Policy@Manchester: LGBTIQ+ experiences of COVID-19 in the UK and the need for more inclusive crisis policies

This post was originally written for Policy@Manchester and posted on March 10, 2021, at http://blog.policy.manchester.ac.uk/posts/2021/03/lgbtiq-experiences-of-covid-19-in-the-uk-and-the-need-for-more-inclusive-crisis-policies/

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The COVID-19 pandemic has had wide-ranging effects for people across the UK. However, some groups have felt the effects of the pandemic and its associated lockdowns more than others. In this blog, Dr Billy Haworth, from the Humanitarian and Conflict Response Institute, shares their recent research into the experiences of LGBTIQ+ populations during COVID-19. They argue that LGBTIQ+ populations have faced unique challenges, and will require additional support to help them overcome the effects of the crisis. There is great diversity and even inequality within LGBTIQ+ populations, and in the longer-term, policymakers need to ensure that their policies are fit for all prior to implementation.

  • LGBTIQ+ populations have reported a vast range of challenges to their lives during the COVID-19 pandemic.
  • The sudden removal of support networks and identity-affirming spaces has disproportionately affected these individuals.
  • LGBTIQ+ community groups and volunteer organisations have filled gaps, and policymakers need to support and expand the important work of these groups.
  • In the long-term, policymakers need to move away from ‘one-size-fits-all’ approaches when they design policies for managing crises.

The coronavirus pandemic and associated response measures have had disproportionate impacts on different segments of society. This includes people with diverse sexual orientation, gender identity/expression, and sexual characteristics (SOGIESC), or who are more commonly known as lesbian, gay, bisexual, trans, intersex, and queer (LGBTIQ+) populations. Mental health challenges, social isolation, substance misuse, loss of livelihood and financial difficulties, scapegoating, discrimination and stigma, elevated risk of violence, reduced access to health and support services, and more have been reported as experienced among LGBTIQ+ populations.

LGBTIQ+ experiences

We know that socio-economically marginalised groups, including LGBTIQ+ people, are often the hardest hit during crises, as marginality leads to increased vulnerability. Crisis responses generally do not adequately account for LGBTIQ+ needs, if at all. Moreover, response strategies themselves can heighten and reproduce vulnerabilities by assuming binary cisgender (people whose gender identity matches their sex assigned at birth) and heterosexual identities as the norm, thereby failing to address the needs of minority populations. A United Nations report described how COVID-19 responses reproduced and intensified pre-existing exclusion and discrimination patterns for LGBTIQ+ people. For example, same-sex couples in the Philippines were denied COVID-19 support because of local government views on what counts as a “family” for food aid distributions.

Complementing other reports, I conducted in-depth interviews with a diverse range of LGBTIQ+ people in the UK between May and October 2020 to capture and understand their experiences of COVID-19. This timeframe represents various stages of the UK’s pandemic response, including lockdowns and periods of easing and tightening of restrictions.

My research exposed key challenges for LGBTIQ+ people during the pandemic. Significant mental health impacts were felt, especially during lockdown. This included increased anxieties about the virus and issues related to gender or sexual identity. Isolation from supportive people and identity-affirming spaces elevated stress. Some participants described being at home with unsupportive families, or having limited biological family relationships, reducing the support networks that so many people relied on in the pandemic.

Supportive spaces

Some industries, like the hospitality and entertainment sectors, have experienced greater impacts of the COVID-19 pandemic and associated social and economic restrictions. LGBTIQ+ people working in these areas expressed concerns over income in the short term and anxieties about longer-term employment prospects. More widely, disruptions to LGBTIQ+ spaces have been acutely felt, including nightlife, but also community spaces, support groups and activities like Pride festivals. These spaces usually provide many LGBTIQ+ people with essential opportunities to freely and safely express themselves and their identities.

The National LGBT Survey found that LGBTIQ+ people were more likely to suffer mental health challenges without adequate support, and that LGBTIQ+-friendly spaces, including nightlife and Pride events, are highly important but in decline. Based on this information, policymakers could have predicted the intensification of these issues during COVID-19, yet gaps persisted in policies and responses.

Existing and new community groups filled critical gaps in providing mental health support and reducing isolation through mutual aid and the creation of safe and identity-affirming (online) spaces. In fact, moving activities online presented opportunities to connect with new and diverse audiences, in some ways improving accessibility. Community organisations and peer-support groups were vital for many LGBTIQ+ people during COVID-19.

Diversity within LGBTIQ+ populations

My research makes clear that there is no single LGBTIQ+ experience. Diversity of COVID-19 experiences reflects diversity within LGBTIQ+ populations, including diversity between different subcategories, but also intersections with other factors, like age, class, disability or race.

My research highlighted unique challenges for transgender people. While cisgender people experienced disruptions to healthcare access, this issue was particularly significant for transgender patients. Healthcare relating to gender affirmation and gender identities was delayed if not halted completely, often without communication. This caused confusion and anxiety, exacerbated mental health concerns, and added to already long waiting periods for gender identity clinics. These delays, coupled with people being at home with their bodies more and reduced access to support, also contributed to gender dysphoria.

If we overlook diversity and only account for the most visible experiences, such as those of cisgender gay men, we risk furthering inequalities within minority groups.

How can policies be improved?

In the short term, policies should prioritise access to disrupted services that were directly related to the aspects of LGBTIQ+ vulnerability most exacerbated during COVID-19 lockdowns. This should include facilitating increased and targeted mental health support through training and resources, and maintaining access to healthcare during crises, especially transgender care.

Resources should be allocated to support and expand upon the important work already being done by LGBTIQ+ community, volunteer and mutual aid organisations. This could include: appointing LGBTIQ+ liaison personnel within COVID-19 recovery groups to build strategic partnerships and facilitate knowledge sharing, linking government and non-government activities, and targeting support measures where they are most needed and will be most effective.

For longer-term change, policies cannot continue being based on assumptions that populations are cisgender and heterosexual. They must not only include and account for LGBTIQ+ needs and capacities, but must recognise diversity within the LGBTIQ+ population. “One-size-fits-all” approaches are ineffective for the broad UK population, and likewise are not appropriate for communities as diverse as LGBTIQ+. To better incorporate LGBTIQ+ diversity, SOGIESC education should be included as part of workplace training programmes for government and crisis management organisations. Co-production of policies should also be a goal; involving communities and harnessing community wisdom is an important component of crisis management. Productive dialogue with LGBTIQ+ people themselves and the groups and organisations that represent them is essential for developing inclusive and efficient strategies.

Lastly, policies must shift focus away from crisis response towards risk reduction. If we were more prepared and marginalised sectors of society were better supported, we would see less severe impacts – as disaster studies have informed. We must work now to address the political, economic and social structures that place particular groups at increased vulnerability to crises, including LGBTIQ+ people, to mitigate the negative impacts of future hazards, pandemic or otherwise.

Take a look at our other blogs exploring issues relating to the coronavirus outbreak.

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Researching experiences of gender and sexual minorities during the COVID-19 pandemic

Dr Billy Tusker Haworth
Pronouns: he/him or they/them
Lecturer in International Disaster Management

Equality, Diversity & Inclusion representative
Humanitarian and Conflict Response Institute,
University of Manchester
Email: billy.haworth@manchester.ac.uk
Website: www.billyhaworth.com
Twitter: @BillyTusker
Main research areas: geography, critical and
participatory GIS, disaster vulnerability, queer
marginality, graffiti and spaces of conflict/peace

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Warning: the following may contain topics which some LGBTIQ+ readers may find distressing.

As the COVID-19 pandemic swept across the globe and we in the UK were sent into lockdown in March, scrambling to work from home and continue living our lives in the face of much uncertainty, I saw a unique opportunity.

I had already begun exploring the experiences of gender and sexual minorities during disasters theoretically with colleagues in Australia, and had been considering future potential case studies. Suddenly I was presented with the chance to conduct primary research during a live crisis that would undoubtedly impact minority groups in profound, and likely insufficiently documented ways. Moreover, I was experiencing the crisis at the same time, also as a member of minority groups, being a migrant to the UK and identifying as queer (though I completely acknowledge the class and race (white) privileges I receive). I felt I was in a position to make a contribution to understanding the experiences of marginalised gender and sexual minorities and to hopefully suggest improvements for more inclusive response strategies for future public health or other crises.

Since gaining University ethics approval in April, I have been conducting detailed interviews with lesbian, gay, bisexual, trans, intersex and queer+ (LGBTIQ+) people over Zoom in the UK and Brazil, with help from my Brazilian research assistant Tiago de Paula Muniz for interviews in Portuguese. There are of course various limitations to this method, not least inequalities associated with internet access, with often marginalised people having the least access to such information and communication technologies, particularly in Brazil, thus influencing participation patterns. However, overall we have gained important insights from a wide variety of people within the LGBTIQ+ community. Though interviews are still ongoing and detailed data analysis is yet to be completed, in this post I wish to share some of the preliminary insights we have gained so far.

Research background

LGBTIQ+ identities are often not considered in disaster and humanitarian strategies, yet they experience unique vulnerabilities linked to inequality and marginalisation.

Prior to COVID-19, LGBTIQ+ people already faced increased risk of anxiety and suicide and disproportionate rates of insecure employment and housing. Research and policies tend to treat gender and sexual minorities as homogeneous, overlooking diversity. This can contribute to further inequalities, with the voices of more visible groups, such as gay men, viewed as representing all LGBTIQ+ experiences. Further, little research or policy attention has been given to coping capacities and resilience of LGBTIQ+ individuals and communities. Revelation of such experiences is particularly important when key aspects of community resilience, such as social connectedness, are being disrupted and eroded through social distancing and lockdowns.

The UK and Brazil represent different social, cultural, economic and political contexts on which the same crisis (coronavirus) is impacting, which provides a unique opportunity to uncover common learnings and important differences in experiences and responses. For example, in the UK, gender identity and sexuality are protected characteristics under the Equality Act and require special consideration, whereas despite advances, LGBTIQ+ people in Brazil still experience discrimination and exclusion without adequate protections; Brazil has some of the highest rates globally of homophobia and transphobia related deaths.

The pandemic has had devastating impacts on LGBTIQ+ populations in both contexts. For instance, in the UK LGBTIQ+ people have reported experiencing increased mental health challenges, isolation, substance misuse, financial difficulties, and reduced access to health and support services. In Brazil, job losses and social and economic exclusion have been severe for gender and sexual minorities, and without effective action from the Bolsonaro government LGBTIQ+ people have had to turn to informal peer support to survive, including communal squat housing.

Initial insights from interviews

Isolation

Through our interviews to date we have learnt of people stuck living for months with family who do not accept their gender or sexual identity, through intersection with faith and other reasons. Isolation from supportive people and identity-affirming spaces has caused significant heightened stress and mental health concerns for some LGBTIQ+ people.

Access to medical care

Transgender people have told me how their medical care, both essential and elective, relating to gender reassignment and their identities has been delayed if not halted completely, often without adequate notice, adding to already-long waiting periods and highlighting a lack of appropriate care for such patients during the pandemic. I’ve learnt of exacerbated gender dysphoria resulting from people being at home with their bodies, seeing their bodies more, having less external incentive to dress or prepare their bodies in particular ways (e.g. chest binding), and with reduced access to support.

Technology

Many of us have benefited from technology during this time, using platforms like Zoom to reduce social isolation by connecting with family, friends, colleagues and other online support. But these benefits are not shared across populations equally, with some of our participants being without access to computers or reliable internet. Further, some described anxiety associated with these platforms and the required mental and physical effort to prepare and present themselves in order to be read as their correct gender over a video call, for example. This demonstrates an important link with identity that is less likely to be experienced by non-trans or non-queer people.

Lack of inclusion and support

A common theme emergent in both UK and Brazil interviews is dissatisfaction with government responses to the pandemic. In the UK people described how they didn’t see themselves, their diverse family makeups, or their lifestyles reflected in government guidance and risk communication, with priorities seemingly cis-heteronormative (e.g. a focus on heterosexual couples with school-aged kids). In Brazil people have described feeling forgotten, like they are being left to die or else find their own means of protecting themselves, with clear guidance and support from authorities lacking.

Some people have told me they don’t know how long they can go on like this, as they face issues like insecure housing, reduced work and income, and isolation. This applies to both the UK and Brazil, as described both by affected individuals and people who have been working in LGBTIQ+ support organisations.

We have also heard stories of resilience, kindness, and mutual aid, with people drawing on their existing coping capacities and collective resources to help others.

Resilience and coping capacities

Some people described how they were able to monitor and manage their personal wellbeing during the pandemic by using indicators and strategies developed through past experiences of distress or marginalisation, such as adopting regular daily routines, maintaining healthy diet and monitoring alcohol consumption, exercising, or talking about their challenges and feelings to friends or therapists.

Networks and community

Existing and new networks and community groups have proven vital for LGBTIQ+ people, providing mutual aid and safe and identity-affirming (online) spaces to share experiences and connect with others. Organisations like Hidayah, which offers support and community for LGBTIQ+ people of Islam faith, have had to move all their activities online. But this has also allowed them to reach audiences much further afield, such as in the Middle East and the US, forging new connections and providing social aid and assistance in new and diverse ways.

Similarly, the queer community group in Manchester, Queer Family Tea, usually holds a weekly in-person alcohol-free meet up with food, activities and entertainment, often for young LGBTIQ+ people seeking an alternative to the “gay scene” of Canal Street to connect with likeminded people. During COVID they have shifted online with weekly meet-ups, online cabarets, life drawing classes and other workshops. As with Hidayah, they have seen many new people joining, and some of those involved have said that running and organising such activities has given them a much-needed sense of purpose and life-motivation in what would otherwise be difficult and lonely times. Responses to future crises should not only better-recognise the unique challenges faced by gender and sexual minorities, but look to support and grow existing resilience, coping and mutual aid capacities.

Societal pressure

For some the pandemic has also provided temporary relief from some of the pressures of “normal life”, such as societal pressures to conform to binary gender roles or the public scrutiny of trans bodies. One participant who had come out publicly as transgender just before the pandemic suggested they wouldn’t mind the lockdown to last a bit longer as it was allowing time for them to transition and become more comfortable with their own body and its changes away from the outside world – the pandemic as an escape. This isn’t to suggest they were insensitive to the challenges many have faced during lockdowns. Rather, it highlights the pressure and challenges that queer people already confront in daily life and reminds us that crises such as a pandemic do not necessarily create marginalisation and vulnerabilities so much as they expose and exacerbate those already present across our societies.

Despite the risks of the pandemic, communities came together for the Trans+ Pride March in London, protesting against inequalities experienced by transgender people in “normal” life.
Photo credit: Steve Eason, 12 September 2020.

Diversity and intersectionality

Experiences of COVID-19 across the LGBTIQ+ community remind us that the queer population is incredibly diverse. Our interviews have highlighted important differences between LGBTIQ+ sub-groups. For example, in general cisgender gay white males experienced less financial, employment and housing instability compared to others (of course this isn’t to say they haven’t also faced challenges). Recognition of such uneven privilege was especially prominent in the Brazilian interviews.

There is also great diversity within those subgroups, and of course it’s not the case that every lesbian or every intersex person, for instance, has the same experience as all others. To many readers these ideas won’t be new, but in practice LGBTIQ+ people are still largely described and treated as one group (including to some extent by me in this post).

I find the concept of intersectionality useful in adding nuance to our understandings of minority experiences and vulnerabilities. Stemming from black feminist activism scholarship, intersectionality can help us see how different characteristics (and axes of oppression) intersect to shape a person’s lived experiences and marginalisation, such as by examining the relationships between gender, sexuality, race, ethnicity, class, education, disability, religion, and more. While I agree there are good justifications for regarding LGBTIQ+ people as one community in many respects, overlooking the diversity of experiences can result in ineffective policies. I don’t pretend that developing strategies aimed at such diverse populations is easy, but to more effectively reduce vulnerabilities for minority groups we must give these issues greater consideration.

Reflections on positionality and the research process

Being queer and experiencing a pandemic at the same time as researching queer experiences of COVID-19 has been insightful but also challenging. I refer specifically to challenges of dealing with heavy topics and the need for self-care. Sometimes during interviews I feel like I am listening to my own friends. Many of the experiences we are hearing about, such as isolation or increased stress, are close to our own lives. Tiago and I are also living in the UK away from our families during the pandemic, who are in Brazil and Australia respectively. Our ‘family’ here is very much other queer people, a kind of chosen family away from home. The overlap of research subject with personal life has been confronting at times.

We’ve learnt some strategies to help us process what are sometimes difficult and saddening interviews. It’s important to ensure we have time to decompress (so don’t do multiple interviews back-to-back or in the evening before bed!), and we are fortunate we can talk to each other about how the interviews made us feel.

But I also recognise my relative privilege compared to many of our participants, in that I have relatively secure income, housing, access to friends and resources etc…which coupled with the stories people tell me motivates me even more to continue the research, despite difficult topics at times. Tiago says the same for the interviews in Brazil. He describes the motivation of giving voice to people who often don’t have one. I have also benefited from that queer community support and collective resilience described above in helping me cope with the pandemic. It also helps me ground and understand what is happening to and around me at this time, as a citizen, a queer person, and as a researcher. As scholars, I think we ought to think about these issues more critically, particularly regarding mental health for those researchers working in the disaster and humanitarian sector.

What next?

I have felt incredibly privileged to hear people’s stories. People are giving me their time, energy and honest reflections during what is a difficult period for everybody, and I now have a responsibility to do something meaningful with the data.

Awareness of the dynamic and diverse challenges LGBTIQ+ people face is critical to foster change for improved outcomes, and so it is essential to produce not only academic research outputs, but materials aimed at policymakers, NGOs and activist groups already working with marginalised communities in a language and format they can use.

Currently I am in the midst of transcribing and analysing interviews and will then begin preparing journal articles and policy briefs in English and Portuguese, as well as communications for wider public audiences. I would eventually like to see the research contributing to improved policies and responses, which could include more targeted funding and relief, tailored mental health support, and approaches that recognise the intersecting and compounding effects of multiple characteristics, such as gender and sexuality with race, disability, income, and more – providing alternatives to inefficient ‘one size fits all’ approaches.

Need support?

If you are LGBTIQ+ and experiencing distress during COVID-19, you could consider contacting one of the following organisations for support:

Contributions of volunteered geographic information (VGI) to community disaster resilience: The good, the bad, and the uncertain. (#GISRUK2018 conference poster)

Below is a poster I prepared on some work following my PhD research into volunteered geographic information and disaster risk reduction. The work is co-authored by Eleanor Bruce and Josh Whittaker. It was displayed at the 26th GIScience Research UK Conference, University of Leicester, April 2018.
Download the PDF version here: Haworth et al_GISRUK2018_poster

Haworth et al_GISRUK2018_poster