Dec 27, 2020 - Health

COVID is making employment and health disparities worse for LGBTQ people

Illustration of an LGBTQ flag as a surgical mask.

Illustration: Aïda Amer/Axios

More LGBTQ Americans, especially young adults, are facing higher risks of poor mental health, homelessness and lost income during the coronavirus pandemic, according to advocates.

Why it matters: LGBTQ people were already more vulnerable before the pandemic, due to persistent gaps in health care access and employment protections, even after this summer's Supreme Court ruling.

Between the lines: Advocates are at the forefront of gathering data on how the pandemic is affecting LGBTQ people, while some state governments are trying to catch up.

  • California Gov. Gavin Newsom (D) signed a bill in September to track the effects of COVID in LGBTQ people.
  • Nevada said it would begin tracking the virus' effect on LGBTQ people in August.
  • “Because LGBTQ people are often invisible when it comes to data collection in a variety of contexts, including health care, that has really limited our ability to get out information about what’s going on,” Jesse Ehrenfeld, the American Medical Association’s former board chair, told CNBC this fall.


LGBTQ Americans, more of whom were already living in poverty before the pandemic compared to cisgender straight adults, have reported less access to jobs this year.


Tevin Giles, director of youth services at the San Francisco LGBT Center, said that more young people especially have lost their homes during the pandemic.

  • "More of our young people are living on the street and not able to find a safe place to be or stay because the shelter system is overwhelmed," they said. San Francisco has reduced how many people can stay in shelters, due to COVID-19.
  • LGBTQ people, particularly trans people of color, are at a greater risk of homelessness due to fewer economic opportunities and less access to LGTBQ-friendly employment, Giles added.
  • When seeking housing in non-LGBTQ shelters, transgender people often have to explain the basics of their identity in order to receive care from staff who misgender them or isolate them in living quarters, Giles said.

Mental health

A decline in mental health has been broadly reported across the country during the pandemic. LGBTQ people, especially young adults, had already been found to have higher rates of depression and anxiety before the pandemic.

  • The number of LGBTQ youth asking for crisis support through the Trever Project has "significantly increased" during the pandemic, research director Amy Green and research scientist Myeshia Price-Feeney wrote in August.
  • The number of LGBTQ youth needing crisis support has been "at times even double our pre-COVID volume," citing isolation from chosen families and quarantining with unsupportive families, Green said in a subsequent statement.

Underlying conditions

Growing evidence has shown that LGBTQ adults experience worse cardiovascular health compared to cisgender and heterosexual people, which the American Heart Association attributes to stress from discrimination.

  • Heart conditions or cardiovascular diseases, including hypertension, can increase the risk of experiencing severe coronavirus symptoms, per the CDC.
  • 29% of LGBTQ respondents to the American Progress survey said they had postponed medical care this year after being sick or injured because they could not afford it.

Methodology for the NORC research

NORC's probability-based AmeriSpeak panel surveyed 1,528 LGBTQ adults from June 9-30 in randomly selected households contacted in-person or by mail or phone. Most households participated in the survey online, with telephone surveys available. Margin of error ±3.45%.

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