Lara Gunderson (Pacific Institute for Research and Evaluation)
Daniel Shattuck (Pacific Institute for Research and Evaluation)
NEOS Volume 12: Issue 2, Fall 2020
In March 2020, students in New Mexico left school expecting a week’s vacation. However, as the COVID-19 pandemic hit the state, the Governor’s office canceled their return. In an economically challenged state ranking 49th in overall child well-being, the shutting of schools changed how students access resources for more than education. Schools addressed a plethora of structural vulnerabilities faced by young people, from food insecurity to healthcare. In particular, sexual and gender minority youth (SGMY) encountered major shifts in their daily social environments that can adversely affect their mental health. The following draws from our study on SGMY experiences with social distancing measures introduced under the pandemic. Specifically, we focus on methodological adaptations to research and recommendations for applying anthropology to better support SGMY mental health during this first-in-a-lifetime, socially isolating event.
Although youth are estimated to have the lowest mortality rates from COVID-19 (Centers for Disease Control and Prevention 2020), they are vulnerable to its influences on well-being. Pre-pandemic, SGMY were at higher risk of depression, anxiety, substance use, and suicidality (Price-Feeney, Green, Dorison 2020; Russell & Fish 2016). While fundamental to public health approaches to minimizing COVID-19 transmission, social distancing may exacerbate extant risks of negative mental health outcomes for SGMY. These youth may experience being cut off from sources of resiliency and protective factors, such as positive relationships with peers and adults based in schools (Johns, Poteat, Horn, Kosciw 2019; Kaniuka et al. 2019). Concurrently, SGMY are spending more time at home, which may or may not be a supportive environment. Social distancing practices also minimize the effectiveness of safeguarding and monitoring systems reliant on people in schools recognizing, preventing, reporting, or responding to signs of abuse and risk. Research also shows SGMY may be more likely to seek help online; two national, online SGMY resource platforms have reported that their mental health services have doubled since the pandemic (Fish et. al. 2020).
In a time when in-person ethnographic methods are less safe, anthropologists can still apply our expertise at human-centered research, flexibility, and adaptation, as shown in the growing anthropology research that examines virtual cultures and life online (Møller and Robards 2019). Between June to August 2020, we used an online survey and semi-structured interviews to examine SGMY experiences with social distancing practices in New Mexico. Considering some SGMY may live in unsupportive or unsafe homes, we leveraged social media and adapted interview methods to allow SGMY to easily and safely participate (e.g., video chat, phone interviews, and text-based communication). We administered the survey to SGMY who attended high school in the past year (ages ranged from 13 to 20) to broadly assess the pandemic’s impact on well-being, mental health, and social support needs. Due to slow progress and low response rates during initial distribution of the survey through advocacy and support organizations serving SGMY, and in consultation with youth during interviews, we shifted recruitment to advertising through Instagram. This change quadrupled responses overnight, for a final 80 percent completion rate (379/474).
We conducted interviews with 15 SGMY and 12 of their formal supporters, including mental health professionals and school personnel. In the spirit of time for COVID-related research, we utilized a rapid data analysis process that involved the creation of a template with key domains derived from our interview questions for each transcribed interview (Hamilton 2013). The SGMY interviewees ranged between the ages of 13 to 17. Seventy percent identified as White; 23 percent as American Indian, Alaska Native or Indigenous Latin American; and five percent Asian or Asian American. Thirty-five percent of the total interviewees also identified as Hispanic or Latinx. We measured their socioeconomic status by parent or caregiver education. Responses were spread nearly evenly across educational levels, from less than high school diploma/GED to completed graduate/professional degree. We used video chat or phone calls for most interviews, but when homes were reportedly unsafe for SGMY to verbalize responses, we corresponded through shared Google documents. Use of a multi-pronged research strategy such as ours is useful for understanding and contextualizing experiences and impacts of pandemic-related social distancing on SGMY, especially for those youth disconnected from resources or in precarious home environments.
Improving Outreach to SGMY During a Pandemic
Combining initial findings from the survey and interview data revealed unique parallels between our adaptations to connect with research participants and those made by formal supporters to serve SGMY (Galea, Merchant, and Lurie 2020). While survey data analysis is currently underway, we already know adaptations to recruitment widened the geographic range of participants from mostly those in cities to those in smaller towns or rural areas, and we were able to reach a substantial number of youth not already connected to SGMY resources.
SGMY spoke of how the pandemic has affected them. One SGMY reflected, “Instead of like going out and being active, like I used to be, I just like watch cooking shows with my mom and it’s, and it’s a different, because I’m used to seeing my friends every day… it’s very hard to not be in band camp, especially when this year I finally made drum line.” Another shared, “You kind of feel trapped in like this little box of a house, a loss of motivation. So once schoolwork online ended, it was kind of like, there’s just nothing to do… It’s just the same old, same old.” A third SGMY said a group of friends started a group chat in the weeks after school closed, “We have a whole group chat [on Discord] and then we also have an Instagram group chat, which we text each other through like 24-7. And we’ve been staying really connected to that.” As a result of the pandemic, a fourth SGMY said she has had more time to self- reflect and “intensified” her identity, drawing inspiration from TikTok, “Since the pandemic now I’ve changed even more and I feel more comfortable in my own skin.”
Formal supporters explained how they diversified communication techniques to make themselves available to SGMY. One therapist, for example, now checks in with current and former clients via monthly texts. Similarly, a teacher underscored the usefulness of sending “dorky” memes to stay connected while she is unable to check on SGMY face-to-face. Others have put themselves on Instagram or shared their personal phone numbers so they may better reach and be reachable to support SGMY. These formal supporters have discovered the need to enhance their outreach and availability.
Even so, several of these same participants stated they had diminished capacity to support SGMY during the pandemic. They too struggled with day-to-day activities and were not always as available as they would like. While a minority knew of online social support groups for youth, most said they would benefit from having a list of resources SGMY can turn to during and after this pandemic.
Participants noted positive changes as well. Fewer SGMY canceled appointments, as they could meet without getting ready to go out. Parents could anonymously attend virtual workshops from a local advocacy organization instead of going in-person. Some participants also mentioned that the SGMY they knew had become observant of the national protests occurring in support of marginalized people, which assuaged the isolation they felt.
SGMY participants described creative ways in which they sought support. One SGMY disclosed that even if friends’ phone minutes ran out, they could all go on an online game, Animal Crossing, to chat at no cost. Most SGMY and some professional supporters clarified that Instagram and TikTok were the primary social media sites to locate and join like-minded groups to learn about sexuality and gender or simply find community. They advised that adult supporters should engage with those platforms, and not Facebook (unless targeting adults) or listservs of already-connected youth. They should also not wait for or expect young people to ask for help—many of those most in need will not do so, according to SGMY and professional respondents.
Anthropologists are acutely positioned to adapt to research participants’ needs. We can support our peers in related realms, including advocacy, education, and mental health, to listen and respond to the needs of SGMY and safely improve methods for serving them. We conclude by stating in the strongest way possible that adults and organizations supporting SGMY must urgently adapt their strategies for outreach.
Support for this work was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (1R01HD83399) and the Pacific Institute for Research and Evaluation’s Corporate Development Award.
Centers for Disease Control and Prevention. 2020. “Hospitalizations and Death by Age, updated on 8/18/20.” Accessed August 21, 2020. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html.
Fish, Jessica N., Lauren B. McInroy, Megan S. Paceley, Natasha D. Williams, Sara Henderson, Deborah S. Levine, and Rachel N. Edsall. 2020. “‘I’m Kinda Stuck at Home with Unsupportive Parents Right Now’: LGBTQ Youths’ Experiences With COVID-19 and the Importance of Online Support.” Journal of Adolescent Health 67 (3): 450-452.
Galea, Sandro, Raina M. Merchant, and Nicole Lurie. 2020. “The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention.” JAMA Internal Medicine 180 (6): 817-818.
Hamilton Allison. 2013. “Qualitative Methods in Rapid Turn-Around Health Services Research.” Paper presented at: VA HSR&D Cyberseminar: Spotlight on Women’s Health. Accessed October 13, 2020. https://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/780-notes.pdf
Johns, Michelle, V. Paul Poteat, Stacey Horn, and Joseph Kosciw. 2019. “Strengthening Our Schools to Promote Resilience and Health Among LGBTQ Youth: Emerging Evidence and Research Priorities from The State of LGBTQ Youth Health and Wellbeing Symposium.” LGBT Health 6 (4): 146-155.
Kaniuka, Andrea, Kelley Pugh, Megan Jordan, Byron Brooks, Julia Dodd, Abbey Mann, Stacey Williams, and Jameson Hirsch. 2019. “Stigma and Suicide Risk Among the LGBTQ population: Are Anxiety and Depression to Blame and Can Connectedness to the LGBTQ Community Help?” Journal of Gay & Lesbian Mental Health 23 (2): 205-220.
Møller, Kristian. and Brady B. Robards. 2019. “Walking Through, Going Along and Scrolling Back: Ephemeral Mobilities in Digital Ethnography.” Nordicom Review 40 (s1): 95-109.
Price-Feeney, Myeshia, Amy Green, and Samuel Dorison. 2020. “Understanding the Mental Health of Transgender and Nonbinary Youth.” Journal of Adolescent Health 66 (6): 684-690.
Russell, Stephen and Jessica Fish. 2016. “Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth.” Annual Review of Clinical Psychology 12: 465-487.
To cite this article: Gunderson L, and Shattuck, D. 2020. Centering Voices of Sexual and Gender Minority Youth: The Urgent Need to Adapt Outreach Techniques. NEOS 12 (2).