The COVID-19 pandemic has exposed vulnerabilities faced by many populations, including the Two-Spirit, lesbian, gay, bisexual, transgender, queer, non-binary, and sexual minority (2SLGBTQ+) communities. Although social and material wealth varies in 2SLGBTQ+ communities as it does among cisgender heterosexuals, 2SLGBTQ+ people have experienced inequitable effects of the pandemic compared with other people in Canada. This may be due to greater health disparities (such as cardiovascular conditions, poorer mental health, and/or greater substance use) and socioeconomic inequities, including a higher representation among low-income and housing-insecure people. Health inequities experienced by 2SLGBTQ+ communities must be understood as intersectional across axes of oppression and privilege.
Evidence presented by CITF-funded researchers Drs. Daniel Grace (University of Toronto) and Nathan Lachowsky (University of Victoria) focuses on a subset of 2SLGBTQ2+ communities in Canada, made up of gay, bisexual, queer, and other men who have sex with men. Because of the importance of socioeconomic diversity and the scarcity of research with the broader 2SLGBTQ+ community, our research synthesis includes studies by other Canadian and international researchers to show the effects of the COVID-19 pandemic on the lives and well-being of members of these communities.
Our synthesis aims to address the following questions:
Most members of 2SLGBTQ+ communities in Canada prioritized their health and complied with public health measures implemented during the COVID-19 pandemic. A survey conducted by Statistics Canada in March 2021 (19) highlighted that:
- 2SLGBTQ+ people in Canada are more likely to get the COVID-19 vaccine than non-2SLGBTQ+ people in Canada.
- Among 2SLGBTQ+ people in Canada aged 15 and older, 83.3% reported that they were somewhat or very willing to get the vaccine in fall 2020 (before vaccines were readily available), compared with 76.9% of non-2SLGBTQ+ people in Canada.
Similarly, in the United States (US):
- 60% of the LGBTQ+ community surveyed in July 2021 reported confidence in the COVID-19 vaccine research and development process, as opposed to 33% of the general adult population (13).
- Another US survey from February 2022 revealed that a great majority of the vaccinated people in 2SLGBTQ+ communities (79%) had received a booster dose, with an additional 17% planning to receive one, which was substantially higher than the 48% of US adults with a booster dose at the time (20).
Furthermore, survey results from Dr. Grace’s Engage-COVID-19 study indicate that:
- Some public health instructions unintentionally reinforced gendered inequalities. Participants explained how “cis-heteronormativity” was common in COVID-19 public health messaging, often reinforcing heterosexual forms of family and relationships and restricting access to queer spaces. Others explained that stay-at-home orders failed to account for the diversity of queer people’s experiences of homelessness, unsafe housing, and structural racism.
- Participants further reported that they adhered to prevention measures implemented during the pandemic, feeling this would avoid further stigmatization, as well as rejection by their peers.
Despite feelings of marginalization and stigmatization, 2SLGBTQ+ communities were more accepting of public health measures and adopted vaccines at a higher rate than did cisgender heterosexual individuals. People in 2SLGBTQ+ communities exhibited significant behaviour change to cope with the pandemic and to protect both their own health and wellbeing and the health of others.
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