Blog by Henry Ng, MD, MPH (he/they)
Millions of people celebrate LGBTQ+ Pride month every June in the United States and around the world. As we emerge from the throes of the COVID-19 pandemic and begin to congregate and celebrate our lives and selves, our jubilance is tempered by sobering statistics from the pandemic on the communities to which we belong. Over the last year, the COVID-19 pandemic has laid bare how sexual and gender minority people have been disproportionately affected with health inequalities and has placed intersectional experiences and identities in the forefront of discussions about what it means to be vulnerable.
African Americans have had staggering disparities in COVID-19 mortality in multiple reports from US Cities and states. In a national analysis of count-level data, counties with higher numbers of African Americans had nigher COVID-19 cases and deaths and these counties have more crowed living conditions, lower social distancing scores, higher unemployment rates, higher rates of being uninsured and higher chronic disease burden. Latinx people have been impacted by structural drivers of health inequalities – anti-immigration policies and rhetoric, restrictive health care insurance access, poorly funded safety net infrastructure, socioeconomic vulnerability due to racialized low-wage labor markets, invisibility from national discourse and lack of data and adequate public health surveillance to capture the impact of COVID-19 on Latinx communities – all impacting vulnerability to COVID-19. Inequities and barriers LGBTQ+ people experience include increased risk factors for COVID-19 infection; barriers to COVID-19 testing, treatment, and vaccination; vaccine hesitancy; and social stigma surrounding sexual and gender minority identities. Compounding the challenges faced by LGBTQ+ people in the COVID-19 pandemic is the lack of inclusion of sexual and gender minority people in federal data tracking. As noted by the Williams Institute, a public policy research institute based at the UCLA School of Law that is focused on sexual orientation and gender identity issues, this lack of data lack of data hinders efforts to incorporate the needs of LGBT populations into COVID-19 recovery efforts.
However, the health inequities that LGBTQ+ people face are not a result of sexual and gender minority status alone. Public health researchers have published how racism remains pervasive and ordinary in the United States, impacting all aspects of society, and is seamlessly embedded in policies and social life. Racism combined with xenophobia, ageism, sexism, homophobia, transphobia, colorism and many other forms of discrimination are the forces that erode the lives and health of many around the world. For those with multiple identities, discrimination and oppression cannot be distilled into a single identity, such as either female, transgender or Black for Black transgender women. Intersectionality, a term coined in 1989 by Kimberlé Crenshaw, describes how race, class, gender, and other individual characteristics “intersect” with one another and overlap. Through an intersectional lens, we can begin to understand the complex underpinnings of inequality and develop meaningful solutions to combat social and health disparities.
#GeorgeFloyd. #BlackLivesMatter. #STOPAAPIHate. #blacktranslivesmatter. These words are not merely hashtags shared on social media to further social justice causes. They are a response to the rise of hate groups and hate-motivated violence. According to hate crime statistics released by the Federal Bureau of Investigation Uniform Crime Reporting (UCR) Program, in 2019 there were 7,103 single-bias incidents involving 8,552 victims. 57.6% of these were related to race/ethnicity/ancestry bias, 16.7% were related to sexual orientation and 2.7% were related to gender identity. While, 2020 statistics have not yet been released, these numbers have likely increased exponentially over the past year. According to the Center for Public Integrity and Ipsos, 3 in 10 Americans have witnessed someone blaming Asian American and Pacific Islander (AAPI) people for the pandemic. And since its launch at the end of March of 2020, the STOP AAPI HATE Reporting Center has received over 6,600 reports of COVID-19 discrimination from AAPI people across the country, with reports coming from 45 states and the District of Columbia. The number of anti-LGBTQ+ hate groups across the United States in the last two years has risen an alarming 43 percent since 2019, from 49 groups in 2018 to 70 in 2019 as reported by the Southern Poverty Law Center.
This year President Joseph Biden proclaimed June 19, 2021, as Juneteenth Day of Observance and the first new federal holiday in the United States in 38 years. Juneteenth, a portmanteau of the dates it’s celebrated, marks the freedom of enslaved black people in the United States. This observance and celebration marks a time for reflection on dialogues surrounding race and equality. Pride month and Juneteenth are yearly events which will come and go. But supporting BIPOC (Black, Indigenous and People of Color) and LGBTQ+ people is an intentional process that needs to occur daily. LGBTQ_ people’s identities and experiences do not exist in a vacuum and cannot be divorced from the social environments in which we live. Honoring those intersections and the impacts they have on health and well are paramount to promoting optimal individual and community health. Without this understanding, we are complicit in performative advocacy and allyship without making real efforts for change.
 Millett GA, Jones AT, Benkeser D, et al. Assessing differential impacts of COVID-19 on Black communities. Ann Epidemiol. 2020;47:37–44. https://doi.org/10.1016/j.annepidem.2020.05.003.
 American Medical Association. (2020). Latinx COVID-19 health inequities report:
Insights for the health care field. Accessed 6/25/2021.
 The Impart of the Fall 2020 COVID-19 Surge on LGBT Adults in the US. The Williams Institute website. February 2021. https://williamsinstitute.law.ucla.edu/publications/covid-surge-lgbt/. Accessed 5/25/31.
 The United States Department of Justice 2019 Hate Crime Statistics. https://www.justice.gov/hatecrimes/hate-crime-statistics. Accessed 6/20/21.
 “New Center for Public Integrity/Ipsos Poll finds most Americans say the Coronavirus Pandemic is a Natural Disaster” Ipsos website. April 28, 2020.. https://www.ipsos.com/en-us/news-polls/center-for-public-integrity-poll-2020. Accessed 6/20/21.
 Stop AAPI Hate National Report. STOP AAPI Hate website. May 6. 2021. https://stopaapihate.org/wp-content/uploads/2021/05/Stop-AAPI-Hate-Report-National-210506.pdf. Accessed 6/20/21.
 Anti-LGBTQ. Southern Poverty Law Center website. https://www.splcenter.org/fighting-hate/extremist-files/ideology/anti-lgbtq. Accessed. 6/20/21.
 A Proclamation on Juneteenth Day of Observance, 2021. The White House website. June 18, 2021. https://www.whitehouse.gov/briefing-room/presidential-actions/2021/06/18/a-proclamation-on-juneteenth-day-of-observance-2021/. Accessed 6/19/2021.
Henry Ng, MD, MPH is a physician, educator and advocate for LGBTQ health. The focus of his work is to provide culturally and clinically competent care to medically vulnerable populations. Dr. Ng has been involved in LGBTQ health care since 2007 and currently he is a physician in the Center for LGBTQ+ Health and the Transgender Surgery and Medicine Program at the Cleveland Clinic Foundation.
Dr. Ng’s academic interests are in LGBT Health, health disparities, and public/population health. He served as an associate editor for the journal LGBT Health, and is a senior associate editor for the journal Annals of LGBTQ Public and Population Health.