Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Transgender and Gender Nonbinary Individuals Engaged in a Longitudinal Cohort Study

ABSTRACT

While the COVID-19 pandemic in the United States disproportionately impacts marginalized communities, no empiric US-based research has focused specifically on transgender and gender nonbinary (TGNB) people. We examined the pandemic’s impact on an established longitudinal cohort of TGNB individuals (N = 208) by administering an online survey between March-June 2020. We used multivariable linear regression to examine reduced LGBTQ/TGNB community support and disruptions in gender-affirming health care as predictors of psychological distress during the pandemic. We found that the pandemic exacerbated ongoing mental health disparities for TGNB individuals. Furthermore, reduced LGBTQ/TGNB support was associated with increased psychological distress during the pandemic. Interruption and/or delay in gender-affirming health care was not associated with increased psychological distress during the pandemic. Special attention is needed to address the unique ways in which TGNB individuals were affected by the COVID-19 pandemic. This includes increasing access to LGBTQ/TGNB community support and addressing long-standing health disparities.

KEYWORDS:

• COVID-19
• transgender
• mental health
• gender-affirming medical care
• depression
• anxiety

Acknowledgments

The authors would like to thank the diverse community advisory board that advised on all aspects of the AFFIRM study. This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grants number R01 HD079603, Walter Bockting, PI). Dr. Kidd’s participation in this research was made possible through a training grant from the National Institute on Drug Abuse (T32-DA007294-24, Frances Levin, PI) and a career-development award from the National Institute on Alcohol Abuse and Alcoholism (K23-AA028296-01, Jeremy Kidd, PI). Dr. Jackman’s participation in this research was made possible through a training grant from the National Institute of Nursing Research (T32NR007969, Suzanne Bakken, PI).

Disclosure statement

The authors have no conflicts of interest to disclose.