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Exploring the impact of COVID-19 on the mental health of sexual and gender diverse communities in Canada: A community-based participatory approach

University of Victoria

Nicole Pal, Kayla Huggard, Carolien Aantjes, Nathan Lachowsky, Ben Klassen, Kathryn Fulcher, Anya Slater, Kiffer Card

Topic areas


Brief summary

A community-based, mixed-methods approach was used to collect data in order to engage community members more equitably in the decision-making and analysis process of the research. This included (1) community-based topic prioritization via three focus groups (2) quantitative survey analysis of the selected factors, and (3) community-based interpretation of quantitative findings via interviews. The social determinants of mental health framework was used to structure data collection and analysis. Community members provided in-depth rationale for findings that highlighted considerable pandemic disruptions to the mental wellbeing of SGD people.


The COVID-19 pandemic and resulting restrictions have had significant mental health consequences, especially for those already experiencing high levels of mental distress such as sexual and gender diverse (SGD) communities. To better understand its impact, this study explored the societal factors that contribute to the mental health of SGD communities within Canada throughout the COVID-19 pandemic.


We conducted a three-phase, mixed-methods study using a community-based, participatory approach. Phases included (1) community prioritization of key determinants of mental health during the pandemic, topics selected included social support and connectedness, housing security, income security and healthcare, (2) secondary quantitative analysis of the selected factors using national survey data collected during the third-wave of the COVID-19 pandemic (April – June 2021) and (3) contextual interpretation of survey data via individual community interviews.

Survey recruitment used web-based convenience sampling. Recruitment occurred using paid advertising in French and English on Facebook, Twitter, Instagram and Google. Convenience and snowball sampling was used to recruit community consultation participants. 2SLGBTQQIA+ community members from across Canada were recruited from the community advisory committee associated with a National 2SLGBTQQIA+ COVID-19 study at the Community-Based Research Centre (CBRC). Additional snowball recruitment occurred through participating community advisory members.


20 community members participated in the community consultations and analyses of 188 survey responses were completed. Using the community prioritized topics, the demographically adjusted Multiple Binomial Logistic Regression identified social support and connectedness variables (loneliness OR:1.75, CI:1.37-2.25, existential loneliness OR:1.35, CI:0.90-2.01, social anxiety OR:1.06, CI:0.98-1.13), housing satisfaction (OR:1.79, CI:1.05-3.07) and age (OR:1.04, CI:1.00-1.08) as strong predictors of mental health status. Interviewed community members provided in-depth rationale for these findings that highlighted considerable pandemic disruptions to the mental wellbeing of SGD people.


Based on these findings, we recommend that programs and policies aimed at reducing the mental health burden for SGD communities target improved social connectedness and support services and housing opportunities with a focus on elderly SGD individuals.

For more information, please contact Nicole Pal at

BC Alliance for Monitoring Mental Health Equity respectfully acknowledges that the land on which we work is the unceded territory of the Coast Salish peoples, including the xʷməθkwəy̓əm (Musqueam), Skwxwú7mesh (Squamish) and Səl̓ílwətaʔ (Tsleil-Waututh) First Nations.

BC Alliance for Monitoring Mental Health Equity

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