Mental health and access to healthcare among racialized and non-racialized migrant sexual and gender minority youth in Canada: findings from a cross-sectional survey conducted during COVID-19

Migrant sexual and gender minority (M-SGM) youth are vulnerable to pronounced mental health challenges and experience significant barriers to healthcare access due to the intersecting forms of stigma related to sexual and gender minority status, racialization, and migration. However, evidence of these inequities remains limited. This study examined mental health outcomes and healthcare access of M-SGM youth in Canada during the COVID-19 pandemic and assessed differences between racialized and non-racialized youth. This cross-sectional study analyzed data from a sub-sample of migrant respondents drawn from a larger national online survey of sexual and gender minority youth. The analytic sample included M-SGM youth aged 15–24 years (N = 291). The survey assessed self-reported changes in mental health during the COVID-19 pandemic, symptoms of anxiety and depression, suicidal ideation and attempts, perceptions of healthcare providers, and unmet mental health needs. Descriptive analyses were conducted and displayed in contingency tables, which allowed stratifying outcomes across racialized and non-racialized respondents. Overall, 75% of the respondents experienced worsened mental health during the COVID-19 pandemic. Suicidal ideation was prevalent across both groups, with a slightly higher prevalence among racialized respondents (44% vs. 39%). Suicide attempts were reported more frequently among non-racialized youth (35% vs. 11%). Across the sample, respondents frequently reported negative healthcare experiences, including limited provider understanding of sexual and gender minority issues and perceived prejudice. Unmet mental health needs were common, particularly related to anxiety, depression, and self-esteem. Racialized youth more often reported unmet needs related to coming out and suicidal ideation. M-SGM youth in Canada experienced substantial mental health challenges and unmet healthcare needs during the COVID-19 pandemic, with differences observed in terms of race. Findings from this sub-sample highlight the need for public health strategies and culturally responsive mental health services that address intersecting social inequities affecting migrant sexual and gender minority youth.