Health

'In Survival Mode': The Pandemic Is Devastating the Black LGBTQ Community

Multiple indicators strongly suggest that Black LGBTQ people might be more likely to get infected with the coronavirus and to suffer severe complications from COVID-19.
May 25, 2020, 11:00am
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Leah Flores/Stocksy

After the COVID-19 pandemic hit, Aiden James Nevils started getting followed. Nevils, who lives in Pittsburgh, is required by Pennsylvania’s statewide regulations to wear a face covering while entering essential businesses, such as drug stores, pharmacies, and laundromats. But when he goes to the grocery store in his blue-and-white-patterned mask, he has noticed lingering stares from other shoppers or security guards who trail closely behind as he’s picking up food for the week.

As a Black man, Nevils says he is viewed as “inherently dangerous,” a reality that's reinforced by centuries of racial biases that send the message that people of his skin color are “wrong, bad, or a menace to society.” Being a transgender man and having his face partially obscured by a mask only reinforces that stigma, he said. It’s essentially four strikes in a game where Black people barely get one chance to swing and miss.

“Because my queerness is outward, people think, ‘Clearly you’re different and you’re also Black,’” he told VICE. “Now that I wear a mask, they’re even more like, ‘Ooh, I'm afraid about this.’”

Nevils works as a retail sales manager for a telecommunications company, and he recalled that his appearance has made people so uncomfortable that they don’t want to work with him or don’t even want to work near him. He said these interactions are especially dispiriting because he has watched white people stroll through public space wearing full ski masks without arousing discomfort or suspicion.

“That’s just the Black experience of wearing a mask,” he said. “It makes me feel like even when I’m trying to be safe just like everyone else, that my safety is less important.”

The COVID-19 pandemic has affected nearly every facet of American life, but perhaps no community has been affected as profoundly as Black LGBTQ people. People who live at this intersection of identity are not only more likely to face higher levels of scrutiny during a crisis in which racial minorities, especially Asian-Americans, are reporting a dramatic increase in hate crimes. They are vulnerable to the novel coronavirus in every conceivable way: from dramatic job loss to unique risks of infection that have yet to be adequately recognized by governmental authorities.

Public health experts, advocates, and leaders in the Black LGBTQ community said the worst is likely yet to come, as the impact of COVID-19 is likely to reverberate years down the line. “We’re going to be in a great depression,” said Ciora Thomas, founder and director of the trans support group Sisters PGH. “It's certainly not going to be over for communities that have already been suffering before COVID-19 and will continue to suffer even worse after.”

A great depression

A recent report from the Human Rights Campaign laid bare the dire situation for the Black LGBTQ community during the COVID-19 pandemic in stark terms. Of surveyed groups, Black LGBTQ people were the most likely to face unemployment as a result of the crisis, with 22 percent saying they had been laid off. That figure is 57 percent higher than the number of white LGBTQ respondents who reported job loss related to COVID-19 and 69 percent higher than the general population.

The situation is likely even worse for Black transgender people, Thomas said. In April, her organization created a mutual aid campaign on GoFundMe to assist LGBTQ people who were struggling to put food on the table or pay their bills during the pandemic, and the vast majority of 138 people who applied for aid were people of color. Almost exactly half were Black, and around a third were transgender women.

Thomas, a Black trans woman and longtime community advocate, believes there’s a reason that so many members of these groups were reaching out. “There were no other services being geared directly toward our communities,” she said. “We’re always the last communities to be thought of, especially trans people.”

Iya Dammons sees firsthand the impact of COVID-19 on Black LGBTQ people, who often have nowhere to turn for help, almost every day. Dammons runs Baltimore Safe Haven, which has begun operating the only mobile outreach unit in Maryland specifically designated for the LGBTQ community. She said the organization is “boots on the ground” four days a week, distributing hot lunches, clothing, and paraphernalia kits for safe drug consumption. It also has set up a station where people can wash their hands to prevent infections.

The Black LGBTQ community, which encompasses the majority of Baltimore Safe Haven’s clients, is in “survival mode,” Dammons said. Many of the individuals who have sought out its services are people who are out of a job, particularly trans sex workers who have lost clients or have nowhere to safely shelter in place. Dammons estimated that 50 percent of the Black trans women she works with are homeless and 60 percent are “finding it hard to have a place to quarantine.”

The lack of safe housing for community members, Dammons added, has put many in extreme danger amid rising rates of mental health crises and substance abuse issues. She said one of Baltimore Safe Haven’s clients, Johanna Metzger, “was murdered in the street” after she was released from a rehabilitation program in April and died hours later. The organization held a vigil for her over Zoom.

Metzger was not Black, but around 90 percent of trans homicide victims are, according to data collection from the Human Rights Campaign. Dammons said they will continue to be at high risk during the COVID-19 pandemic, especially if they lack even basic resources for their own survival.

“I’ll die out here before I allow the system to treat our girls this way,” Dammons told VICE. “I’m very vigilant in this fight. Me and my staff, we’re here and we’re doing the best that we can.”

An invisible epidemic

The disproportionate impact of COVID-19 on Black LGBTQ people remains under-recognized and understudied, even as so many are struggling to get by. The federal government, which did not include questions about gender identity or sexual orientation in the 2020 Census, has yet to begin collecting data on how the community is affected by COVID-19, whether on rising joblessness rates or widespread fears from public health experts that those who live in the margins are more likely to suffer complications from coronavirus.

Sean Cahill, director of health policy research at Fenway Health, said multiple indicators strongly suggest that Black LGBTQ people “might be more likely to get infected with the coronavirus” and to suffer severe complications from COVID-19. Research has shown, for instance, higher systolic blood pressure among Black queer women than straight women. He added that Black queer men show higher blood glucose levels, and there are higher rates of asthma across all Black LGBTQ groups.

If Cahill said people with a history of diabetes and cardiovascular disease are among those “who are really having a difficult time when they develop COVID-19,” these phenomena are largely the result of decades of segregationist housing policies, which forced Black communities into public housing in areas with high rates of air pollution.

That has forced Black LGBTQ people into a double bind of environmental racism under COVID-19. These groups predominantly live in apartments, single-family homes, and communities where it’s difficult to maintain six feet of distance from others.

“When you live in dense housing, your chances of contracting coronavirus are probably higher than if you live in your own home with a yard,” Cahill told VICE. “It’s hard to socially distance when every time you leave your apartment, you’re running into neighbors in the hallway, in the stairway, and in the elevator.”

Dustin Duncan, associate professor in the department of epidemiology at Columbia University's Mailman School of Public Health, added that high rates of HIV among Black LGBTQ people also make them especially vulnerable to COVID-19. He cited research showing that around one in two Black queer men will contract HIV within their lifetimes, a rate that’s more than five times higher than their white counterparts, and a suppressed immune system makes it more difficult for people living with HIV to fight off infections like coronavirus.

“We know there are significant disparities in immunosuppression and behaviors that contribute to immunosuppression, such as alcohol drinking,” Duncan told VICE. “We also know that there’s an increased rate of smoking among LGBTQ people overall.”

Many said this confluence of factors has made Black LGBTQ people fearful of leaving their homes, whether it’s going to the doctor for a checkup or for a walk around the neighborhood. Ashton P. Woods, lead organizer and founder of Black Lives Matter Houston, said he has to “take extra steps” during COVID-19 to ensure his health and safety as a person living with HIV. That includes wearing a mask when he’s in public, but he worries that seeing “people clutching their purse” as they walk by may discourage other Black LGBTQ people from taking precautions that could save their lives.

“I’ve lived my entire life being a six foot tall black man over 200 pounds,” Woods told VICE. “I'm already dangerous to people just off my appearance. This is something that I’m used to, but I worry that my ability to collect white tears may not be the same as someone else. Sometimes people just want to be able to exist, go get what they need, and go to their home and just be them.”

Getting everyone counted

Many said the only way to ensure that these ailing communities get the resources and assistance they need to persist is to get them counted. Leslie Herod, the first Black LGBTQ person to be elected to Colorado’s state legislature, began pushing to expand demographic data collection on COVID-19 after she was unable to find any information on the number of people of color in Colorado who were infected. After reaching out to Governor Jared Polis and the Colorado Department of Public Health and Environment, she discovered that officials weren’t tracking the race or ethnicity of COVID-19 patients.

As a Black, queer woman living with asthma, this erasure felt personal for Herod. Reports in states like New York have also indicated that people of color, including LGBTQ individuals, are more likely to be essential workers, which could put people like her at close contact with a virus that could be severely harmful for them. Herod said she thought to herself, “Let’s see the numbers, because we’re disproportionately impacted and no one’s talking about it.”

“If you don't see the data, people ignore the information,” Herod told VICE. “We can sound the alarm as much as we want. We can show the pictures of people who have passed away from coronavirus and see that they're disproportionately Black and Brown. That’s not enough.”

By mid-April, Colorado released data indicating exactly what Herod expected to hear: Black individuals are almost twice as likely to have a positive COVID-19 test and twice as likely to die from coronavirus. Those findings are consistent with reporting from the APM Research Lab, which examined data from 39 states and found that Black mortality rate under COVID-19 was 2.6 times higher than it was for white people.

“We think those numbers are actually underrepresented, but it does show the disparities,” she said, adding that the pandemic has served to magnify “structural inequalities that have been prevalent in our country for a long time.”

But that information remains largely incomplete. Just one state, Pennsylvania, has mandated data collection on LGBTQ identity in its COVID-19 tracking. In California, a bill introduced by state Senator Scott Wiener would require state reporting agencies to provide “in-depth data on COVID-19 and the LGBTQ community to give us a more comprehensive picture of the problem,” as he wrote in an op-ed for the LGBTQ website Q Voice News. The legislation has yet to receive a full vote on the floor, despite unanimous approval in committee.

Pushes to begin tracking the impact of COVID-19 on LGBTQ patients have also begun in New Jersey, Utah, Michigan, and Washington state. Last week, more than 100 members of Congress called on the Trump administration to begin data collection on sexual orientation and gender identity in its federal reporting on COVID-19.

The push to get the LGBTQ community, particularly people of color, counted in all areas of COVID-19 data collection will help advocates and policymakers lobby for appropriate funding to meet the needs of populations at highest risk from coronavirus. But at a time when so many Black LGBTQ people feel ignored and excluded from the national conversation on public health, it would make their pain visible.

“It hurts to be a part of a society that we’ve worked for, worked in, and eventually died for and still be swept under the rug and forgotten about,” Nevils said. “People are literally dying every day and the only ones that talk about our deaths are the people they leave behind. It makes us feel like no one cares.”

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