Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

MacDermid, Joy C.

Abstract

Research Questions

We examined the mental health experiences of women and gender-diverse people during the pandemic by answering three research questions. Q1. How did the levels of depressive and anxiety symptoms change during the pandemic by sex and gender? Q2. What individual and intersectional factors were related to experiencing the greatest levels of depressive and anxiety symptoms following the start of the pandemic? Q3. Why did some individuals experience more negative mental health outcomes?

Methods

This was a two-part mixed methods study. The first part was a quantitative study using an online survey; the second part was a qualitative explanatory study. The survey consisted of demographic, homelife, and mental health questions. We asked participants to complete the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-2 (GAD-2) scales, and to describe how they were feeling during the pandemic.

Results

A total of 1847 participants (43 countries) completed the study and revealed that depressive and anxiety symptoms increased by 74.2% and 57.1%, respectively. Q1. Women and gender nonconforming people had significantly higher levels of depression and anxiety than men. In man, woman, and other genders, for PHQ-9 (maximum: 27) and GAD-2 (maximum: 6) scores, respectively, there was an increase of 3.3, 4.8, and 6.5 in scores. of 0.9, 1.3, and 1.6. Q2. We examined various aspects of participants’ lives and found that an interaction between gender (non-man) and having a child(ren) were variables of significance (p < 0.05) in predicting post-pandemic PHQ-9 and GAD-2 scores. Q3. Using the groups revealed in Q2, we developed seven themes and a theory that adjusting to changes caused by the pandemic (such as caring for children at home) combined with a loss of control culminated in worse mental health outcomes for mothers and gender nonconforming parents.

Conclusion and Significance

Depressive and anxiety symptoms increased after the start of the pandemic among women and gender-diverse people more than men. This increase was related to parenthood where mothers and gender nonconforming parents had negative mental health outcomes. Finding that women and gender-diverse individuals were most at-risk highlights the need for clinicians, psychiatrists, and policy makers to adopt gender-sensitive screening, treatment, and policy.

Summary for Lay Audience

The COVID-19 pandemic has negatively affected mental health for many people, with women and gender-diverse people experiencing a greater burden. When the pandemic first began, much of the research conducted was on the virus and its physical effects. Even though researchers started to examine mental health, they did not assess the impact for people of different sexes and genders.

To learn more about mental health during the pandemic, we designed a study to examine depression and anxiety. In a two-part study, we asked participants to pick ratings on standardized depression and anxiety scales and to answer open-ended questions about how they were feeling. We also asked demographic questions, including participants’ identification of their sex and gender.

We wanted to answer three research questions. First, what was the change during the pandemic in mental health measures by sex and gender? Second, what aspects of a person’s life were related to having worse mental health outcomes during the pandemic. Third, why did some individuals experience worse mental health during the pandemic?

In total, 1847 participants completed the online study. We found that all people experienced more depression (74% more) and anxiety (57% more) after the start of the pandemic. Even though depression and anxiety increased for everyone, women and gender-diverse people had significantly higher levels than men. Next, we examined what type of personal characteristics were related to experiencing depression and anxiety during the pandemic. We found that being a mother or gender nonconforming parent was related to increased depression and anxiety during the pandemic. To answer the third question, we looked at what mothers and gender-diverse people told us about their mental health during the pandemic. We found that trying to adjust to the many changes of the pandemic (such as taking care of children at home) plus a loss of control was distressing to these parents.

Through our research, we found that women and gender-diverse people’s mental health was negatively impacted during the pandemic, especially those who were parents. Health care providers should be ready to screen women and gender-diverse people for depression and anxiety and provide gender-appropriate supports and treatment.

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