 percent used recreational marijuana more frequently during the pandemic, according to the University of Maryland study.
Addressing the problem
In order to support the LGBTQ+ recovery community during this time, reducing stigma is vital. Widespread homophobia and transphobia can dissuade LGBTQ+ people from receiving the help they need. The stigma surrounding substance use disorders also needs to be lessened; otherwise, LGBTQ+ people with SUDs will continue to experience higher levels of shame due to their sexuality and struggles with addiction.
Finally, LGBTQ+ people need to have their experiences validated by treatment professionals with additional training in topics that are central to the LGBTQ+ community, including identity, sexuality, and self-love. However, for some, seeking a specific treatment modality designed for LGBTQ+ individuals can be in itself devaluing, furthering the stereotype that being LGBTQ+ is a mental health condition, which is why treatment should be personalized to each client. It is important to address any factors that the client identifies early on, which may include stigma, family dynamics, violence, and social isolation.