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While the world continues to push towards some semblance of “normalcy,” the lasting impact of the COVID-19 pandemic on the LGBTQ community, particularly as it relates to mental health, is far-reaching. A study published by the Kaiser Family Foundation in March of this year found that 75% of the LGBTQ community say that worry and stress from the pandemic has had a negative impact on their mental health compared to 49% of those who are not LGBTQ1.

The biggest contributing factor? Isolation.

Stigma and discrimination have long triggered mental health issues among LGBTQ individuals; add to that the isolation felt during the pandemic as well as the feeling of a loss of control and it should not be a surprise that the pandemic served to exacerbate conditions such as depression and anxiety as well as substance abuse.

“The isolation of COVID had me so depressed,” said HCAI patient Dan C. “It was like living under a rock. Humans need physical connection and when you don't get it, it's like you can't breathe.”

At Health Care Advocates International (HCAI), we have seen firsthand the increased need for mental health treatment with our counseling services nearly tripling due to the toll the pandemic has had on patients. This toll resulted in an increase in suicides and suicide attempts across age groups.

According to The Trevor Project’s National Survey on LGBTQ Youth Mental Health, 42% of LGBTQ youth considered suicide in the past year including more than half of transgender and nonbinary youth2. I personally had two transgender teenage patients attempt suicide during the pandemic and, in both cases, being cut off from the people and places where they felt most comfortable was the biggest contributing factor.

One of these teenagers is a 16-year-old transgender male who had finally found a place for himself in school. He made friends who he trusted enough to disclose he was transgender and had close relationships that were a source of security and inclusion. When the pandemic hit, he was quarantined at home with a loving, supportive mother but a father who refused to accept him. He later contracted COVID himself and continued to test positive so when others began to return to school, he was unable to go back himself. This prolonged isolation led to his suicide attempt. Since then, his family got him into counseling and he is doing well.

Sadly, I did lose a patient to suicide during the pandemic. A male, HIV positive patient in his mid-30’s experiencing discrimination and challenges at work while being isolated and working at home, took his life without any signs that he had reached this point seen by his husband, friends, nor me, and without any attempt by him to reach out to me or anyone else for help.

What I personally experienced as a physician with patients who contracted COVID and a handful who died from the disease triggered my own PTSD of the HIV epidemic in the early 1980’s. Those in my generation can see the similarities of a disease sweeping the population, the growing fear and isolation, and people not wanting to die alone. This certainly played a role in the mental health of those of us who have now experienced both health crises.

During the pandemic, we mobilized to find new ways to engage and connect with patients from video conferencing to social media. Not only was it important to create more human interactions, but also to educate LGBTQ individuals on the facts of the pandemic, prevention, illness recognition, treatment and vaccination.

COVID-19 has taken the isolation, loneliness and anxiety of seniors living with HIV/AIDS to an extreme. Having a tele-med counselor that works with my care team and is very aware of the realities, barriers and challenges of living with HIV/AIDS, made dealing with COVID-19 manageable.
Alex G., a patient at HCAI

The good news is monoclonal antibodies and steroids have worked with variants prior to the delta variant to treat COVID. The vaccination is safe and effective. We are proud to have reached 95% vaccination among our patients and despite some individuals being vaccine-hesitant, we hope to hit 99% soon. That said, and especially in the setting of this next wave of highly transmissible delta variant COVID infections, we can expect to see an increased need for counseling. The surge in depression, anxiety and substance abuse triggered by the pandemic will not go away overnight, but getting vaccinated and attaining protection against severe COVID illness and death will most certainly help.

It is critically important for LGBTQ individuals to seek help. There are people who love you out there, who understand you and can empathize with you. Let resources like HCAI connect you with the people and services you need. My personal advice to every member of the LGBTQ community is to get vaccinated and make human contact a priority. It truly can save lives.

1 The Impact of the COVID-19 Pandemic on LGBT People, The Kaiser Family Foundation, March 11, 2021: https://www.kff.org/coronavirus-covid-19/poll-finding/the-impact-of-the-covid-19-pandemic-on-lgbt-people/

2 National Survey on LGBTQ Youth Mental Health 2021. The Trevor Project, Retrieved July 19, 2021: https://www.thetrevorproject.org/survey-2021/?section=Introduction

About the Author

Dr. Gary Blick is an internationally renowned HIV/AIDS clinician, clinical researcher, lecturer, and humanitarian. He is the chief medical officer of Health Care Advocates International, a public health and advocacy organization serving the LGBTQ community. He is also co-found of HIV Advocates and founder of the Zimbabwe AIDS Project (ZAP). While in medical school at the University of Miami in the early 1980s, he was inspired to become an infectious disease specialist due to the burgeoning national HIV crisis. Dr. Blick completed his residency training at Yale University and Greenwich Hospital Association and went on to receive additional credentialing from the American Academy of HIV Medicine. He has had a successful medical career for more than 30 years. To learn more about Health Care Advocates International visit https://www.hcaillc.com/.

Image Source: Cotton bro at Pexels

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