Abstract
Background:
It is reported that the marginalised and underprivileged sections suffer bitter consequences in the event of calamities and pandemics. The present study aims at assessing the level of anxiety, depression and social support of the LGBTIQ communities during the COVID-19. Since the ‘LGBTIQ’ community is an integral part of society, it is necessary to study these psychological dimensions in the face of multiple waves of the pandemic in the country.
Aim:
The study aims to measure the anxiety, depression and social support of LGBTIQ during COVID-19 in Kerala.
Method:
The study followed descriptive research design and using snowball sampling, total of 106 respondents were interviewed from the urban and rural areas of Kerala. The researchers used the ‘DASS21’ to assess anxiety and depression and the Multidimensional Scale of Perceived Social Support to assess social support.
Results:
Approximately half (44.3%) of the participants were experiencing severe or extremely severe levels of depression. At the same time, many of them had episodes of anxiety disorder at much higher levels (41.5%) than the other members of society. Perceived social support was negatively correlated with depression, anxiety and stress, while depression, anxiety and stress showed a positive correlation with each other.
Conclusion:
Common mental health problems such as anxiety, depression and stress were largely prevalent in the LGBTIQ community during COVID-19, who found the social support inadequate and suffered from other social and economic problems. There is a need to address these issues among this population.
Keywords: Anxiety, depression, social support, LGBTIQ, COVID-19
Introduction
Sexual minorities are one of the marginalised and underprivileged sections in society. The emotional and physical trauma persists due to the problems of geniality, desolation, negligence, inadequate support from family and inadequate employment possibilities, added to the pre-existing conditions of marginalisation and social exclusion.
A study conducted in 174 countries revealed that the social acceptance of the Lesbian, Gay, Bisexual and Transgender (LGBT) population increased by 75% over the period from 1981 to 2017 (Flores, 2019). However, LGBT population in schools and other educational institutions faces bullying from peers and other professional staff (Watson & Miller, 2012), and the degree of mental health issues increased among the LGBT youth. The lifetime prevalence of depression and anxiety is more than 2.5 times among LGBTQ when compared to heterosexuals (Bennett, 2020). During the COVID-19 pandemic, 72% of LGBTQ youth experienced anxiety disorder symptoms, 62% experienced symptoms of depressive disorder in the US and 70% reported that the pandemic had affected their mental health (Trevour, 2021).
LGBTIQ includes Lesbian, Gay, Bisexual, Transgender, Intersex and Queer. They account for approximately 8% of India’s population, as per the scientific estimates cited by the Supreme Court of India while decriminalising same-sex relationships (Sahu, 2016). The social acceptance of the LGBTIQ community has risen since 2010 after a slight decline in the prior decade (Flores, 2019). The need for social awareness about the concept of the LGBTQ community and the mentoring needs of the parents to be more subservient and acquiescent to their children’s sexual orientation are essentially vital to improving the familial and social acceptance along with the mental health of the sexual minorities in India (Tripathi & Talwar, 2022).
Methodology
The study has used a quantitative research design followed by a qualitative interview. A total of 106 LGBTIQ individuals (20 Lesbian, 10 Gay, 14 Bisexual and 62 transgender) were recruited for the study from different parts of Kerala via snowball sampling. Kerala is a progressive state in the Indian Union, has high literacy rate, has a history of sexuality and gender-related debates and government has taken various initiatives to empower gender and sexual minority by providing social security, healthcare, education and employment opportunities (Thampy, 2022; Tharayil, 2014). Hence, Kerala was chosen as a place to conduct the study.
All individuals of the LGBTIQ community who have completed the age of 18 years from all socio-economic status, cultural and religious backgrounds, those who can read and understand English or Malayalam and whether or not socially disclosed their sexual orientation, were invited to participate in the study.
The data collection was conducted in March and April 2020. The participants were recruited based on individual contacts via sexual minority supportive organisations and social media. The community members interested in the study were asked to give informed consent before participating in the study without compensation.
The data were collected from a single situation using the questionnaire method. The socio-demographic schedule and the DASS-21 (Depression, Anxiety, Stress Scale-21) developed by the University of the New South Wales was used (Lovibond & Lovibond, 1995). DASS-21 scale had Cronbach’s alpha scores of .91 for depression, .84 anxiety and .90 stress. The Multidimensional Scale of Perceived Social Support (MSPSS), developed by Zim, was used to assess the level of social support. These self-reported questionnaires were shared among the population using pen and paper and Google forms. The individuals who had access to smartphones filled the questionnaires through Google form, while others utilised the pen and paper method. The collected data were analysed using IBM SPSS (25) by applying frequency analysis, independent sample test, One-way ANOVA test, Pearson Correlation test and Regression analysis. The study was approved by the Departments ethics committee.
Result
Socio-demographic details
About 19% were lesbians, 9% were gays, 13% were bisexuals and 59% were transgenders. As far as the religion is concerned, 69% follow the Hindu religion, 11% follow Christianity, 17% follow Islam and 3% others. About 44% of the participants were graduates or post-graduates, one fifth were unemployed, 11% were daily wage workers, 32% had a private job, 10% were sex workers, 18% were self-employed and 9% were professionals. About 56% earned less than 1 lakh, and 3% earned between 1 and 2.5 lakhs. It was observed that 60% belonged to the below poverty line category, 65% did not socially disclose their sexual orientation.
The mean age of the respondents was 33.35 years (SD ± 9.36) with the minimum age being 19 years and maximum, 66 years. It was also observed that the lowest duration of stay at the current location of the respondents was 1 year, and the highest time of stay was 61 years with the mean duration of stay being 18.60 years (SD ± 14.65).
Depression, anxiety and stress
About 12%, 25%, 15%, and 29% experienced mild, moderate, severe and extremely severe levels of depression respectively. Regarding anxiety, 28%, 29%, 7% and 6% experienced mild, moderate, severe and extremely severe anxiety levels respectively (Table 1). About 30% and 21% reported severe and extremely severe stress, respectively.
Table 1.
Depression, anxiety & stress of the respondent.
| Variables | Categories | N (%) |
|---|---|---|
| Depression | Normal | 20 (18.9) |
| Mild | 13 (12.3) | |
| Moderate | 26 (24.5) | |
| Severe | 16 (15.1) | |
| Extremely severe | 31 (29.2) | |
| Anxiety | Normal | 32 (30.2) |
| Mild | 30 (28.3) | |
| Moderate | 31 (29.2) | |
| Severe | 07 (6.6) | |
| Extremely severe | 06 (5.7) | |
| Stress | Normal | 17 (16.0) |
| Mild | 05 (4.7) | |
| Moderate | 30 (28.3) | |
| Severe | 32 (30.2) | |
| Extremely severe | 22 (20.8) |
About 19%, 73% and 53% received high support from family, friends and significant others respectively. The total perceived social support shows that 8%, 51%, 42% received low, moderate and high social support, respectively (Table 2).
Table 2.
Perceived social support of the respondents.
| Variables | Categories | N (%) |
|---|---|---|
| Support from the family | Low | 46 (43.4) |
| Moderate | 40 (37.7) | |
| High | 20 (18.9) | |
| Support from friends | Low | 6 (5.7) |
| Moderate | 23 (21.7) | |
| High | 77 (72.6) | |
| Support from significant others | Low | 24 (22.6) |
| Moderate | 26 (24.5) | |
| High | 56 (52.8) | |
| Total perceived social support | Low | 8 (7.5) |
| Moderate | 54 (50.9) | |
| High | 44 (41.5) |
The Below Poverty Line (BPL) is an economic benchmark standard of the government of India related to the threshold income. It helps to identify the financially weaker sections of the population who need government support. Above Poverty Line (APL) mentions the individuals or households not coming under the Below Poverty Line category. There was a significant difference in mean support from significant others between the families of Above Poverty Line (APL) and Below Poverty Line (BPL; t104 = 2.874, p < .05; M ± SD = 20.85 ± 8.50). There was no significant difference between APL and BPL families in the support received from family, friends, perceived total support, depression, anxiety and stress (p > .05; Table 3).
Table 3.
Test of difference between the socio-economic status of respondents and research variables.
| Dependent variables | Socio-economic status of the participant | N | M | SD | t | df | Sig. (two-tailed) |
|---|---|---|---|---|---|---|---|
| Support from significant others | Above the poverty line | 42 | 20.85 | 8.50 | 2.874 | 104 | .006 |
| Below the poverty line | 64 | 16.15 | 8.49 | ||||
| Support from family | Above the poverty line | 42 | 12.14 | 7.66 | 0.105 | 104 | .917 |
| Below the poverty line | 64 | 11.98 | 7.60 | ||||
| Support from friends | Above the poverty line | 42 | 21.78 | 6.19 | 0.508 | 104 | .612 |
| Below the poverty line | 64 | 21.14 | 6.51 | ||||
| Perceived total support | Above the poverty line | 42 | 54.78 | 16.44 | 1.668 | 104 | .098 |
| Below the poverty line | 64 | 49.28 | 16.73 | ||||
| Rate of depression | Above the poverty line | 42 | 17.47 | 11.14 | −1.395 | 104 | .166 |
| Below the poverty line | 64 | 20.53 | 10.95 | ||||
| Rate of anxiety | Above the poverty line | 42 | 11.47 | 8.02 | −1.394 | 104 | .166 |
| Below the poverty line | 64 | 13.75 | 8.33 | ||||
| Rate of stress | Above the poverty line | 42 | 19.00 | 8.82 | −0.878 | 104 | .382 |
| Below the poverty line | 64 | 20.65 | 9.92 |
ANOVA results using sexual orientation as the predictor variable, revealed that the support from the significant others was significant (F(3,346) = 0.020, p < .05), and the participants belonging to Lesbian sexual orientation had more support from significant others (M ± SD = 22.60 ± 6.90) than from other groups. Sexual orientation did not have a significant bearing on the support received from family, and friends, total perceived social support, and depression, anxiety and stress experienced by the respondents (p > .05; Table 4).
Table 4.
ANOVA results using sexual orientation as the predictor variable.
| Criterion | Predictor | N | M | SD | Sig. Values |
|---|---|---|---|---|---|
| Support from significant others | Lesbian | 20 | 22.60 | 6.90 | SS = 6.416, MS = 247.212, df = 3, F = 3.436, p = .020* |
| Gay | 10 | 21.00 | 8.45 | ||
| Bisexual | 14 | 17.92 | 9.86 | ||
| Transgender | 62 | 16.08 | 8.61 | ||
| Support received from family | Lesbian | 20 | 11.85 | 7.81 | SS = 741.637, MS = 2.139, df = 3, F = 0.036, p = .991 |
| Gay | 10 | 11.80 | 7.65 | ||
| Bisexual | 14 | 12.64 | 5.74 | ||
| Transgender | 62 | 12.01 | 8.02 | ||
| Support received from friends | Lesbian | 20 | 23.30 | 4.52 | SS = 109.496, MS = 36.499, df = 3, F = 89.8, p = .445 |
| Gay | 10 | 21.10 | 7.75 | ||
| Bisexual | 14 | 19.85 | 7.00 | ||
| Transgender | 62 | 21.17 | 6.50 | ||
| Perceived total support | Lesbian | 20 | 57.75 | 13.58 | SS = 1161.932, MS = 387.311, df = 3, F = 1.394, p = .249 |
| Gay | 10 | 53.90 | 18.18 | ||
| Bisexual | 14 | 50.42 | 16.16 | ||
| Transgender | 62 | 49.27 | 17.39 | ||
| Experienced depression | Lesbian | 20 | 22.80 | 10.03 | SS = 408.702, MS = 136.234, df = 3, F = 1.114, p = .347 |
| Gay | 10 | 15.40 | 9.28 | ||
| Bisexual | 14 | 18.71 | 13.71 | ||
| Transgender | 62 | 18.96 | 10.97 | ||
| Experienced anxiety | Lesbian | 20 | 13.90 | 8.06 | SS = 354.885, MS = 118.295, df = 3, F = 1.775, p = .157 |
| Gay | 10 | 11.20 | 6.94 | ||
| Bisexual | 14 | 8.57 | 8.13 | ||
| Transgender | 62 | 13.74 | 8.36 | ||
| Experienced stress | Lesbian | 20 | 20.90 | 8.14 | SS = 165.116, MS = 55.039, df = 3, F = 0.604, p = .614 |
| Gay | 10 | 19.20 | 8.75 | ||
| Bisexual | 14 | 17.00 | 10.12 | ||
| Transgender | 62 | 20.51 | 9.93 |
ANOVA results using the annual income as the predictor variable expressed that the support from the significant others was significant (F(3,566) = 0.017, p < .05), and the participants who have an annual income between 2.5 lakh and 5 lakhs had more support from significant others (M ± SD = 26.66 ± 2.23) than the other groups followed by the participants with an annual income between five lakhs and eight lakhs (M ± SD = 21.00 ± 9.89). The annual income did not have a significant association with the support received from family, and friends, total perceived social support; and depression, anxiety and stress experienced by the respondents (p > .05; Table 5)
Table 5.
ANOVA results using annual income as the predictor variable.
| Criterion | Predictor | N | M | SD | Sig. Values |
|---|---|---|---|---|---|
| Support from significant others | Below INR100,000 | 59 | 17.01 | 08.56 | SS = 766.979, MS = 255.660, df = 3, F = 3.566, p = .017 |
| Between INR100,000 and 250,000 | 36 | 17.33 | 09.13 | ||
| Between INR 250,000 and 500,000 | 9 | 26.66 | 02.23 | ||
| Between INR 500,000 and 800,000 | 2 | 21.00 | 09.89 | ||
| Support from family | Below INR100,000 | 59 | 10.52 | 07.11 | SS = 319.302, MS = 106.434, df = 3, F = 1.895, p = .135 |
| Between INR100,000 and 250,000 | 36 | 13.75 | 08.21 | ||
| Between INR 250,000 and 500,000 | 9 | 14.33 | 07.33 | ||
| Between INR 500,000 and 800,000 | 2 | 16.00 | 0.00 | ||
| Support from friends | Below INR100,000 | 59 | 20.64 | 06.99 | SS = 113.611, MS = 37.870, df = 3, F = 0.932, p = .428 |
| Between INR100,000 and 250,000 | 36 | 22.77 | 05.36 | ||
| Between INR 250,000 and 500,000 | 9 | 21.33 | 04.09 | ||
| Between INR 500,000 and 800,000 | 2 | 19.00 | 12.72 | ||
| Perceived total support | Below INR100,000 | 59 | 48.18 | 17.35 | SS = 1945.094, MS = 648.365, df = 3, F = 2.400, p = .072 |
| Between INR100,000 and 250,000 | 36 | 53.86 | 15.80 | ||
| Between INR250,000 and 500,000 | 9 | 62.33 | 10.14 | ||
| Between INR 500,000 and 800,000 | 2 | 56.00 | 22.62 | ||
| Depression experienced | Below INR100,000 | 59 | 19.52 | 10.98 | SS = 430.605, MS = 143.535, df = 3, F = 1.175, p = .323 |
| Between INR100,000 and 250,000 | 36 | 20.55 | 10.51 | ||
| Between INR250,000 and 500,000 | 9 | 12.88 | 13.19 | ||
| Between INR 500,000 and 800,000 | 2 | 20.00 | 14.14 | ||
| Anxiety experienced | Below INR100,000 | 59 | 13.52 | 08.25 | SS = 305.873, MS = 101.958, df = 3, F = 1.519, p = .214 |
| Between INR100,000 and 250,000 | 36 | 13.16 | 08.46 | ||
| Between INR250,000 and 500,000 | 9 | 07.33 | 06.92 | ||
| Between INR 500,000 and 800,000 | 2 | 12.00 | 0.00 | ||
| Stress experienced | Below INR100,000 | 59 | 20.84 | 10.32 | SS = 197.151, MS = 65.717, df = 3, F = 0.723, p = .540 |
| Between INR100,000 and 250,000 | 36 | 19.72 | 08.52 | ||
| Between INR250,000 and 500,000 | 9 | 16.00 | 08.24 | ||
| Between INR 500,000 and 800,000 | 2 | 18.00 | 0.00 |
The Pearson correlation test between the independent and dependent variables revealed that age negatively correlates with depression (r = −.251, p < .01). and postively corelated with duration of staty (r = 0.315, p < .001). The support from the significant others showed direct relation with support from family (r = 0.434, p < .01), support from friends (r = 0.376, p < .01); and negatively correlated with depression (r = −0.418, p < .01), and anxiety (r = −0.205, p < .05). The support from family was negatively correlated with depression (r = −0.523, p < .01), anxiety (r = −0.253, p < .01) and the stress experienced by the respondents (r = −0.299, p < .01). The total perceived social support had a significant level of negative correlation with the rate of depression (r = −0.431, p < .01). The depression had a significant level of direct relationship with the anxiety (r = 0.635, p < .01) and stress (r = 0.695, p < .01). The anxiety had a direct relationship with the stress (r = 0.756, p < .01; Table 6).
Table 6.
Details of Pearson correlation test between the independent variables and dependent variables.
| Age | Duration of stay | Support from | Perceived total support | Depression | Anxiety | Stress | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Significant others | Family | Friends | ||||||||
| Age | r | 1 | ||||||||
| p | ||||||||||
| N | 106 | |||||||||
| Duration of stay | r | .315 ** | 1 | |||||||
| p | .001 | |||||||||
| N | 106 | 106 | ||||||||
| Support from significant others | r | .155 | .189 | 1 | ||||||
| p | 114 | .053 | ||||||||
| N | 106 | 106 | 106 | |||||||
| Support from family | r | .032 | .129 | .434 ** | 1 | |||||
| p | 741 | .189 | .000 | |||||||
| N | 106 | 106 | 106 | 106 | ||||||
| Support from friends | r | .075 | .074 | .376 ** | .062 | 1 | ||||
| p | .443 | .448 | .000 | .530 | ||||||
| N | 106 | 106 | 106 | 106 | 106 | |||||
| Perceived total support | r | .124 | .185 | .863 ** | .704 ** | .605 ** | 1 | |||
| p | .205 | .057 | .000 | .000 | .000 | |||||
| N | 106 | 106 | 106 | 106 | 106 | 106 | ||||
| Depression | r | −.251 ** | −.188 | −.418 ** | −.523 ** | .064 | −.431 ** | 1 | ||
| p | .010 | .054 | .000 | .000 | .518 | .000 | ||||
| N | 106 | 106 | 106 | 106 | 106 | 106 | 106 | |||
| Anxiety | r | −.167 | −.072 | −.205 * | −.253 ** | .094 | −.186 | .635 ** | 1 | |
| p | .087 | .464 | .035 | .009 | .340 | .056 | .000 | |||
| N | 106 | 106 | 106 | 106 | 106 | 106 | 106 | 106 | ||
| Stress | r | .043 | −.080 | −.126 | −.299 ** | .170 | −.137 | .695 ** | .756 ** | 1 |
| p | .661 | .417 | .196 | .002 | .081 | .162 | .000 | .000 | ||
| N | 106 | 106 | 106 | 106 | 106 | 106 | 106 | 106 | 106 | |
Correlation is significant at the .01 level (two-tailed).
Correlation is significant at the .05 level (two-tailed).
ANOVA results showed that there was no significant difference between social disclosure of sexual orientation and study variables (p > .05) among various religious groups on study variables (p > .05) and among participants of various educational qualifications and study variables (p > .05).
Regression analysis for the dependent variable social support, with other independent variables such as duration of stay, educational qualification, annual income, sexual orientation and age of the participants showed that these variables predicted 17% (R2 = .174), and the ANOVA expressed that F = 4.207 and p = .002 (Table 7).
Table 7.
Regression analysis for dependent variable social support.
| Variable | Unstd β | Unstd SE | Std β | t | Sig. | R 2 | F |
|---|---|---|---|---|---|---|---|
| (Constant) | 1.784 | 0.383 | 4.662 | .000 | .174 | 4.207 | |
| Age of the participant | .014 | 0.007 | .219 | 2.112 | .037 | ||
| Sexual orientation of the participant | −.119 | 0.053 | −.231 | −2.241 | .027 | ||
| Educational qualification of the participant | .052 | 0.055 | .103 | 0.943 | .348 | ||
| Annual income of the participant | .107 | 0.084 | .128 | 1.275 | .205 | ||
| Duration of stay in the current location | .006 | 0.004 | .150 | 1.557 | .123 |
Discussion
The findings of the present study revealed that the participants with higher level of social support reported lower levels of anxiety and depression, and the support from their family, friends and significant others positively influenced the respondents’ mental health. It also revealed that social support could improve the mental health of individuals. The current study was in line with the existing findings. A similar study carried out in Canada has identified that those who received higher levels of social support experienced lower levels of mental health issues/distress, and effects of social support had four times more effects among sexual and gender minorities (Jacmin-Park et al., 2022). The perceived discrimination and harassment itself were an idol of low social support and social acceptance and negatively affect the mental health and quality of life of sexual minorities (Pandey, 2018). A systematic review reported that the LGBT community was using increased precautions and avoiding public transportation in comparison with the general public due to the fear of pandemics and lack of community support (Konnoth, 2020). The significant challenges of the LGBTQ were: being isolated from unsupportive families, losing in-person identity-based socialisation and social support and reduced access to individual services (Fish et al., 2020). The socially transitioned transgender children backed up their gender status had average levels of depression and only a minimal rise in anxiety (Olson et al., 2016).
The results showed that nearly half the participants underwent either severe or extremely severe rate of depression during the pandemic, which was remarkably high for the community. The statistics illustrate that the national average of depression in Indian society was 7.93% (Gururaj et al., 2016) which points that the risk of severe depression among the LGBTIQ population was six times as high as that in the typical population. The results are also on par with the findings of the census bureau of the United States that 38.2% of the LGBTIQ respondents experienced depression for most of the days in the week (Anderson et al., 2021) and experienced higher levels of anxiety, depression and problematic level of alcohol intake during the times of pandemic when compared with the cisgender counterparts (Akré et al., 2021). Among general population, the severity level of anxiety in the LGBTIQ community was two times higher compared to national average which was 5.54% (Murthy, 2017). It was found that more than half of the respondents experienced severe and extremely severe stress levels. Studies conducted on the mental health needs of sexual and gender minorities during COVID-19 identified that 60% of the participants experienced a higher level of anxiety, depression and other psychological distress during the outbreak (Clark et al., 2022; Gonzales et al., 2020), which is going in line with the finding of the current study. Another study reported higher levels of difference in the depression and anxiety during the lockdown and before the lockdown in Belgium among the sexual and gender minorities (Reyniers et al., 2022).
It was proclaimed that more mental health problems such as depression, anxiety and stress are recognised among sexual minorities than sexual majorities (Peterson et al., 2021), which is in line with the finding of the current study. The aberrant effects of pandemic solicitudes on psychological symptoms such as distress could be curbed by individual resilience, which distinguished that the LGBTIQ community experienced higher physiological and psychological issues throughout the pandemic (Goldbach et al., 2021), and the same can be inferred from the results of the current study. As an effect of the pandemic situations, young transgender persons might experience gender dysphoria and aerial anxiety, depression and suicidal behaviour (Salerno et al., 2020), which was confirmed by the present findings that depression is higher in lower age group than higher age. A study reported that austerity of depression and anxiety was disproportionally very high among the sexual and gender minorities, and sexual minorities exhibited a greater ubiquity of psychological distress than cisgender and heterosexuals (Moore et al., 2021). It was reported that the risk for anxiety and depression disorders was 1.5 times higher in lesbian, gay and bisexual people, along with increased dependence on alcohol and substance (King et al., 2008).
The current study’s findings also implied that the LGBTIQ community faced discrimination based on the socioeconomic status. Among the participants, the transgender community was the most vulnerable and received the lowest levels of social support from the significant others, which colours the social scenario that most transgender people in the country are engaged in sex work to meet their needs (Dabas, 2016). However, the condition of the transgender community had significant improvement in Kerala when compared with that in the other parts of the country, which can be inferred from the data that only 10% were engaged in sex work for their livelihood.
Two studies stated that higher levels of perceived social support lowered the likelihood of increased symptoms among black transgender women (Bukowski et al., 2019). The youth with higher perceived social support expressed lower depressive symptoms along with increased self-esteem and coping mechanisms towards the situations (Wilkerson et al., 2017), and the current study described that there exists a negative correlation between anxiety, depression, stress; and support received from family, friends and significant others.
Limitations
Even though a roughly estimated 25,000 LGBTIQ communities are living in Kerala, only 106 people could be identified due to the COVID-19 outbreak and travel restrictions study. The less visibility of the LGBTIQ community, along with the pre-existing conditions, forced the researchers to limit the scope of their study and could not explore the other contributing factors which had a stake in the mental health conditions of the populations. The lack of reliable data on the prevalence, experiences, needs of the gender minorities in the state as well as the scope and nature of sexual orientation, gender identity and expression change efforts, which are aimed to suppress or deny the identities, made things difficult for the researchers. The study could not focus on other social and physical issues faced by the respondents, which may also have contributed to their stress and anxiety. The participation of other stakeholders was considerably limited in the study due to the pandemic and lockdown. There were more than 70+ identified categories of sexual minorities. In an inclusive study of all of them, the results may vary.
Recommendations
The future research in this dimension should try to include the other members of the queer spectrum, and more samples should be included in the study. The study should cover dimensions of mental health other than the ones used in the present study. Future studies should also develop an effective intervention plan to improve the target population’s mental health and social support status.
Conclusion
The legislative and judicial involvements; and organisational interventions generated a considerably notable level of improvement in the life of the LGBTIQ community in the past decades. Significant improvement in the visibility of the LGBTIQ community members was noted in society. In such a situation, it is very relevant to consider the life situation of the LGBTIQ community within society. Even though the livelihood and standard of living of the LGBTIQ population improved, the health concerns of the community still pose a major challenge. During COVID-19, people from all over the country experienced severe mental and emotional issues due to social isolation, alienation and lack of emotional support. So, it is vital to check and understand the physical, mental and emotional well-being of the LGBTIQ community during COVID-19, especially in the domains of anxiety, depression and social support. The study revealed that the life and livelihood of the LGBTIQ community during COVID-19 were miserable in every aspect. In the physical aspect, most of them had lost their jobs, faced an economic crisis due to unemployment, and they struggled to fulfil their basic needs. All the after-effects of these physical struggles were reflected in their emotional well-being. Around half the population were experiencing severe and extremely severe levels of depression besides anxiety disorders experienced by a considerably larger number and, in addition, lack of physical and emotional support from family and significant others. The study was able to clearly understand the problems of the LGBTIQ community while assessing the emotional and psychosocial well-being of the participants. The results clearly indicated the severity of the issue while considering the situation of the respondents’ unawareness of their problems while taking the attitude of mental health hospitals towards the LGBTIQ population into account.
Footnotes
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was conducted as part of the partial fulfilment of the Masters in Social Work from the Central University of Karnataka, Kalaburagi.
ORCID iDs: Harisankar Kannankott Das 
https://orcid.org/0009-0001-1958-5622
Lakshmana Govindappa https://orcid.org/0000-0002-1324-5387
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