Sexual and Gender Minority Young Adult Coping Disparities During the COVID-19 Pandemic

PURPOSE: The COVID-19 pandemic has exacerbated several existing health disparities in the U.S. Sexual and gender minority (SGM) health disparities may also be widening during the pandemic, though few studies have assessed this question. This study examined SGM young adult disparities in health-related behaviors to cope with isolation during the pandemic. METHODS: Respondents from a prospective cohort of Southern California young adults (N = 2,298) reported whether they engaged in various strategies (e.g., substance use, diet, exercise, relaxation) to cope with isolation during the pandemic (each: yes/no). Differences in coping were assessed across five SGM subgroups: heterosexual men and women, lesbian, gay, bisexual, pansexual, queer (LGBQ) men and women, transgender/nonbinary (TNB) respondents. Negative binomial regressions estimated sexual/gender identity differences in the number of positive or negative behaviors endorsed, adjusting for sociodemographic characteristics and prepandemic health behaviors. Differences were also tested across individual coping behaviors. RESULTS: Heterosexual women (IRR = 1.11 [1.01–1.21]), LGBQ men (IRR = 1.31 [1.12–1.54]), LGBQ women (IRR = 1.33 [1.19–1.49]), and TNB respondents (IRR = 1.29 [1.03–1.61]) engaged in more negative coping behaviors than heterosexual men. LGBQ men (IRR = 1.19 [1.02–1.39]) and LGBQ women (IRR = 1.20 [1.08–1.34]) also reported more negative coping behaviors versus heterosexual women. Generally, LGBQ men reported the highest prevalence of substance use, while LGBQ women and TNB reported the highest prevalence of adverse eating behaviors and self-harm. CONCLUSIONS: SGM young adults may be disproportionately, adversely impacted by the COVID-19 pandemic. Tailored public health and clinical interventions are needed to decrease pandemic-related SGM health disparities.