Long COVID is more common among bisexual and trans people. The reasons why are complicated

For more than two years, Edi Whitehead, 27, hasn’t been able to stand for more than a few minutes without feeling like he was going to pass out. Since contracting COVID-19 in 2020, they have suffered torturous headaches and difficulty breathing, but these acute aspects of the disease have since subsided and evolved into a crippling set of symptoms including debilitating fatigue. and cognitive dysfunction. Whitehead, who is trans, is part of an estimate 2 million people in the UK living with long-term COVID or persistent long-term health conditions following infection with COVID-19.

Long COVID is difficult to diagnose, in part because it encompasses a vast constellation of possible health problems; it may manifest as cognitive impairment, shortness of breath, heart palpitations, and some 200 other symptoms. These post-COVID conditions can affect multiple organ systems, last for years, and have been found with alarming frequency; the last US Census Bureau Household Pulse Survey estimates that nearly 18% of people who have contracted COVID-19 in America may be living with long COVID. Meanwhile, the US Government Accountability Office has estimated that post-COVID health issues have left as many as 1 million American adults unable to work.

Who gets long COVID?

In addition to showing higher rates of long-lasting COVID among young adults and women, the Census Bureau survey also found that trans and bisexual adults are significantly more likely to report having the disease. Compared to 5% of cisgender men and 9% of cisgender women, 12% of trans adults in the United States report currently experiencing lengthy COVID symptoms. Meanwhile, 14% of bisexual adults in the United States are living with post-COVID conditions, compared to 7% of heterosexual adults and 5% of gay or lesbian adults. These rates more broadly reflect health disparities experienced by trans and bisexual communities – and highlight the disconcerting ways in which our healthcare systems can fail them.

In a world where transgender people are more likely to live with a chronic disease in the first place, it may not seem so surprising. “Sure [trans people] have higher rates of long COVID,” says JD Davids, co-founder of the advocacy and policy group The Network for Long COVID Justice. “We have lower rates of being treated like humans. People who are denied access to health care, resources, or bodily safety are at higher risk for health issues, including that massive disabling event known as long COVID. Davids has lived with long COVID since March 2021 and has also lived for decades with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), an equally debilitating condition.

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The long effects of COVID can be distressing. Whitehead, who once enjoyed playing football with friends, is now physically disabled and uses a mobility scooter. “I’ve spent two years trying to manage my life to the point where I can work part-time and feel some semblance of the life my friends live,” Whitehead says. Like many who have long COVID, Whitehead worries that reinfection could make their symptoms or outcomes worse. Recurrent COVID infections may put individuals at increased risk of developing long COVID, and with LGBTQ+ people at a greater risk of COVID infection in general, this puts queer and trans communities at increased risk of contracting the disease. “A society that continually puts trans and bisexual people at risk is going to roll those dice more and more often,” Davids adds.

There is nothing inherent in being queer or trans that predisposes people to chronic illnesses, including long COVIDs. Yet the interlocking network of structures healthcare disparities queer and trans people face — such as reduced access to doctors or stigma around their gender or sexuality — could partly explain the higher rates, as well as other LGBTQ+ health disparities the community faces.

Longer COVID burden heavier for bi and trans people

These health disparities may also explain why bisexual and trans people experience long COVIDs at higher rates than lesbians or gay men. Due to the increased stress and stigma associated with bisexuality, bisexual people worse health outcomes overall than homosexuals or lesbians. The same goes for trans people, who often face discrimination and stigma. health care providers. These inequalities can create fertile ground for chronic disease and disability, two factors that can put a person at risk of developing long-term COVID.

Another reason why queer, trans, and bisexual adults might be overrepresented among people with long COVID is that they are more likely to recognize the duration of COVID in the first place. This is because queer people are used to responding to health emergencies like the HIV/AIDS epidemic, which has created a network of advocates who have used their experience to respond to this crisis in the wake of COVID-19, including by disseminating knowledge about acute and chronic COVID infection. . “We only strengthen our efforts to address the AIDS crisis by mobilizing to address the inequalities of COVID-19 at the same time,” said Asia Russel, executive director of Health Global Access Project and former ACT organizer. UPPhiladelphia. In these times last summer. These efforts have coalesced into projects like the one in New York COVID-19 task forcewhich brought together several leading local AIDS organizations and worked to ensure a strong, community-driven response to the coronavirus pandemic.

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