LGBT Adults Report Anxiety, Depression at All Ages

Regardless of age, lesbian, gay, bisexual, and transgender (LGBT) adults have consistently reported higher rates of symptoms of both anxiety and depression than non-LGBT adults during the COVID-19 pandemic, according to a new analysis of the U.S. Census Bureau’s experimental Household Pulse Survey (HPS).

Previous Census Bureau research showed that LGBT adults – both those living alone and with others – experienced more mental health challenges than non-LGBT respondents. The current research expands that analysis by also examining LGBT and non-LGBT respondents by age.

The HPS initially asked respondents to identify only their sex (male or female). Since July 2021, the survey has included three SOGI questions.

The first asks about assigned sex at birth:

• What sex were you assigned at birth on your original birth certificate? (Choice of answers: Male or Female.)

The next question asks about current gender self-identification:

• Do you currently describe yourself as male, female, or transgender? (Choice of answers: Male, Female, Transgender, or None of these.)

The latest version of the survey now also asks about sexual orientation:

• Which of the following best represents how you think of yourself?  (Choice of answers: Gay or lesbian; Straight, that is not gay or lesbian; Bisexual; Something else; or I don’t know.)

Survey respondents are categorized as LGBT if they report a sex at birth that does not align with their current gender identity; report a sexual orientation of gay, lesbian or bisexual; or if they currently identify as transgender.

Respondents whose sex at birth aligns with their current gender identity and who select Straight on the sexual orientation question are categorized as non-LGBT.

Respondents who select None of these on the current gender question and either Something else, I don’t know, or Straight on the sexual orientation question are categorized as “Other.”

Additionally, respondents whose sex at birth aligns with their current gender identity but who select either Something else or I don’t know on the sexual orientation question are also categorized as “Other.”

Survey questions related to sexual orientation and gender identity aim to understand the effect of the pandemic across different subpopulations.

However, because the HPS is designed to rapidly produce experimental estimates, exercise caution when using these results as standalone markers of the prevalence of LGBT adults in the general population.

The survey asks four mental health questions, two relating to symptoms of anxiety and two about symptoms of depression. 

These questions were developed in partnership with the National Center for Health Statistics (NCHS). This analysis follows an approach outlined by NCHS, which categorizes individuals based on how frequently they reported feeling anxious or depressed, consistent with diagnoses of generalized anxiety disorder or major depressive disorder. 

The HPS is designed to provide near real-time data on how the pandemic has affected people’s lives. Information on the methodology and reliability of these estimates can be found in the Source and Accuracy statements for each data release. These statements also include information on the invitations and response rates.

Data users interested in state-level sample sizes, the number of respondents, weighted response rates and occupied housing unit coverage ratios can review the quality measures file, available on the Household Pulse Survey Technical Documentation webpage. 

In comparison to other Census Bureau surveys, HPS response rates are low and data users should exercise caution when interpreting estimates from the survey, especially with regard to the impact of potential non-response bias.   

As a part of the Census Bureau’s experimental data series, the HPS was designed to have low respondent burden, provide quick turnaround on product releases and produce estimates that meet urgent public needs. All estimates discussed here were calculated from public-use microdata files.