Bearing the Weight of Intersectionality: Longitudinal Mental Health Disparities in Stress, Anxiety, and Depression in the COVID-19 Era

The COVID-19 pandemic exacerbated existing mental health disparities between majority and minoritized identity groups in the United States, across factors including race, ethnicity, sex at birth, sexual orientation, and gender identity. Though each of these identities has been related to disparities in mental health, little empirical research assesses 1) the cumulative and synergistic impact of holding multiple marginalized identities upon mental health, as predicted by intersectionality theory, 2) how these identities interact with discrimination, or 3) how holding minoritized identities might shape psychological responses to significant events. Here we use data from a longitudinal survey of a national sample of adults (N=1070) during the COVID-19 pandemic to investigate how intersectionality relates to experiences of discrimination, stress, anxiety, and depression. For each participant, a Composite Intersectionality (CI) score was calculated as the cumulative count of minoritized identities across race, ethnicity, sex, sexual orientation, and gender identity. Both higher CI scores and greater self-reported discrimination, as measured by the Everyday Discrimination Scale, were associated with increases in mental health symptoms, however, there was no interaction between the two. In addition, events such as the murder of George Floyd and the 2020 presidential election impacted mental health trajectories, with individuals showing stalled symptom reduction following Mr. Floyd’s death and more rapid declines in stress following the 2020 election compared to pre-election. These results suggest that the stress of being minoritized operates through multiple pathways, and that both intersectional load and discrimination are associated with higher levels of mental health symptomatology. These findings contribute to a growing body of literature that demonstrates the importance of considering our intersectional identities when addressing mental health.