LGBTQ Americans are getting coronavirus, losing jobs. Anti-gay bias is making it worse for them.

From USA Today by Petruce Jean-Charles

Transgender singer and actress Mizz June was coughing up blood and wheezing. Her ribs hurt when she breathed. She had painful migraines. 

But after she called 911, the emergency medical technicians told her she shouldn’t go to the emergency room unless she was really sick.

"I said I needed to go. I'm in pain. It hurts to breathe," she said. "They were like, you're just going to sit there. So do you want to, at 3 o'clock in the morning, go to this emergency room and just sit there?"

Mizz June pushed back. I can't breathe, she told them. 

“They began questioning me, but I was so angered that I demanded to go to the hospital,” she said. “If I had not been the kind of woman that I am, a black transgender woman who has been through so much adversity, I would be dead.”

The coronavirus outbreak is pummeling LGBTQ Americans, especially those of color, leaving a population already vulnerable to health care and employment discrimination suffering from high job losses and a growing rate of positive cases, according to preliminary data collected from multiple LGBTQ advocacy groups. 

Many LGBTQ Americans live in states that have seen the highest number of coronavirus cases, including California, New York and Washington. These areas have also been hit by job losses driven by economic shutdowns. 

As a result, many more LGBTQ people are struggling with unemployment, homelessness and food insecurity compared with other Americans, while simultaneously facing increased rates of health issues stemming from bias, mental illness and lack of insurance.

Scout, a transgender activist and deputy director at the National LGBT Cancer Network, a nonprofit organization based in New York City, said many LGBTQ Americans already face discrimination when seeking health care, and are worried these barriers could make it harder to get treatment during the pandemic. Scott cited a recent controversy over a field hospital in New York's Central Park run by a religious organization that requires its staff to sign a pledge against same-sex marriage.

"Imagine if you were in New York City and you're queer and your partner gets COVID. Your closest hospital might be that one in Central Park that is very anti-LGBT," he said. "Can you imagine what kind of fear you might have to send your partner to the hospital knowing you couldn't visit them again, right, because you can't visit the hospitals. And you can't be there to protect them and to make sure that they get the kind of care they deserve."

LGBTQ Americans more vulnerable to COVID-19

Advocates said the U.S. needs more comprehensive data on who is being tested for COVID-19. So far, many states have collected COVID-19 data based on age, race and ethnicity, but are not collecting sexual orientation and gender identity data.

That's prompted activists to try to create their own data on positive cases in the LGBTQ community, while also surveying respondents on health care disparities stemming from discrimination from medical providers, including being turned away because of their sexual orientation and gender identity. 

"I would say that there is definitely not as much research out there as other communities because so few surveys ask questions about sex orientation and gender identity," said Naomi Goldberg, policy research director of the Movement Advancement Project, a nonprofit think tank that provides LGBTQ research in Colorado.

Scout said the health care system needs to take into account prior medical histories, as well as societal issues while treating Americans for coronavirus, especially LGBTQ people.

"No one's measuring our outcomes, which, in my mind, is people in the health care system forcing us back in the closet," he said. "They're hiding the way this pandemic is going to play out our extra vulnerabilities and have a disproportionate impact on us."

Experts agreethat LGBTQ people may have health complications that could put them at higher risk of contracting COVID-19 or heighten complications after contraction. For example, LGBTQ people are more likely to be smokers than other Americans, according to the Human Rights Campaign. They also are more likely to have asthma. LGBTQ Americans, especially those who are nonwhite, are also more likely to have chronic medical conditions such as HIV or AIDS.

Access to health care can also be contributing to high cases of COVID-19 among LGBTQ Americans. Roughly 17% of LGBTQ adults do not have any health insurance coverage, compared with 12% of non-LGBTQ Americans, according to the National Center for Transgender Equality based in Washington, D.C.

"We need to be talking about disparities, especially around race and class, recognizing that people of color have less access to health care," said Daniel Ramos, executive director of One Colorado, an LGBTQ advocacy group based in Denver.

Stigma and discrimination can also deter LGBTQ people from seeking medical care, even when they do have health insurance. One in four LGBTQ people reported experiencing discrimination, while 8% of lesbian, gay and bisexual adults and 29% of transgender adults reported that a health care provider refused to see them because of their sexual orientation or gender identity, according to a national survey by the Center for American Progress, a policy research organization in Washington, D.C.

Sean Cahill, director of health policy research at the Fenway Institute, a center for research and advocacy in Massachusetts, said there is still an anti-LGBTQ stigma in health care.

"This affects their health, well being and affects their sense of safety," he said.

Michael Adams, chief executive officer at SAGE, a nonprofit organization focused on LGBTQ aging in New York, suspects that many older Americans dying from COVID-19 could be part of the LGBTQ community. LGBTQ older adults are twice as likely to be living alone and four times less likely to have children compared to people their same age who aren't gay, which means that older LGBTQ people are especially at risk for lack of care or support from family during COVID-19, according to a study by SAGE.

“In a public health crisis like this there are very thin support networks among LGBT older adults,” Adams said. 

To help raise awareness, activists plan to host virtual pride events starting June 1, the beginning of gay pride month, said Brian Hujdich, executive director of HealthHIV, one of the largest national HIV nonprofit organizations in Washington, D.C.

Mizz June said she contracted COVID-19 in mid-March and fears she may get it again. The symptoms initially left her with a dry cough and blood in her mucus. Then she felt constipated for a week.  

“I had a mild case but still I was coughing up blood, wheezing and I could feel my lungs and ribs hurting when I breathed,” she said. “It’s just a disgusting virus.” 

She said was she baffled by the claims from the first responders that she should avoid going to the emergency room because it was too crowded. Only three other patients were waiting when she arrived. 

"They told me I could contract the disease if I went. How could I when there were only three people, I expected at least a full room of 100 coronavirus patients," she said.

She has recovered since her hospital stay, but is worried that other black transgender women might have the same experience where "symptoms weren't taken seriously." She's been encouraging other black trans women to get tested for the virus. 

"I don't think people understand the seriousness of it," she said. "Whenever I go outside I put on gloves and a mask, I keep my distance because I've had it. I don't know if I can still pass it on to people but also I don't want to catch it again."

LGBTQ Americans more likely to be hurt by mass job losses

For LGBTQ Americans who don't get sick from coronavirus, many are struggling with unemployment or other financial burdens, activists said. 

"When we think about the kind of economic earthquake that has happened as a result of COVID-19, with job losses and unemployment benefits, there's a lot of reason to be concerned about the precariousness of LGBTQ people and their families at this moment," said Goldberg of the Movement Advancement Project.

As the economy plummeted, more than 5 million LGBTQ workers were likely to have been impacted by COVID-19, according to recent estimates from the Human Rights Campaign. Jobs in restaurants and food service, hospitals, K-12 and higher education and retail industries have been hit, making up about 40% of all industries where LGBTQ people work, the organization found. More than 33 million Americans have submitted unemployment claims since March.

"While we do not have official numbers on how many LGBTQ people have contracted coronavirus or have died because of it, we know in addition to health disparities, LGBTQ people are employed in the industries heavily impacted by the pandemic, such as retail, nightlife, restaurants, and they are more likely to live in poverty, be food insecure, and uninsured," said Tyrone Hanley, senior policy counsel of the National Center for Lesbian Rights, the first national LGBTQ legal organization founded by women in California.

Roughly 9% of LGBTQ were unemployed, compared with 5% of all Americans, before the outbreak. About 27% of LGBTQ people were food insecure, compared with 15% of all Americans.

LGBTQ Americans are also more likely to be homeless than other Americans. Up to 45% of homeless youth are LGBTQ, while LGBTQ people ages 18 through 25 are two times more likely to be homeless than their peers, according to the Williams Institute, a leading research center on sexual orientation and gender identity at the University of California, Los Angeles, School of Law.

"We estimate that 139,700 transgender adults were unemployed at the time the coronavirus pandemic began. Recent job losses due to official orders enforcing social distancing practices will likely increase this number and exacerbate existing employment disparities," said Jody L. Herman, a scholar of public policy at the Williams Institute and co-author of a recent report on COVID-19 and transgender Americans.

LGBTQ people of color tend to face much harsher discrimination compared with their white counterparts because of their ethnicity, in part because of barriers such as inadequate or nonexistent nondiscrimination protection for LGBTQ workers, and a lack of mentoring, said Goldberg.

“We know that with the economic issues arising many of them won’t be able to work at their jobs, or their jobs aren’t remote, meaning they'll lose a paycheck,” Goldberg said.