Loneliness and discrimination reported by 2S/GBTQ+ people living with disabilities between 2019 and 2022 in Canada: A pooled cross-sectional analysis

Introduction: Social inequities (e.g., loneliness and discrimination due to sexual orientation) are prevalent across disabled people and Two-Spirit, Gay, Bisexual and Trans men, Queer and Non-Binary (2S/GBTQ+) communities. However, little is known about how loneliness and discrimination were experienced in Canada at the intersection of disability and 2S/GBTQ+ communities before and during the COVID-19 pandemic. Method: To address this knowledge gap, four cycles (2019, 2020, 2021, 2022) of cross-sectional, community-based survey data were used, which included 2S/GBTQ+ people aged 15 years or older and living in Canada. A total of 12,355 2S/GBTQ+ participants responded to loneliness outcomes, and 11,575 to discrimination outcomes. Among 2S/GBTQ+ participants living with disabilities, multivariable logistic regression models of each outcome identified 1) temporal trends by survey year, and 2) social determinants of health correlates. Results: Compared with 2019 (before COVID-19), the odds of reporting loneliness were greater for 2S/GBTQ+ participants living with disabilities in 2020 and 2021 (but not 2022). 2S/GBTQ+ participants living with a disability who reported a racialized identity, financial strain, or a gender-expansive identity had greater odds of reporting loneliness. Compared with 2019, decreased odds of reporting discrimination were found in 2021 and 2022. Older 2S/GBTQ+ participants living with a disability were less likely to experience discrimination. 2S/GBTQ+ participants living with disabilities who were racialized, queer versus bisexual identified, and gender-expansive reported greater odds of discrimination. Conclusions: These findings suggest that 2S/GBTQ+ people living with disabilities were impacted by greater loneliness and lesser discrimination during COVID-19. Equitable policy planning is needed to ensure that underserved yet deserving communities are not disproportionally affected by future pandemics and associated public health responses.