The psychological impact of social distancing on Gender, Sexuality and Relationship Diverse populations

During the Coronavirus (Covid-19) pandemic, it is important to attend to the specific needs of Gender, Sexuality and Relationship Diverse (GSRD) people.

This includes, but is not limited to, the needs of lesbian, gay, bisexual and transgender (LGBT+) people and those in consensually non-monogamous relationships.

The BPS has already produced Guidelines for psychologists working with gender, sexuality and relationship diversity (GSRD) and here I will outline some additional points to consider during this crisis.

[Please note: the BPS guidelines for psychologists working with gender, sexuality and relationship diversity are aimed at practitioners working with adults.]

As well as having access to inclusive psychological professionals, access to LGBT+ specific support can be a vital lifeline. So below I highlight sources of information and support that LGBT+ people can be signposted towards.

It's important to remember that LGBT+ people are a heterogeneous group with varying levels of vulnerability and resources. Nevertheless, members of LGBT+ communities are at a higher risk of experiencing common mental health problems than the general population (King et al., 2008; Semlyen et al., 2016; Millet, Longworth & Arcelus, 2017).

Social distancing measures are likely to result in higher levels of mental distress and loneliness in this population and will impact their relationships and sex lives in ways that may negatively affect their wellbeing.

1. Social isolation

   Being forced to stay at home and away from friends, partners and usual safe spaces may cause distress, social isolation and loneliness. Some segments of the LGBT+ community may be particularly vulnerable to social isolation (Klinenberg, 2016).

   Some young LGBT+ people may be hiding aspects of their lives from people they are living with and experience isolation due to not being able to talk to members of their household about their sexuality or gender identity, being isolated from safe spaces and being physically separated from LGBT+ communities (Johnson & Amella, 2014). The LGBT+ youth charity The Proud Trust are running their youth groups digitally during the coronavirus (Covid-19) outbreak.

   Older LGBT+ people are less likely to have children than their cisgender and heterosexual counterparts and are therefore less able to rely on traditional support systems. The charity Opening Doors London are supporting older LGBT+ people via their telebefriending service during the coronavirus outbreak.

   Many LGBT+ organisations are creating new ways for LGBT+ people to connect with each other by developing new online communities, virtual community centres and digital pride festivals. Many LGBT+ charities such as MindOut, the LGBT Switchboard and the LGBT Foundation are also continuing to offer support online or via their usual helplines.

2. Relationships

   Social distancing measures will affect people's living arrangements and their relationships. The measures taken to tackle coronavirus (COVID-19), such as staying at home, may cause anxiety for those living with people who are not accepting of their gender identity, sexuality or relationships.

   Where LGBT+ people choose to 'come out' or household members find out about their sexuality or gender identity, they may have to cope with negative reactions by household members with limited access to social support outside of the household. Some LGBT+ people may be isolated in hostile households or be at risk of domestic abuse. LGBT+ people may experience similar patterns of domestic abuse to the general population; however, some manifestations of domestic abuse are more specific to LGBT+ people including household members restricting access to sources of LGBT+ affirmative support, coercing them to undergo conversion therapy or preventing them from expressing their gender identity at home. The LGBT+ anti-violence charity Galop is continuing to operate its National LGBT+ Domestic Abuse Helpline.

   Social distancing will put a strain on many people's relationships whether they are living together or apart. Those in non-cohabiting relationships are advised to either live together temporarily during social distancing measures or avoid face-to-face contact. This may be particularly difficult for those in polyamorous relationships who have multiple non-cohabiting partners. The LGBT+ inclusive charity Relate has provided advice on how to maintain relationships during the coronavirus (Covid-19) crisis.

3. Sex

   Current guidance is to avoid contact with people outside of the household where possible which means 'hooking up' is discouraged. Dating and 'hook-up' apps are used by some LGBT+ people to reduce social isolation (Bruce & Harper, 2011), so some may find this guidance difficult or following the guidance may exacerbate feelings of isolation. Hook-up apps can still be one useful means of connecting and chatting with other LGBT+ people and some hook-up apps are signposting people to support services such as mental health advice. The HIV and sexual health charity Terrance Higgins Trust have also provided tips on how to manage sex lives during social distancing.

4. Health concerns and access to health services

   Some may have concerns or be anxious about the implications of coronavirus (Covid-19) for living with HIV or for accessing sexual health services. Useful Information and advice specific to coronavirus (Covid-19), HIV and sexual health are available from the Terrance Higgins Trust.

   Gender identity clinics are offering limited services during the coronavirus (Covid-19) crisis. It will be a challenging time for existing service users and those on waiting lists who may experience a delay in treatment. Some services may be delivered remotely and trans charities like MermaidsUK and Gendered Intelligence are providing online support to trans people and their families.

References

• Bruce, D., & Harper, G. W. (2011). Operating without a safety net: Gay male  adolescents and emerging adults' experiences of marginalization and migration, and implications for theory of syndemic production of health disparities. Health Education & Behavior, 38(4), 367-378.
• Johnson, M. J., & Amella, E. J. (2014). Isolation of lesbian, gay, bisexual and  transgender youth: A dimensional concept analysis. Journal of Advanced Nursing, 70(3), 523-532.
• King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8(1), 70.
• Klinenberg, E. (2016). Social isolation, loneliness, and living alone: identifying the risks for public health. American Journal of Public Health, 106(5), 786.
• Millet, N., Longworth, J., & Arcelus, J. (2017). Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature. The International Journal of Transgenderism, 18(1), 27–38.
• Semlyen, J., King, M., Varney, J., & Hagger-Johnson, G. (2016). Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC Psychiatry, 16(1), 67.