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Washington Blade: Gay News, Politics, LGBT Rights: Global study finds pandemic exacerbates inequities for trans people


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COVID-19 crisis, gay news, Washington Blade

A new global study has found the coronavirus pandemic has had a disproportionate impact on transgender people’s mental health and economic stability.

The study by a team of seven researchers from the Johns Hopkins Bloomberg School of Public Health and the University Center for Public Health and Human Rights found 77 percent of respondents expected a decrease in income. And more than half of them reported losing gender-affirming resources; including surgery delays, inability to purchase beauty products and other factors. 

The study is one of the first of its kind to analyze the intersections of economy, mental health and gender-affirming care for trans people.

The team was also purposeful in making the work community-based with equitably involving queer scientists in the study, said Brooke Jarrett, an author of the study who is a queer woman of color and a doctoral candidate in epidemiology at the university. 

“I
think that this topic is something that … is always lit within us,” said
Jarrett. “And so whenever I see an area where there’s an opportunity to
highlight, to bring out our voices, I think it’s so important to do that.”

LGBT Foundation CEO Sean Howell, who is the founder of Hornet, a global queer dating app, also served as an author of the study.

He disseminated a survey on the app, as well as the queer dating app Her, from April to August. It received responses from 76 countries that include Turkey, Thailand and Russia. More than 900 users participated in the survey, which was translated into 13 languages.

Howell
said the team was purposeful in releasing and analyzing this data during the
pandemic in hopes the data will point to the need for changes to help trans and
non-binary people economically and health-wise. 

The study found positive screens for depression and anxiety are correlated with access to gender-affirming care, and more than 40 percent of respondents reported losing access to mental health counseling. One in six respondents also expected to lose their health insurance.

Access to these resources is essential for trans and non-binary people, said Will Beckham, a study author and a queer trans man who focuses much of his work on trans research. Beckham also serves on Johns Hopkins University’s junior faculty.

He said delays in surgeries are related to symptoms of depression and anxiety. Beckham added losing access to health services or being unable to afford haircuts, binders and other gender-affirming products also have profound negative consequences on mental health.

“It’s not elective, it can be literally life-saving for someone to get a trans-related surgery when they need it,” he said. “Policies need to change, we need to grow the awareness that trans-related surgeries are not elective, but are actually essential medical services.”

Before
focusing his research on LGBTQ and trans topics, Beckham focused his work on
HIV and was completing research in Tanzania when he realized he was trans. He said
he  came back to the U.S. to “live fully”
and transition. Beckham added limited access to gender-affirming care is a
crucial issue that needs to be addressed, and medical and supply chain models
need to be reformed to make surgeries deemed as essential.

In
addition, a third of respondents reported an inability to live openly in their
gender. This could be a result of youth moving back in with unsupportive
families as a result of the pandemic, which correlated to positive screens for
depression and anxiety.

“They’re
having to live less in their affirmed gender, which certainly has an impact on
mental health,” Beckham said. “I know very well personally, having been in the
closet for a while in Tanzania.”

Jarrett
said virtual health interventions, like therapy apps, need to be expanded and
explored as a solution to this uptick in depression and anxiety. Beckham said health
systems as a whole need to be more inclusive, as well.

Researchers said economic instability is also a notable aspect of the trans experience during the pandemic, with 77 percent of respondents indicating they expected a disruption in their income. More than half of respondents also reported needing and not receiving financial aid.

Jarrett
said trans people already dealt with economic instability prior to the
pandemic, and “live on the margins of society economically already, especially
in places where there’s a lot of stigma and discrimination.” She added those
who are employed often have unstable jobs that include casual labor and factory
work.

“So
when a thing like COVID hits, and there was a lot of job loss, they are the
people already on those margins that are the most quickly kicked out of those
places and spaces,” said Jarrett. 

Jarrett
and Beckham said the amount of community-based assistance popping up during the
pandemic for trans people in need is helpful, such as fundraising campaigns for
rent payments or giving free haircuts. But they both said there is a need for
systemic solutions, such as LGBTQ organizations expanding their advocacy for
trans and non-binary people.

Howell
said there aren’t government entities or non-profits that have been models in
trans inclusion, and this study shows that fact. He said priorities need to be
more balanced to better support trans and non-binary people.

“The
community has often been put as an afterthought, and I think now we have
evidence of a global health crisis that further exacerbated those things,” said
Howell. “We’ve known this for quite a long time. But we have to take better
action because there’s human factors that are being realized, more and more.”

The
research team is currently expanding on this research and beginning new
research focused on partner violence, surgery delays and digital mental
healthcare during the pandemic.

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