At the onset of pandemic shelter-in-place orders and safety precautions in the spring of 2020, American women who identify as lesbian or bisexual perceived COVID-19 to be a bigger threat to themselves, their families and their communities than heterosexual women did, according to a new study that offers the first evidence of perceptions of and exposure to the coronavirus among sexual minority women.

Emma Potter, a postdoctoral research associate at the University of Virginia and lead author of the paper, published Dec. 10 in the journal Psychology of Sexual Orientation and Gender Diversity, theorized that sexual minority women would experience the pandemic differently given the economic and health vulnerabilities already facing the population.

Using a sample of 493 cisgender women who identified as lesbian, bisexual or heterosexual, Potter and her research team studied the participants’ demographics, health conditions, employment status, workplace safety conditions and their perceived threat of the COVID-19 virus during May 2020. Transgender and nonbinary adults were not included in the research to avoid an analysis that conflated sexual and gender identity, according to the paper.

The researchers’ analysis found that sexual minority women perceived the coronavirus pandemic as a greater general threat than did heterosexual women, which was partially associated with the former’s increased exposure to the virus. 

“We found that lesbian and bisexual women in the United States have more direct and indirect exposure to COVID-19 through their personal networks and workplace environments than do heterosexual women,” the authors said in the study. “This exposure partially explained why lesbian and bisexual women perceive COVID-19 as a greater threat than do heterosexual women, and these findings suggest that lesbian and bisexual women may differ from heterosexual women in how they experience the COVID-19 pandemic.”

The study is the first evidence of perceived threat and increased exposure to COVID-19 among sexual minority women, the researchers noted, as few states are collecting data on sexual orientation in terms of COVID-19 statistics.

Direct and indirect vulnerabilities to COVID-19 explained some of these differences in perceived threat. But lesbian and bisexual women’s perceptions of the threat of COVID-19 were not fully explained by their objective health risks, depressive symptoms or other predictor variables, the authors said. 

Potter told The Academic Times that this study was a continuation of her previous research on the health of sexual minority adults in the U.S. She has focused on health-related quality of life, which refers to how an individual perceives their physical health, mental health and sleep. Lesbian and bisexual women already experience worse health-related quality of life and sleep than do their heterosexual peers, for example, Potter said. 

The participants were also asked about the threat of COVID-19 to their family, friends and other community networks. “Sexual minority women rated COVID-19 as a greater threat on each measure compared to heterosexual women; these differences were not attributed to their own COVID-19 status, as none of the women in the study tested positive for coronavirus themselves,” Potter said.

The research team found that lesbian and bisexual women had greater personal connections to COVID-19, and were more likely to report knowing someone who had been diagnosed with COVID-19 than heterosexual women. But the personal connections to COVID-19 were not a result of living in a “hot spot,” or a place with a higher rate of coronavirus infections. 

Workplace safety also influenced COVID-19 threat perception among sexual minority women, as lesbian and bisexual women were more likely than heterosexual women to say that current conditions in their workplace increased the chance that they would be exposed to the coronavirus.

“These differences were not due to personal characteristics like patient or overall health. They were really driven by exposure to COVID-19 through knowing someone who had it, as well as the perception of [their] workplace environment,” Potter said.

Potter cited data released by the Human Rights Campaign in May 2020 that found that LGBTQ+ people are more likely to work jobs in industries “highly affected” by COVID-19, with more exposure and higher economic sensitivity. These industries include restaurants and food services, hospitals, education and retail.

The researchers used the Health Belief Model as a framework to examine perceived threat and its implications for sexual minority women. The model theorizes that “individuals’ health behaviors are based on how seriously they view the threat of an illness or disease,” according to the paper.

The study’s findings were consistent with the model in that the groups that reported greater health risks and greater network exposure also reported a greater perceived threat.

For further research on the topic, Potter suggested investigating whether greater perceived threats result in increased usage of preventative health behaviors, such as social distancing and mask wearing. 

And because knowing someone who contracted COVID-19 mattered significantly to how the study participants perceived the coronavirus, Potter said it is important for future research to consider that connection, as well as how perception of the virus has changed over the course of the pandemic.

The study, “Perceived Threat of COVID-19 Among Sexual Minority and Heterosexual Women” was published in the Psychology of Sexual Orientation and Gender Diversity journal on Dec. 10. Emma Potter of the University of Virginia was the lead author. Doyle P. Tate of Pennsylvania State University Scranton and Charlotte J. Patterson of the University of Virginia served as co-authors.

This story has been updated to correct Potter’s position at the University of Virginia.