O'Shea, Jonathan; (2025) Investigating the impact of the COVID-19 pandemic on the mental health of sexual and gender minority young people. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

BACKGROUND: The introduction of public health measures brought in as a response to the COVID-19 pandemic raised short and long-term concerns for marginalised young people’s mental health, including those who identify as a sexual or gender minority (SGM). This thesis examines in detail the impact of the COVID-19 pandemic on the mental health of SGM young people. METHOD: A systematic review of systematic reviews and meta-analyses and systematic review were performed to determine the position of the current literature. Two patient and public involvement events were then held to advise the conduct of secondary data analyses assessing the prevalence, severity and risk factors of adverse mental health outcomes during the pandemic among SGM young people both cross-sectionally and longitudinally. RESULTS: Systematic reviews consistently indicated SGM young people experienced greater prevalence and severity of several mental disorders compared to heterosexual/cisgender young people both before and during the pandemic. Several risk factors were linked to these disparities. With a co-produced analysis plan with SGM young people, analyses indicated SGM consistently experienced greater odds and severity of adverse mental health compared to heterosexual/cisgender young people during the pandemic. Longitudinal analyses indicate marginal change from pre-pandemic mental health. Whilst many assessed risk factors significantly impacted SGM young people’s mental health during the pandemic over time, results indicate they had an equal or greater impact on heterosexual/cisgender young people. CONCLUSIONS: Consistent disparities in adverse mental health among SGM young people during the COVID-19 pandemic reflect a continuing pre-pandemic trend, highlighting a pressing need to focus on SGM young people within clinical practice and policy development as we emerge into a post-pandemic world. The findings of this thesis also present an opportunity to reflect on the challenges faced by this research field, including risks to statistical power, intersectional diversity within research samples and comprehensive measurement of SGM identity.

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