LGBTQ People Face Unique Challenges in COVID-19 Crisis

Restaurants closing. Retailers shuttered. Health care systems overwhelmed and health workers at risk. Homeless young people with no school and no shelter.

Those consequences of the COVID-19 pandemic are all likely to create unique challenges for LGBTQ people, says a new issue brief from the Human Rights Campaign Foundation.

"We are facing a global public health crisis, and as in all emergencies, the most marginalized are at increased risk," HRC President Alphonso David said in a press release announcing the brief, released today. "Many in the LGBTQ community may lack the resources to effectively combat COVID-19, lacking access to paid sick leave or living without health coverage, and are more likely to work in an industry that has been most affected by the pandemic, putting them in greater economic jeopardy or increasing their exposure to the virus. It is also critical to understand the challenges facing the LGBTQ young person who has been sent home from school to face family rejection or the LGBTQ senior who is more likely to be living alone during this crisis. It is important to know and understand the unique impact of the virus on the LGBTQ community so that we can prepare to weather this crisis as we have weathered crises before -- by uniting as a community and helping those in greatest need."

For instance, LGBTQ Americans are more likely than others to work in industries affected by the crisis -- restaurants and food service, hospitals, K-12 education, colleges and universities, and retail. Those make up 40 percent of the industries where LGBTQ people work, as opposed to 22 percent for non-LGBTQ workers.

"As of March 19, 2020, the media reports that at least 15 state governors have ordered all dine-in restaurant services to stop, which means these workers could lose shifts or their jobs," the brief notes. "Meanwhile, hospital workers, who serve at the frontlines of this crisis, are at increased risk of exposure. Moreover, many teachers and professors have also had their work lives fundamentally changed by COVID-19, navigating new demands around virtual classrooms with little to no support."

And contrary to stereotype, LGBTQ people are poorer on the whole than straight and cisgender people. "Nearly one in ten LGBTQ people are unemployed and are more likely to live in poverty than straight and cisgender people, meaning they cannot always afford the health care that they need or afford to engage in preventative health care measures," the report relates.

It cites a 2019 Williams Institute analysis indicating that 22 percent of LGBTQ adults in the U.S. live in poverty, compared to 16 percent of straight and cisgender people. Transgender adults and cisgender bisexual women both have 29 percent poverty rates. Black trans adults have a 40 percent poverty rate and Latinx trans adults have a 45 percent rate, making these groups more likely to live in poverty than any other race.

These high rates of poverty may well be linked to discrimination, as many LGBTQ people live in a state without explicit antidiscrimination protections, and discrimination hits trans people particularly hard. LGBTQ workers also may not have access to paid leave.

"Even for LGBTQ workers whose employers have a formal paid leave policy, one in five respondents to [a 2018 HRC Foundation survey] reported that fears of discrimination could prevent them from requesting a leave if it would require disclosing their LGBTQ identity. And without explicit federal laws protecting us from being fired simply because of who they are, LGBTQ workers also remain at risk of being fired if they are forced to come out when requesting leave. This means that if a person suspects that they have contracted COVID-19, they may be unable to take time off to care for themselves or other family members and minimize spreading the illness."

Additionally, LGBTQ people are less likely than others to see a doctor, either because of cost or fear of discrimination. An HRC analysis found that one in five LGBTQ adults have not seen a doctor when needed because they could not afford it. The rate was even higher for Black and Latinx LGBTQ adults and transgender women. LGBTQ people are also more likely to lack health insurance -- 17 percent are without it, compared to 12 percent of straight and cisgender Americans.

There are other ways in which LGBTQ people are disproportionately affected. Older LGBTQ people are twice as likely to live alone as their straight and cisgender peers. Forty percent of homeless young people identify as LGBTQ, and many of them rely on school for food and basic needs -- and now public schools in many states are closed.

LGBTQ people have some health factors that put them at higher risk than the general population. Thirty-seven percent are smokers, compared with 27 percent of straight and cis people, and smoking is believed to increase the risk of severe COVID-19 complications. So does asthma, and LGBTQ people have a higher rate of that.

The impact of COVID-19 on people with HIV is currently unknown, but HIV-positive people are more likely to have certain chronic medical conditions that put them at risk of complications from the coronavirus, such as cardiovascular and lung disease, and immune suppression.

HRC has joined more than 100 LGBTQ and supportive organizations in a call to health care providers to be aware of the community's needs.

"The responses to COVID-19 taken by the government, policymakers, and the private sector must actively consider the unique situations of LGBTQ people in their plans for addressing this crisis," the brief concludes. "This especially includes those within the LGBTQ community who are most marginalized." It calls for attention to paid leave, meal stability, and other measures for all Americans, but also taking into consideration the particular needs of LGBTQ people.