#Dispatches from a Pandemic: ‘I was in a dark place’: Many LGBTQ people struggled with their mental health during COVID — here’s how they got through it

A friend recommended therapy, which has helped her “get a grip on everything,” she said. “If [there’s] anything that COVID has taught me, it’s taught me to embrace life, because tomorrow is not promised to any of us,” she added. 

Washington is one of many LGBTQ people who have struggled with their mental health during the pandemic. The public-health crisis and ensuing recession have disproportionately impacted LGBTQ mental health and worsened existing health disparities, research and experts say.

About three in four LGBT people — versus half of non-LGBT people — report that stress and worry from the pandemic has negatively impacted their mental health, according to polling published in March by KFF, a healthcare think tank. LGBT people were also more than twice as likely to say the negative mental-health impact had been “major.”

“Even prior to the COVID-19 pandemic, LGBT people faced mental-health disparities,” said Lindsey Dawson, KFF’s associate director of HIV policy and a coauthor of the report. “And then it appears LGBT people were also impacted by the pandemic in certain ways that were more pronounced than [for] non-LGBT people.”

While the overall U.S. population has experienced unprecedented stress over the past 15 months, “it doesn’t hit everybody equally,” said Laurie Drabble, the associate dean for research and faculty at San José State University’s College of Health and Human Sciences, who researches LGBTQ health with a focus on sexual minority women.

Drabble, drawing from a model of four categories of stressors that drive risk for alcohol and drug-related problems, says a similar framework can be used to explain how the “cumulative stress” of the pandemic has weighed on LGBTQ people. 

General stressors like job loss have impacted many people in the U.S., but disproportionately LGBTQ people, Drabble said. Minority stress, or additional stress marginalized groups experience due to discrimination and prejudice, impacts LGBTQ people and people of color. And LGBTQ people and LGBTQ people of color are more likely to have experiences of violence and victimization, a third stressor. Of course, disasters like earthquakes, hurricanes and pandemics impact everyone.

“Even though we may share the stressors associated with the pandemic, these three other areas disproportionately impact LGBT communities and communities of color,” Drabble said. “Some people are bringing into this with them lifetime experiences of other stressors that have to do with minority stress and histories of victimization.”

Data compiled for MarketWatch by the Crisis Text Line showed that close to half of texters in 2020 who shared their sexual orientation identified as LGBTQ+ in a voluntary post-conversation survey. Those who self-identified as such were over 30% more likely to talk about suicide and over 60% more likely to talk about self-harm, said senior data researcher Lili Torok.

Self-identified LGBTQ+ texters were almost 50% more likely than heterosexual texters to be younger than 18, added Torok, who emphasized that the data was not representative of all people in the U.S. or of what all people in crisis were experiencing.

‘My finances had kind of crumbled’

LGBT adults have faced pandemic-era job loss at higher rates (56%) than their non-LGBT counterparts (44%), the KFF study found. A UCLA Williams Institute study carried out during the fall 2020 coronavirus surge found that LGBT people were more likely than non-LGBT people to be laid off or furloughed, and to report issues affording basic household goods or paying their mortgage or rent.

Matthew Ranaudo was working in administration at a dance studio when the pandemic hit. Ranaudo, a 28-year-old musical theater performer living on New York’s Upper West Side, saw his hours cut and was eventually terminated; meanwhile, he and his husband fell behind on rent and thought they would be evicted. “All my finances had kind of crumbled,” he said.

While they managed to secure emergency assistance from the city, Ranaudo’s heightened financial uncertainty, $69,000 in student-loan debt and lost ability to pursue his performing career fed into his anxiety.

“It was this final culmination of me not being able to find joy in a way that I knew how to,” Ranaudo said. “I realized I needed to start focusing on things outside musical theatre, building up who I am, finding out how to restructure happiness.”

Ranaudo eventually acknowledged to himself and his loved ones that he was struggling, and sought mental-health help. In February, he found work as an office coordinator and advocate in the diversity, equity and inclusion space, a career he is now pursuing alongside acting and musical theatre.

“I am nowhere near recovered,” Ranaudo said, “but I am on a path to finding some semblance of [a] healthy mental, healthy physical state of being.”

Compared to the general population, LGBTQ Americans were more likely to have had work hours cut, similarly likely to have become unemployed, and more likely to say their personal finances were “much worse off” than a year earlier, according to research by the Human Rights Campaign and PSB Insights published early in the pandemic. LGBTQ people of color were more likely than white LGBTQ people to have lost work hours or their jobs.

One explanation is that LGBTQ workers were more likely than non-LGBTQ workers to work in industries at high risk of being heavily impacted by pandemic-related job loss, lost shifts or increased virus exposure, including restaurant and food services, hospitals, K-12 education, higher education and retail, the HRC pointed out last year.

“If I’m losing my wages and not able to make it from day to day, [there is] that added stressor of not knowing where your next paycheck is going to come from,” said J. Maurice McCants-Pearsall, the director of HIV and health equity at the Human Rights Campaign. “Not having steady pay or employment has a direct correlation to mental health.”

People with compromised immune systems or those living with HIV who rely on employment for their medication may also have lost their job-sponsored health insurance, he added.

Particularly for people of color, McCants-Pearsall said, “having employment issues compounded with COVID and a summer of unrest directly [had] an impact on one’s mental health.”

Prior to the pandemic, many LGBTQ people — particularly transgender people and cisgender bisexual women — were already more likely to live in poverty than their straight and cisgender counterparts, according to the Williams Institute. They were also more likely to experience unemployment and homelessness.

‘Living in fear of being discriminated against’

Eryck Dillard, 28, of Washington, D.C., who works in HIV prevention, says his anxiety was “going through the roof” at the beginning of the pandemic as he helped his mother get through cancer and worried about losing his job. 

But he says a particularly stressful period for him was the 2020 presidential election, which created a sense of uncertainty for many LGBTQ people who felt their civil rights hung in the balance. Former president Donald Trump’s administration took multiple steps to roll back LGBTQ Americans’ legal protections.

“Being one, a Black man, and two, being a gay Black man — it’s like a double doozy, almost,” Dillard said. “I want to make sure that not only the generations behind me can live in their truth, but I want to make sure that I can live in my truth too. Living in fear of being discriminated against — that plays a lot into a person’s mental health.”

Indeed, research has consistently shown that structural stigma, which includes experiences of discrimination, impacts mental health, Drabble said.

And policies that give people equal or unequal rights “do a lot to shape vulnerability during a disaster like COVID,” said Julia Raifman, an assistant professor of health law, policy and management at the Boston University School of Public Health. 

“Policies that prevent LGBT people from having equal protections can exacerbate the disparities and economic consequences of the pandemic, leaving them more vulnerable to unemployment and food and housing insecurity,” Raifman told MarketWatch. 

LGBT people in many states still lack protections from discrimination in employment or housing, may not have equal access to policies and programs that support people experiencing economic vulnerability during a disaster, and may have less in the way of social support systems, Raifman said. 

Stigmatized populations can also be scapegoated in periods of societal turmoil, she added, pointing to the introduction of anti-transgender bills in several states.

“There have been some positive things, like efforts to institutionalize anti-discrimination laws that prohibit discrimination against LGBT people in the workplace,” Drabble said. “But people still experience a great deal of discrimination in their interpersonal interactions in the workplace and in other environments, and we still have a lot of parts of the country where there [is] institutionalized discrimination.” 

‘I basically returned to isolation’

Not being able to engage with friends, family and community during the pandemic has also created increased isolation for many LGBTQ people, McCants-Pearsall said. “Within the LGBTQ community, friends become family,” he said. “In many ways, they take the role of family when there isn’t a biological connection to your birth family.”

LGBTQ people were more likely than their non-LGBTQ counterparts to report having problems coping with social and physical isolation, according to a study of COVID-19’s impact on LGBTQ households conducted last summer by the Movement Advancement Project.

Donald Jones, 41, the head of small-business delivery at the advisory firm Next Street, had a rough go of COVID-19 and its lingering side effects in the spring of 2020. He felt isolated on two levels: emotional distance from his family — a byproduct of his coming out as gay several years earlier, he said — and the loss of in-person social connection that came from quarantining with a coronavirus infection.

“I do think that we have this instinctive resilience, going through the coming-out process,” Jones said. “You learn to be scrappy, and for me, I didn’t want to burden people — so you also feel this hesitation of wanting to call and just share that you were lonely.”

In a positive turn, he added, he was able to reconnect with some family members after word of his bout with COVID-19 reached home. “It brought me closer to my family,” he said.

Jenn Lantrip, a 38-year-old illustrator who works in retail and lived in Indiana at the start of the pandemic, also struggled with feeling isolated. Lantrip and her then-partner of 12 years weren’t openly affectionate in public, and their relationship felt like a “behind-closed-doors situation.” 

But through her travels to art conventions across the country, she had found hugs, acceptance and creative freedom in queer spaces — all things she lost when the coronavirus drove gatherings online. She also found herself deprived of physical affection at the beginning of COVID-19 after her partner moved out of their bedroom, afraid that she and her family could potentially contract the virus due to Lantrip’s essential-worker exposure. 

“When COVID started, I basically returned to isolation,” Lantrip said. “I was the only queer person in my workspace; the situation at home was very frigid. … I kind of felt like I was a little ship alone in a vast ocean.”

After Lantrip’s partner broke up with her last summer, she packed up and moved to Portland, Ore., where she has found a supportive community. With financial help from a friend, she now sees a therapist who offers services on a sliding scale. “I’m still working on it, but it’s much better now,” she said.

Challenges faced by LGBTQ youth

LGBTQ youth were at higher risk for depression, anxiety and suicide attempts even prior to the pandemic, and “it’s no surprise that the widespread anxiety, isolation, and economic strain caused by COVID-19 have exacerbated mental health challenges among many LGBTQ youth,” said Myeshia Price, a senior research scientist at the Trevor Project, a suicide-prevention and crisis-intervention organization for LGBTQ youth.

“For many LGBTQ young people, physical distancing meant being stuck in unsupportive living environments and hiding who they are to maintain safety,” Price, who uses she/her and they/them pronouns, told MarketWatch in an email interview. “Others expressed losing access to LGBTQ-affirming spaces, support systems, and mental-health care — all of which are essential for mental health and suicide prevention.”

Eight in 10 LGBTQ youth said the pandemic had made their living situation more stressful, and seven in 10 reported “poor” mental health most or all of the time during the pandemic, a recently released Trevor Project report found. 

Nearly two in five employed LGBTQ young people reported losing their jobs during the pandemic, and three in 10 LGBTQ youth — including half of Native and Indigenous LGBTQ youth and one in three Black and Latinx LGBTQ youth — had trouble affording sufficient food in the past month.

LGBTQ youth of color in the survey also reported higher rates of suicide attempts than their white peers, and half reported discrimination based on their race or ethnicity over the past year. 

“It’s clear that LGBTQ youth of color face unique stressors and challenges as they find themselves at the intersection of multiple marginalized identities, which places them at higher risk for poor mental health,” Price said.

What’s more, almost half of all LGBTQ youth couldn’t access desired mental-health care in the past year, she added. Past Trevor Project research shows affordability, insurance issues, concerns about being outed or requiring parental permission, and overall lack of accessible and/or culturally competent providers stand in the way of LGBTQ youth accessing care.

“We desperately need policymakers to build on the telehealth advancements that have been made amid COVID-19 and invest in culturally competent care that is accessible and affordable to all youth,” Price said.

‘It does indeed get better’

Many LGBTQ people are getting help for their mental health by connecting with community, keeping personal friendship networks alive, and finding and accessing professional mental-health services, Drabble said. LGBTQ organizations have been integral to helping people survive the pandemic, she added.

And LGBTQ youth, Price said, continue to show “a deep sense of resiliency.” Respondents to the Trevor Project survey “reported finding strength and joy in a wide range of everyday sources, including chosen family, art and creative expression, their pets, representation in media, learning about LGBTQ history, and having supportive and accepting friends,” they said.

Jones found it helpful to connect with both his inner circle and his broader community; seek out a therapist for the first time in years; and find meaning in his work at a mission-driven advisory firm that promotes racial equity and entrepreneurship and small-business ownership in communities that have systemically been held back.

He has also become more intentional about checking in with LGBTQ friends who own businesses and patronizing his favorite LGBTQ-owned and Black-owned establishments. “What I’ve tried to do is think about my identity and my community as assets, and also use those as a way to also just be there and available to others,” Jones said.

Dillard, who also went to therapy, found mental-health support through the Outloud Project, a nonprofit he launched that aims “to liberate the lives of Black and brown same-gender-loving men” and advocate against social and racial injustices. “I was able to connect with other people who understood what I was going through,” he said. 

Washington, a trans woman, wants people to know that “it does indeed get better” when they seek the help they need.

“I know that sounds difficult, especially when you’re in it, when you’re struggling with your mental health,” she said. “But it does and it will indeed get better. If you do the work to see a therapist and follow the tools that are given, it’ll get better.”