Since declared a global pandemic by the World Health Organisation (WHO) in March, COVID-19 continues to pose serious health risks to the global population alongside a detrimental toll to worldwide economies. The impact on health services has been particularly grievous, with even the strongest healthcare systems around the world struggling to keep up with the demand for protective equipment and test kits.

COVID-19 does not discriminate in who it affects but it is clear that marginalised communities worldwide have been hit disproportionately hard. Historically, LGBTIQ+ communities have always had to navigate more barriers than most, especially when it comes to accessing quality healthcare services. Around the world, LGBTIQ+ people face the multiple burdens of stigma, discrimination, and even refusal of services by healthcare professionals, which is further linked to lower comprehensive health insurance. Examples of medical discrimination based on SOGIE (sexual orientation and gender identity and expression) have been widely documented and proven in countries across the globe and the reluctance of LGBTIQ+ people to visit doctors due to this current state of heightened medical surveillance has been further exacerbated during the COVID-19 pandemic. Furthermore, another problem with regards to healthcare is the deprioritisation of health services for LGBTIQ+ people such as HIV testing and treatment, hormonal treatment and gender affirming treatments for trans individuals.^[1] As hospitals and healthcare centres continue to be overwhelmed, treatments for marginalised communities will be pushed to the side, leaving LGBTIQ+ individuals exposed and vulnerable.

Other than barriers to healthcare services, LGBTIQ+ people, especially youth, are also facing an elevated risk of domestic violence and rise in mental health issues such as anxiety and depression due to being forced into quarantine with family members or partners who may not be supportive of their sexual orientation and/or gender identity and expression. As the levels of domestic violence continue to rise across the globe due to lockdowns and quarantines, we see that the majority of domestic violence hotlines have reported a sharp increase in calls and reports, however even so, very few hotlines are able to deal with the specific issues facing LGBTIQ+ populations. Furthermore, even when helplines may be accessible, they are difficult to access. Quarantine also exacerbates feelings of social isolation and depression amongst LGBTIQ+ people, once again, particularly amongst youth. A study by OutRight International found that LGBTIQ+ people were most afraid of being outed at home, experiencing heightened anxiety, on top of the daily anxiety caused by living in highly hostile, homophobic and/or transphobic contexts during quarantine.^[2] The study further expanded on the fact that the mental health toll of quarantine on trans individuals was especially difficult due to the lack of safe spaces and resources.

Finally, a majority of LGBTIQ+ people are in low income jobs, live on unstable financial resources, or are unemployed. During the COVID-19 crisis, the number of job cuts and losses means that LGBTIQ+ individuals will be particularly affected, especially as they lack access to sick leave (paid or not) due to working in the informal sector. An estimated 25-40% of young people experiencing homelessness identify as LGBTIQ+^[3] and the current pandemic has clearly brought to light the ways in which they are extremely vulnerable with regards to both job and house security.

Outright International’s study on the impact of COVID-19 on LGBTIQ+ people narrows down six main recommendations for UN agencies, NGOs, and private sectors who are working on the response to the pandemic^[4]:

1. Ensure inclusive emergency relief health services by engaging LGBTIQ communities, understanding their needs, forging partnerships, and tailoring programming to LGBTIQ realities.
2. Develop safe, respectful, sensitive, and secure approaches to ensuring access to relief commodities and services.
3. Collaborate with LGBTIQ communities to develop tailored information that addresses infection control, availability of safe health services and safe spaces, and availability of social support.
4. Include LGBTIQ issues when describing the gendered impacts of the COVID-19 pandemic.
5. Document lessons learned from inclusive emergency relief and pandemic control efforts.
6. Develop global guidance on ensuring an inclusive response to pandemics and other health emergencies.

It needs to be realised that there is a severe lack of data when it comes to the experiences and outcomes affecting LGBTIQ+ people. Though there is progress being made, these gaps in data make it particularly difficult to properly assess the needs that face the LGBTIQ+ community and without making a concerted effort to remedy this, we will not be able to truly make progress in our efforts to ‘leave no one behind.’

^[1] https://www.ohchr.org/Documents/Issues/LGBT/LGBTIpeople.pdf

^[2] https://outrightinternational.org/content/vulnerability-amplified-impact-covid-19-pandemic-lgbtiq-people

^[3] https://www.ilga-europe.org/sites/default/files/COVID19%20_Impact%20LGBTI%20people.pdf

^[4] https://outrightinternational.org/content/vulnerability-amplified-impact-covid-19-pandemic-lgbtiq-people

By Evelynne Gomez