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LGBTQ+ individuals’ intersectional stigma experiences during COVID-19 outbreaks:

Effective risk communication to motivate testing, tracing, and treatment

JungKyu Rhys Lim, Ph.D. 1*, University of Maryland

Hyoyeun Jun, Ph.D., Salve Regina University

Victoria Ledford, Ph.D., Auburn University

Members of stigmatized groups, including lesbian, gay, bisexual, transgender, or queer-

identifying (LGBTQ+) individuals, face greater vulnerability to infectious diseases, such as

HIV/AIDS, coronavirus disease (COVID-19), and monkeypox, than non-stigmatized groups.

Stigma can impact LGBTQ+ people’s access to health resources and can lead to

discrimination. Risk communication messages for LGBTQ+ communities can also activate

stereotypes and de-incentivize positive health behaviors. This vulnerability became clear for

already heavily stigmatized LGBTQ+ people living in South Korea during the COVID-19

pandemic. As governments and media outlets communicated the sites of COVID-19

outbreaks, they shared details about transmission in LGBTQ+ spaces (e.g., gay nightclubs,

bathhouses) that activated stereotypes about health, risk, and identity. LGBTQ+ individuals

in South Korea subsequently experienced intersectional stigma related to gender, sexuality,

and COVID-19. Since little research has examined intersectional stigma with COVID 19, the

current study used in-depth interviews (N = 21) to examine the intersectional stigma and

discrimination that LGBTQ+ communities experienced before and after the COVID-19

outbreak in Korea. Also, this study investigated risk communication that can help reduce and

overcome stigmatization and thus encourage LGBTQ+ individuals to get tested, traced, and

treated. Results revealed that reducing stigma is critical to encourage stigmatized groups to

1 Lim was a Ph.D. student at the University of Maryland when data collection and analysis

were conducted. Lim is a digital media behavioral scientist at the World Bank.

jk.rhys.lim@gmail.com https://orcid.org/0000-0002-5006-2491

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engage in infectious disease testing and treatment. Implications for public health are

discussed.

Keywords: coronavirus disease (COVID-19), infectious disease, LGBTQ+, stigma and

discrimination, prejudice, vulnerable populations, risk and crisis communication, anonymous

testing

Highlights

• LGBTQ+ people in South Korea experienced intersectional stigma with COVID-19

• Anonymized testing procedures can reduce stigmatization and encourage testing

• Health authorities can partner, consult, and collaborate with stigmatized groups

• Health authorities can use trusted in-group messengers and messages with compassion

• Governments should proactively develop anti-discrimination policies

Please use the following citation:

Lim, J. R., Jun, H., & Ledford, V. (2022). LGBTQ+ individuals’ intersectional stigma

experiences during COVID-19 outbreaks: Effective risk communication to motivate testing,

tracing, and treatment. PsyArXiv. https://doi.org/10.31234/osf.io/2nbmj

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LGBTQ+ individuals’ intersectional stigma experiences during COVID-19 outbreaks:

Effective risk communication to motivate testing, tracing, and treatment

Infectious diseases, including HIV/AIDS, COVID-19, and monkeypox have

disproportionately impacted marginalized populations, as they often experience intersectional

and layered stigma from their identities, statuses, and disease infection (Bragazzi et al., 2022;

CDC, 2021; Daskalakis et al., 2022; Gatos et al., 2021). To promote public health, it is

crucial to understand how intersectional stigma, or layers of stigma that individuals

experience when they belong to multiple stigmatized groups, affects public health behaviors.

Despite its societal importance, researchers have understudied intersectional stigma

(Remedios & Snyder, 2018; Turan et al., 2019). Moreover, only limited studies revealed how

such intersectional stigma can inhibit stigmatized individuals’ public health behaviors during

the pandemic.

There is also scant research identifying risk communication messages that can help

stigmatized groups reduce or overcome stigmatization and engage in prosocial health

behaviors, especially during infectious disease outbreaks. Prior research has primarily

focused on stigmatizing messages’ features (Smith et al., 2019), how stigmatized people cope

with stigmatization (Meisenbach, 2010; Nancy & Eckstein, 2016), and how to reduce stigma

among the public (Borschmann et al., 2014; Corrigan et al., 2012). However, little research

has examined how risk communication can help stigmatized groups overcome stigmatization

and engage in public health behaviors, except for a few studies (Drapalski et al., 2021;

Lefebvre et al., 2020).

In South Korea, the already heavily stigmatized LGBTQ+ populations were blamed

for an increase in COVID-19 cases (Kwon, 2020). As the epidemic curve of COVID-19 cases

plateaued in April of 2020 in Korea (Jung et al., 2020), nightclubs reopened and people

around the country visited the Itaewon area of Seoul, an area well known for its diversity

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(Kang et al., 2020). Subsequently, several COVID-19 cases were confirmed across the

country from the Itaewon area (Kang et al., 2020). Korean news media reported that gay

nightclubs were at the epicenter of the renewed COVID-19 outbreak (M. Kim, 2020).

Additionally, public health authorities issued COVID-19 warning messages, including the

actual names of gay nightclubs and bathhouses, where outbreaks occurred. Regardless of

intentionality in this risk communication strategy, the result was clear: LGBTQ+ individuals

experienced another layer of stigma (COVID-19) adding to their already stigmatized

experience as sexual minorities living in conservative South Korea.

These stigmatizing messages necessitate a deeper understanding: to fill these gaps,

this study uses qualitative, in-depth interviews (N = 21) to examine intersectional stigma and

discrimination that lesbian, gay, bisexual, transgender, or queer-identifying (LGBTQ+)

people in South Korea experienced during the COVID-19 outbreak and what elements of risk

communication affected their stigma experiences (e.g., LGBTQ+ stigma and COVID-19

stigma).

This study provides timely insights into how LGBTQ+ populations are experiencing

intersectional COVID-19-related stigma, and how governments, LGBTQ+ communities, and

media can effectively communicate risks to ensure that stigmatized groups engage in testing,

tracing, and treatment.

Literature Review

Intersectional and Layered Stigma

Historically, human societies have “singl[ed] out, shunn[ed], or avoid[ed] groups of

people with attributes that seem undesirable or threatening to others”, such as disease

symptoms or individuals with perceptions that they may carry a disease (Fischer et al., 2019,

p. 989). Stigma is a societally created image used to discredit a group of people who possess

a discrediting attribute (Smith, 2007). From visually apparent (discredited) stigma attributes,

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such as body size (Anderson & Bresnahan, 2012) to more discreditable stigmas, such as

opioid use disorder (Ledford et al., 2021), public stigma—or the general population’s

negative perception that stigmatized people are undesirable or unacceptable— can lead to

stereotyping, prejudice, and discrimination (Vogel et al., 2013). Self-stigma, or the

internalization of public stigma among the stigmatized group (Vogel et al., 2013), exerts

similar negative effects, such as shame, limited integration with others, and the avoidance of

public health services, to avoid being labeled as a stigmatized group (Kranke et al., 2011).

Self-stigma and can lead to marginalization, such as stigma pervasive within systems and

structures (structural stigma; Hatzenbuehler, 2016), public stigma acquired through

interacting with a member of a stigmatized group (courtesy stigma; Smith et al., 2016), and

self-stigma experienced by that guilt through association (affiliate stigma; Mak & Cheung,

2008). Still, few studies have embraced an intersectional perspective of health-related stigma.

Intersectional stigma is “the convergence of multiple stigmatized identities within a

person or group” (Turan et al., 2019, p. 1), or when an individual or group experiences

multiple forms of oppression to their overlapping social identities (Mizock & Russinova,

2015; Taylor et al., 2020). Intersectional approaches to stigma are rooted in work from Black

feminist thought and critical race theory, specifically Crenshaw’s (1989) work arguing that

interlocking systems of oppression make consistently salient, multiple, and intersecting social

identities. People experiencing multiple stigmatized identities feel greater invisibility and

discrimination (Remedios & Snyder, 2018). While intersectional stigma scholars have used

various other terms to describe intersectional stigma, such as ‘layered,’ ‘double,’

‘overlapping,’ and ‘multilevel stigma,’ these terms all point toward an intersectional stigma

mechanism (Turan et al., 2019). While some research has illustrated intersectional stigma

(Hull et al., 2020) or health disparities (Tai et al., 2021) among minorities in the United

States, such as black LGBTQ+ people on taking PrEP (Quinn et al., 2019), research has yet to

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substantially examine the impacts of these stigma layers during the COVID-19 pandemic in

non-U.S. contexts.

LGBTQ+ Stigma. People with different sexual orientations and gender identities

often experience stigma. Queerphobic attitudes can vary by location, class, race, ethnicity,

and religion (Adamczyk & Liao, 2019; Schnabel, 2016). Globally, LGBTQ+ individuals have

experienced stigma in a multitude of ways (Adamczyk et al., 2016). People from sexual and

gender minority groups often experience stigma and discrimination from dominant groups

(Gower et al., 2019), other members of the LGBTQ+ community, and even themselves

through internalized stigma (Herek et al., 2009).

Intersectional stigma and discrimination towards LGBTQ+ individuals have resulted

in higher levels of distress, and sexually transmitted infections (STI) than cisgender

heterosexuals (Burnham et al., 2016). The presumption of heterosexuality in the clinical

context has also led LGBTQ+ individuals to be less likely to trust their doctor and disclose

health information (Utamsingh et al., 2015). For example, Arnold et al. (2014) found that

Black gay men living in the U.S. experienced stigma and discrimination uniquely because of

how their sexuality, race, and HIV-related stigma coalesce to impact stigmatizing beliefs and

attitudes within communities.

Layered LGBTQ+ Stigma in Korea. In general, Asian countries are less tolerant of

LGBTQ+ individuals and have stronger stigma than others; Korea is one of the least

LGBTQ+ supportive countries (Adamczyk & Cheng, 2015; OECD, 2019; Poushter & Kent,

2020; Youn, 2018). Confucianism, a dominant socio-political viewpoint, focuses on the value

of a heterosexual family unit (Nguyen & Angelique, 2017). Heterosexual-oriented values

have dominated most social interactions at home and work in Korea (W. Lee et al., 2019). No

Korean law protects LGBTQ+ individuals against discrimination in employment and housing

(W. Lee et al., 2019).

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Confucianism also interacts with Christianity, in South Korea. Some Korean

Christians believe that by not supporting LGBTQ+ people, they can keep their Christian faith

(Hong, 2018). As such, most Asian-American churches have lacked interest in social justice

and supporting LGBTQ+ people (Lee, 2006). Consequently, LGBTQ+ individuals in Korea

have experienced high stress, internalized queerphobia, depression, and suicidal ideation

(Cho & Sohn, 2016; Yi et al., 2017).

COVID-19 Stigma. Stigma surrounding COVID-19 has impacted patients and

healthcare workers worldwide (Bagcchi, 2020; Villa et al., 2020). Twitter users often mention

the perils of COVID-19 (e.g., threats to health, normal life), physical stigma marks (e.g., flu-

like symptoms), group labeling (e.g., “Wuhan, China, Asian virus”), and responsibility

attributions (e.g., “bat eating” people) (Li et al., 2020)—all features of stigma communication

(Smith et al., 2007). This stigma has inevitably incited fear of interaction and even disclosing

COVID-19 symptoms or status to others (Abdelhafiz & Alorabi, 2020; Murray et al., 2021).

Studies in Italy, India, and China have revealed that frontline medical workers and COVID-

19 patients expressed varying levels of stigma, distress, social avoidance, and fear of disease

disclosure (Duan et al., 2020; Li et al., 2021; Ramaci et al., 2020).

Minority groups have often been associated with and stigmatized for the spread of

infectious diseases (Fischer et al., 2019; Hull et al., 2020), including COVID-19 (Kapiriri &

Ross, 2020; Ransing et al., 2020; Wallach et al., 2020) and monkeypox (Bragazzi et al., 2022;

Daskalakis et al., 2022). In South Korea, COVID-19 has become associated with

unconventional, pseudo-religious groups (i.e., religious cult), sexual minorities, and with

defying national interests (Yi & Lee, 2020). Although LGBTQ+ individuals globally

experienced psychological burden and limited healthcare access during the pandemic

(Banerjee & Nair, 2020; Gato et al., 2021), scant scholarly attention has been paid to the

unique multiple-layer stigma experiences of LGBTQ+ individuals living in Korea during the

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pandemic: LGBTQ+ stigma and COVID-19 stigma. To examine intersectional, layered

stigma that LGBTQ+ individuals have experienced from their sexual orientation, gender,

religion, race, and ethnicity surrounding COVID-19, this study asks:

RQ1: What stigma and discrimination have LGBTQ+ populations experienced in

Korea before, during, and after the COVID-19 outbreak?

Communicating Stigma and Risks

Communication Exacerbating Stigma. The model of stigma communication (MSC)

(Smith, 2007) focuses on how social stigmas are created through the intrinsic message

features that allow private prejudices to become collective norms or social facts. As Smith

(2007) argues in the MSC, stigma messages often contain a label—a term that implies a

person is defined by their stigma attribute within their stigmatized group. “Homos'' and

“homosexuals'' or emphasizing COVID-19’s origin in China exemplify this labeling (Dhanni

& Franz, 2021), whereas talking about individuals in the LGBTQ+ community more

inclusively communicates that people are both individuals and have group identities. Tactics

of marking also lead to stigma transmission. A stigma mark triggers a stigmatizing

visualization, be it a physically apparent image (e.g., the stigmatizing portrayal of body size)

or a mental image, such as the association of HIV status with disease-laden imagery (Smith,

2007).

People also communicate stigma by talking about a group’s responsibility for their

stigma and warning others of suspected peril to the community. This is where stigma

messages can unfortunately intersect with poor risk communication in health contexts. For

example, much of the stigma surrounding HIV comes from blame and shame attributed to

people with HIV (Duffy, 2005). Stigmatizing messages may imply that transmission, even

when preventive measures were taken, is the sole fault of the person who contracted a

disease. Warnings and peril messages about HIV also abound, as HIV is often communicated

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as a death sentence. These stigmatizing messages do not lead to less HIV transmission—they

lead only to isolation, fear of disclosure, and discrimination.

In the context of this study, stigma messages may be communicated through the

government or media, interpersonal communication, or healthcare settings (Islam et al., 2021;

Labbé et al., 2022), since South Korea implemented contact tracing procedures that isolated

people who visited gay night clubs (Kwon, 2020). Thus, to examine stigma and risk

communication that may have encouraged or discouraged COVID-19 testing, this study asks

the following research question:

RQ2: What increased stigmatization and discouraged Korean LGBTQ+ individuals

from getting tested for COVID-19?

Risk Communication to Help Overcome Stigmatization. Prior research has

examined three primary ways to reduce the stigma that the public holds (Heijnders & Van

Der Meij, 2006; National Academies of Sciences, 2016; Rao et al., 2019). First, anti-stigma

education that corrects inaccurate stereotypes has been effective at reducing mental health

stigma (Borschmann et al., 2014; Corrigan et al., 2012; Islam et al., 2021). For example,

researchers have found that carefully depicting stigmatized individuals (Hull et al., 2017;

Ledford et al., 2021) and explaining the cause of the stigmatized attributes (e.g., external

factors) can reduce stigma (Heley et al., 2020). Second, interpersonal contact-based (i.e.,

exposing people to stigmatized group members) anti-stigma programs are common

(Livingston et al., 2012) and have positively changed attitudes (Corrigan et al., 2012;

Yamaguchi et al., 2013). Finally, social activism and protests (e.g., letter writing, boycotts,

and public demonstrations) focusing on legislative reform can enhance protections of rights,

increase access, and reduce inequalities, yet were found to be least studied and effective

(Arboleda-Flórez & Stuart, 2012; Corrigan et al., 2012; Griffiths et al., 2014). Still yet, these

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stigma-reduction studies have largely focused on the experiences of non-stigmatized group

members rather than those within stigmatized groups.

To date, only a few studies have explored communication techniques that can help

stigmatized groups overcome stigma. For example, one study attempted to reduce stigma by

communicating with people with lived experiences, normalizing the use of treatment, and

reducing shame (Lefebvre et al., 2020). Another intervention to reduce internalized stigma

offered strategies including changing self-stigmatizing thinking and strengthening positive

aspects (Drapalski et al., 2021). Additionally, a review paper on interventions to mitigate

health disparities during the pandemic suggested using culturally-adapted communication and

technology and partnering with trusted communities (Williams et al., 2022). Lastly, despite

stigma’s detrimental impacts, stigma-reduction researchers have understudied structural

factors, such as legal or policy measures, to help and protect stigmatized groups (Logie &

Turan, 2020; Nyblade et al., 2019; Rao et al.,2019).

Still, more research is needed to examine how to help stigmatized groups to overcome

stigma and engage in public health behaviors. Like other stigmatized minority groups

associated with infectious diseases (e.g., HIV/AIDS, Tuberculosis [TB], Severe acute

respiratory syndrome [SARS], Ebola virus disease, Zika virus) (Fischer et al., 2019; Hull et

al., 2020; Kapiriri & Ross, 2020; Wallach et al., 2020), there were concerns that LGBTQ+

people exposed to COVID-19 in Korea were hesitant to get tested for the coronavirus (Jung

et al., 2020; Kang et al., 2020; KCDA, 2020) because of existing stigma and discrimination

against LGBTQ+ individuals (Youn, 2018) and COVID-19 stigma. Thus, to examine stigma

and risk communication that encouraged COVID testing, this study asks the following

research questions:

RQ3: What reduced stigmatization and encouraged Korean LGBTQ+ individuals to

get tested for COVID-19?

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Methods

In-depth, semi-structured interviews with 21 members of LGBTQ+ communities were

conducted and qualitatively analyzed. A university Institutional Review Board (IRB)

approved the study.

Participants

From June to December 2020, participants were recruited using snowball,

convenience, and maximum variation sampling. The researchers initially contacted LGBTQ+

rights organizations, social media groups, and university clubs in Korea and asked

participants to share the study with their contacts. Participants identified their sexual

orientation as gay (n = 14), bisexual (n = 5), lesbian (n = 4), and pansexual (n = 1).

Participants’ ages ranged between 20 and 49 (see Table 1).

Table 1. Participant Information

Participant Information

Pseudonym Gender Identity Sexual Orientation Age Group

1 Minjun Transgender male,

Gender-fluid Gay 20s

2 Doyoon Cisgender male Gay 40s

3 Siwoo Cisgender male Gay 30s

4 Joowon Cisgender male Gay 30s

5 Hajoon Cisgender male Gay 30s

6 Seoyeon Gender-fluid Lesbian 30s

7 Jiho Cisgender male Gay 30s

8 Joonseo Cisgender male Gay 30s

9 Minseo Cisgender female Bisexual 20s

10 Hayoon Cisgender female Lesbian, Bisexual 20s

11 Joonwoo Cisgender male Bisexual 20s

12 Jiyoo Cisgender female Bisexual, Pansexual 20s

13 Hyunwoo Cisgender male Gay 30s

14 Jimin Cisgender female Lesbian, Bisexual 30s

15 Dohyun Cisgender male Gay 30s

16 Jihoon Cisgender male Gay 30s

17 Gunwoo Cisgender male Gay 30s

18 Woojin Cisgender male Gay 30s

19 Sunwoo Cisgender male Gay 30s

20 Minjae Cisgender male Gay 30s

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21 Chaewon Cisgender female Lesbian 20s

Procedure

After recruits agreed to participate, we conducted semi-structured, in-depth

interviews. The interview focused on how LGBTQ+ populations perceived stigmatization

during COVID-19 outbreaks and their perceptions of risk messages (see online appendix for

the interview script). We also showed participants the Korean government’s COVID-19

warning messages during the outbreak (Ministry of the Interior and Safety, 2021) and asked

for their thoughts (see Figure 1). We conducted all interviews using Zoom, except for one

written interview for privacy reasons. Then, the interviews were professionally transcribed.

Bilingual researchers cross-checked the translation. The interviews averaged 59.29 minutes,

with a range between 24.15 and 88.55 minutes.

Figure 1. Government Warning Messages

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Source: Ministry of the Interior and Safety (2021)

Analysis

Following Corbin and Strauss (2015) and Miles et al. (2020), we conducted

qualitative data analysis using the software Dedoose. Two researchers deductively drew some

codes from the prior literature, while some codes inductively emerged from the data (Lindlof

& Taylor, 2011; Miles et al., 2020). We listed initial codes from the literature review and

drafted memos. In the first cycle of coding, we summarized data by codes. Then, we

discussed codes that emerged from data. We iteratively grouped codes into patterns and

themes in the second cycle of coding. We also looked for negative evidence, outliers, and

checked possible rival explanations. To ensure addressing the intersectionality, we compared

participants’ identities, such as age, sex, gender, sexuality, occupation, and COVID-19

experiences, in the data.

Member Reflections (Member Checking)

We returned the findings summary to participants for member reflections (Tracy,

2010). Member reflections validate the credibility of a study, while offering opportunities for

questions, critique, feedback, and reflexive elaboration (Birt et al., 2016). All participants

were invited to read the summary. Eleven participants shared feedback, which researchers

addressed and incorporated.

Results

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RQ1. LGBTQ+ Populations’ Intersectional Stigmas and Discrimination (RQ1)

RQ1 focuses on the intersectional stigmas (e.g., LGBTQ+ stigma, COVID-19 stigma)

and discrimination that LGBTQ+ individuals experienced before and after the outbreak in

Korea. All participants shared various intersectional stigmas that they have experienced,

which were exacerbated after the COVID-19 outbreak, across ages and gender identities.

Seoyeon explained:

Minorities’ rights aren’t often respected. For me, it’s difficult to live with multiple

layers of minority identities, such as gender-fluid female, lesbian, working for

vulnerable youth outside schools. My girlfriend’s and my family are devout

Christians. My girlfriend’s mother prays every morning that she becomes

heterosexual. Every day, I'm enduring and fighting to prove my existence. Then, after

COVID-19 outbreak, I felt that LGBTQ+ individuals were witch-hunted.

Six following themes emerged (see Table 2). These themes interact with each other.

Table 2. Findings Summary

Findings Summary

RQ1. LGBTQ+ Populations’ Intersectional Stigmas and Discrimination

1. COVID stigma: “how dare you hang out?”

2. “Disgusting” people spreading diseases

3. Being LGBTQ+ makes you a target

4. Fear of losing jobs

5. Internalized self-stigmas and being in the closet

6. Exposed LGBTQ+ cultures, concerns, and opportunities

RQ2. What Increased Stigmatization and Discouraged COVID Testing

1. Public health authorities’ lack of understanding and sensitivity

2. Disclosing contact tracing data that can identify individuals

3. Calling out LGBTQ+ bars, clubs, and bathhouses

4. Negative media reports regarding LGBTQ+ cultures

RQ3. What Reduced Stigmatization and Encouraged COVID Testing

1. Anonymous testing and risk communication not exposing LGBTQ+ people

2. Fear of causing trouble and transmission

3. Encouragement from LGBTQ+ communities

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COVID Stigma, “How Dare You Hang Out?”. Most participants shared that

contracting COVID-19 after being at nightclubs implied to many people that they

irresponsibly ignored public health guidelines for their pleasure. Jiyoo said: “People asked,

how dare they hang out in nightclubs, and spread COVID? Just for fun? Everyone’s trying to

contain COVID. Kids can’t go to school. Small businesses are collapsing. Couldn’t you just

stand not going out?”

Participants noted that people blamed individuals for getting infected, rather than

public health authorities lifting safety measures. Minjae said: “Getting COVID-19 can mean

that they cannot manage themselves well. People may think, where did they get COVID-19?

Where did they go and what did they do, rather than staying home?”

However, some participants stated that they realized it was not entirely an individual’s

fault. Woojint said: “I used to think that people can get COVID if they are careless. I don’t

say that individuals aren’t responsible. However, [public health authorities] should’ve had

systematic backup plans when lifting measures, which they didn’t.”

“Disgusting” People Spreading Diseases. Before the COVID outbreak, the majority

of participants experienced stigmatization due to the claim that LGBTQ+ individuals have

anal sex and spread STDs, especially AIDS. Dohyun said: “Korean Christian YouTube

channels often argue that gays are spreading AIDS.” Chaewon said: “There are usually

opposing protests at the queer parade. They say, ‘We do not want a male daughter-in-law’

and ‘Are you going to let your child die from AIDS?’”

After the outbreak, all participants stated that people demonstrated hate towards

LGBTQ+ populations, associating the existing stigma about anal sex and STDs with COVID-

19 and infectious diseases. Minjae said: “Many people say that ‘disgusting’ LGBTQ+ people,

who are crazy about sex and spread AIDS, now spread the COVID virus.”

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Some participants shared that people believe that COVID-19 spreads among “bad

apples,” stigmatizing LGBTQ+ individuals. Woojin shared: “As we have COVID outbreaks

among the religious cult groups and then LGBTQ+ communities, many people say that only

bad apples get the COVID.”

Moreover, participants shared that Christians’ anti-LGBTQ+ movement worsened the

stigmatization and discrimination. Jiho mentioned: “Some Christians say, look at this. This

happens when you live promiscuously. LGBTQ+ individuals spread homosexuality and

COVID. They’re evil.”

Being LGBTQ+ Makes You a Target. Before the outbreak, the majority of

participants had already experienced some verbal abuse or violence. Dohyun said that he

heard his friends openly say, “Gays’re so disgusting. I’ll beat them up till they die.” Minjun

shared a traumatic experience at one Queer Festival; a local church group, which was

protesting at this festival, started tussling with LGBTQ+ individuals and harmed some. Few

of the participants were out of the closet. Joonseo said: “Some YouTubers, who want to go

viral, sometimes screenshot gays’ Facebook pages and share them.”

After the outbreak, all participants stated they had an extreme fear of being outed.

Since public health authorities disclosed personal information for contact tracing, testing

positive could result in being publicly outed. Minjun shared: “Everyone who went to clubs

was in a panic. Once they find out you visited the club, you become quarantined and are

forced to work at home. You can’t keep it secret. You’re out.” Chaewon also mentioned: “I

remember one gay’s posting saying that ‘we’ll be out no matter what if we get tested. Let’s

not get tested, and hang in there.’”

Specifically, participants reported that LGBTQ+ people are witch-hunted and

searched out, regardless of whether they visited Itaewon or contracted the virus. Dohyun said:

“Witch hunts are intense. People dig and reveal information about when, and which places

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[LGBTQ+ people] visited, and with whom.” Hajoon added: “There was a threat online that

they will hack a big gay community website and expose all users’ information. Even those

who didn’t go to Itaewon were scared. It was like an exodus. Many removed their accounts.”

Indeed, many participants shared that LGBTQ+ individuals who tested positive were

outed. Minjun said: “Some people put up posters at the infected person’s apartment.” Woojin

said: “People shared infected people’s information, including their workplace, colleagues,

pictures, and relationships, like gossip.”

Fear of Losing Jobs. Before the outbreak, revealing or being revealed as LGBTQ+

individuals can make them lose their jobs. Seoyeon said: “When I see good friends of mine,

especially working in public organizations, coming out is never an option. If revealed, the

organizations won’t fire you, but can make the situation forcing you to leave.” Participants

noted that individuals working in conservative workplaces, such as the military, public

organizations, and education, are more vulnerable than others. Joonseo, who teaches, stated:

“Even though all your colleagues may understand, you won’t be able to continue to work if

parents complain.” Dohyun added: “If you’re in the military, you can get punished when

outed per the Military Criminal Act.”

However, the fear of losing a job intensified after the outbreak, especially with the

lack of anti-discrimination laws in Korea. Minjun shared: “Companies could unfairly fire

LGBTQ+ individuals because they can harm the business if they spread COVID. Families

could cut their ties and support.” Chaewon mentioned: “Whether you tested positive or

negative with a close contact, you have to tell your workplace, and you’re outed.”

Internalized Self-Stigmas. About half of the participants revealed that they have

internalized stigmas or have been stigmatizing themselves for being LGBTQ+ in Korea.

Hayoon shared: “Heterosexual relationships feel natural. Homosexual relationships are

something wrong, and different. I’m afraid of not getting accepted by my peers.” Some gay

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participants admitted that they attempt to act like heterosexuals. Jiho said: “I blindly imitated

my peers, who talk and walk more manly, to fit into macho Korean society. I lied that I had a

girlfriend. I felt I was a hypocrite, I was depressed.”

Before and even after the outbreak, the majority of participants expressed that they are

unable to share their sexual orientations with their close friends and family. A few

participants often heard hateful statements from their family and friends. Jimin shared that

she often hears: “It’ll be somewhat gross to have LGBTQs right next to me.” Jiyoo noted that

people often say: “I don’t want to be close to them.”

Participants shared experiences, such as “I had to move out of parents’ home because

my parents couldn’t accept me,” “my father would kill himself if he realized I’m gay,” or

“they would drag me to an anti-homosexuality church camp.” Some participants felt that one

reason could be Korea’s conservative and patriarchal culture. Gunwoo explained:

“Conservative family culture and the patriarchal culture based on the mandatory military

service worsened stigmatization.”

After the outbreak, some participants felt that LGBTQ+ individuals are treated as

second-class citizens. Hajoon said: “We weren’t even second-class citizens. Rather, the

lowest.” Minjun explained: “No anti-discrimination laws exist in Korea. Governments don’t

pay attention to LGBTQ+ individuals. We can even be punished through the Military Act.”

Many participants shared that many LGBTQ+ community members felt depressed,

especially after the outbreak. Sunwoo, who tested and quarantined, stated: “I felt extremely

insecure. Because of me, all my friends are under the threat of being outed. Every time I turn

on TV or the Internet, I see people blaming LGBTQ+.” Some participants also shared that

their friends and colleagues who quarantined felt extreme depression and felt like they were

“living in hell.”

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Given the extremely high suicide rates among LGBTQ+ people in Korea (e.g., almost

half of under-18s in the LGBTQ community have tried to commit suicide) (Chingusai, 2017),

a few participants noted that it was “fortunate that there were no known suicide cases” among

LGBTQ+ communities. Hajoon said:

It was fortunate no one committed suicide. People who visited the club were

extremely scared. You wouldn’t even imagine the pressure. I saw one person who

can’t even get tested and wants to die because his life will end if his secret is revealed.

Exposed LGBTQ+ Cultures, Concerns, and Opportunities. After the outbreak,

participants identified both concerns and opportunities regarding LGBTQ+ cultures being

exposed. On the one hand, especially for gay bathhouses, participants felt concerned that it

may worsen the stigmatization. Dohyun stated: “Many people become curious and interested

in gay bathhouses, as public health authorities displayed their names on the warning message.

I felt embarrassed. The bathhouse can be criticized socially and ethically, as conservative

Christians blame gays as sex addicts.”

Conversely, the outbreak revealed LGBTQ+ clubs’ positive and healthy aspects that

defy public prejudice. Joonwoo said: “One recording from the gay club went viral on Twitter

and Facebook. In the video, gay men are dancing to a girl idol group’s song all together.

People were surprised because it wasn’t sexual at all.” Woojin added: “People realized that

gay clubs aren’t dirty.” However, Sunwoo noted: “It’s not that sexual tensions don’t exist in

gay clubs. [LGBTQ+ clubs’] sexual aspects also need to have visibility to question

heteronormativity.”

Participants hoped that such exposure offers an opportunity to reduce ignorance and

fear, increase awareness, and discuss their cultures and rights. Gunwoo said: “Ironically,

revealing information reduced fear and ignorance. Although it wasn’t on purpose, it revealed

LGBTQ+ places and how we hang.” Doyoon added: “Heterosexual Koreans don’t have

18

bathhouses and know about them. Gays have diverse opinions about bathhouses. We’ll need

to discuss our cultures, sexual rights, and how we consent to intercourse [inside and outside

LGBTQ+ communities].”

RQ2. What Increased Stigmatization and Discouraged COVID Testing

RQ2 asked what increased stigmatization and discouraged LGBTQ+ individuals from

getting tested. All participants said that increasing stigmatization made them hide and end up

not getting tested, traced, and treated, which could contribute to spreading COVID-19. Some

participants stated that public health authorities learned from their mistakes. Participants

identified the following discouraging factors for COVID-19 testing (see Table 2).

Public Health Authorities’ Lack of Understanding and Sensitivity. About half of

the participants believed that public health authorities lack understanding of and sensitivity

toward sexual minorities. Chaewon said: “I wish governments had considered the

discrimination and prejudice that sexual minorities face. Then, they could’ve more carefully

and thoughtfully responded without stigmatizing LGBTQ+s.” Minjae said: “Why didn’t

governments have anonymous testing from the beginning? People would’ve gotten tested

because they want to know. Then, I realized that governments had no idea how important it is

to let LGBTQs take the test anonymously.”

Some participants said that some local governments were not aware of LGBTQ+

groups and thought LGBTQ+ communities are like religious groups, with clear leadership

and hierarchy. Jiho said: “One local government dealt with gays as they dealt with a religious

cult, assuming that gays must have a president. They said we have to persuade the president

to get them tested.” Minjun shared:

One city government called the [city] Queer Festival Committee and asked for a list

of LGBTQ+ individuals living there. I realized they have no idea. There’s no such

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list. That's an outing. I was wondering if they thought of us like a religious or sports

group or something.

Conversely, a few participants shared that some local governments did consult with LGBTQ+

right organizations, which improved their understanding and responses.

Disclosing Contact Tracing Data That Can Identify Individuals. Most participants

felt concerned that public health authorities disclosed contact tracing information in such

detail that anyone can identify individuals, even without a name. Sunwoo said: “As contact

tracing reveals where they live and went in detail, their family and colleagues can identify

them. Also, they’re self-quarantined.”

As people questioned self-quarantined individuals’ sexual orientations with the

outbreak, many participants were frightened of being outed. Woojin shared: “One Itaewon-

infected person lives close to me. I got a warning message that he lives in [name] apartment

complex. I was very scared that I could be outed like him if I got tested.”

Some participants stated that identified individuals are subject to gossip. Woojin

added: “My colleagues were having so much fun learning who tested positive for COVID,

like celebrity gossip. They said, ‘he’s so good-looking, apparently gay; he has a girlfriend.

Then, maybe he’s bi or gay?’ Even the girlfriend’s photos were circulated.”

A few participants stated that the government improved such contact tracing by

keeping it confidential once they collected the needed data. Sunwoo said: “Now, they have

improved. Once the public health authority identifies people and their contacts, they keep it

confidential.”

Calling Out LGBTQ+ Bars, Clubs, and Bathhouses. Most participants felt that the

government’s emphasis on ‘gay’ bars, clubs, and bathhouses increased stigma and

discouraged getting tested. Chaewon said: “Governments should’ve considered that sexual

minorities can be a target of hatred and discrimination. They may say that they followed

20

protocols informing all locations and names. However, calling out clubs and bathhouses by

name caused unnecessary and inappropriate attention.” Minjae added: “They should’ve

shared that these locations are bars and clubs, not ‘gay’ bars or ‘gay’ clubs. Then, there’s no

concern about being outed, and people could confidently get tested.”

Some participants state that in particular, exposing a gay bathhouse in the warning

message stigmatized LGBTQ+ people, especially gay individuals, and made them hide.

Dohyun said: “People would judge gays as sexually freewheeling. I didn’t want to cooperate

after reading the warning message [calling out a bathhouse].” Jihoon said: “I wonder, did

they have to reveal and highlight a bathhouse? People may think, wow, all of them are weird.

We were framed.” Sunwoo added: “The CDC should’ve not called out LGBTQ+ spaces at

the beginning. You had to reveal that you were gay if you want to get tested. Then, there

were fewer risks of being outed.”

Negative Media Reports Regarding LGBTQ+ Cultures. Most participants pointed

to media reports that sensationalized LGBTQ+ cultures. Doyoon said:

A newspaper Kookmin Ilbo published an article, saying the COVID-19 case visited a

gay club in Itaewon. They should’ve asked whether they should call it gay or if

[clubgoers] should disclose their sexual orientations, and it’d help to contain COVID.

Yet, the media and the reporter have written so many [queer]phobic articles. It was

malicious and clickbait.

A few participants believed that the media eventually realized that such frames do not

help contain COVID-19 and changed their language. Sunwoo said: “After two, three days,

journalists started to say that this is wrong; people will be scared of being outed and hide, and

we’ll have more COVID cases. They changed the term from gay clubs to Itaewon clubs.”

Doyoon added that reporting revealing sexual minorities’ identities is against the

human rights reporting guidelines that the National Human Rights Commission of Korea and

21

Korea Journalist Association drafted. He said: “Kookmin Ilbo has violated the human rights

reporting guidelines. The journalist said that ‘it’s just a guideline and I don’t have to follow

it. If you want to raise an issue, you can do it in court.’”

RQ3. What Reduced Stigmatization and Encouraged COVID Testing

The second research question examined what reduced stigmatization and encouraged

LGBTQ+ individuals to get tested for COVID-19. All participants emphasized that reducing

stigmatization and not blaming stigmatized individuals are the key to help them get tested,

traced, and treated, especially when risks of being identified are high. Doyoon explained:

Infectious disease can get way worse when the infected people can’t reveal

themselves and get tested, but have to hide. It’s important to create an environment

where they can get tested freely. It’s not helpful to blame the infected or see them as

morally wrong to contain the disease.

Participants identified the following motivating factors to get tested for COVID-19 (see Table

2).

Anonymous Testing and Risk Communication Not Exposing LGBTQ+ People.

Most participants shared that anonymous testing helped reduce the risks of outing stigmatized

groups and thus encouraged them to get tested. Gunwoo said: “Seeing anonymous testing,

I’ve got the impression that the government finally realized the risks of outing the LGBTQs

and addressed the issue by creating a safe setting for them to get tested.”

Some participants also pointed out that communicating about the general

neighborhood and period, rather than publicizing names of LGBTQ+ clubs and bathhouses,

helped reduce stigma and encouraged getting tested. Doyoont said: “At the beginning, the

government mentioned specific clubs with specific dates. Then, they realized that some

people feel uncomfortable. Instead, they called it the Itaewon neighborhood and expanded the

period. Some people, who had been afraid, got tested.”

22

Fear of Causing Trouble and Transmission. About a half of participants said that

many LGBTQ+ individuals got tested because they were afraid of spreading the virus to their

friends and family, even without the government's anonymized testing. Doyoon from an

LGBTQ+ rights organization said: “After media reports, many people went to get tested. Not

everyone hid.” Jimin said: “Despite the risks, many people still got tested because they were

worried about their family and LGBTQ+ friends.” Sunwoo added:

I ran to the public health center and got tested. I met others who went to the club. I

was so scared of spreading COVID and outing others. I had to know that I’m negative

so that I can let others know that they’re safe.

Some participants explained that some people were so afraid of causing trouble to

others that they got tested. Gunwoo said:

Some of us were extremely scared of causing trouble to others and making others sick

with COVID, not just us being sick. Despite high risks, many gays got tested, because

they didn’t want to be a murderer. You’re a murderer if you don’t get tested.

Encouragement from LGBTQ+ Communities. A few participants noted that

LGBTQ+ communities’ encouragement on community websites, dating apps, and other

social media motivated them to get tested. Minjun, who was on a task force team, said:

We placed banner ads on dating apps, community websites, and cartoon pages by

contacting the companies and paying for the ads. The key message was that now that

we have anonymized testing, let’s get tested for your partner, family, and community.

Jimin noted: “It was more comforting and credible to see messages from the LGBTQ

community asking us to get free, anonymous COVID testing, compared to emergency

messages from the government.”

Many participants shared that LGBTQ+ individuals supported and encouraged each

other to get tested. Doyoon said: “Many LGBTQ+ individuals shared support messages in

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various communities, such as ‘we’re in this together,’ ‘let’s help get tested,’ ‘don’t blame

each other,’ and ‘stay positive although you tested positive.” Joowon said:

People were looking out for one another. Everyone was aware of what’s happening

and what to do. A lot of people were like, “Fuck what the others say, I am going to get

tested.” Even on [dating apps], a lot of people put up pictures saying, “Go get tested”

for a few weeks.

Lastly, some participants said that celebrity support was also helpful. Gunwoo said:

“When [openly-gay] celebrity Hong Seok-Cheon encouraged LGBTQ+ individuals to get

tested and be responsible, it inspired others.”

Discussions

As one of the first empirical studies to examine the intersectional stigmas that

LGBTQ+ individuals in Korea experience during the COVID-19 pandemic, this study

provides insights into such stigma among minorities and how organizations can better

communicate infectious disease risks to help stigmatized groups overcome stigma.

Intersectional Stigmas (RQ1)

First, results reveal the compounding effect of intersectional stigma (e.g., LGBTQ+

stigma, COVID-19 stigma) on LGBTQ+ individuals living in Korea. For individuals in this

study, experiences with COVID-19 stigma mirrored past interactions where they had been

stigmatized because of their sexuality, while worsening and exacerbating the stigma

experiences from their layered identities. Participants shared stories of being called

“disgusting,” and of being accused of spreading everything from anal sex, STDs, and AIDS

now to COVID. The faulty logic of this stigmatizing belief may seem (and is) absurd.

However, moral stigma associated with sexual minority status has long led dominant groups

to blame these minorities, such as LGBTQ+ individuals, for disease transmission (Kapiriri &

Ross, 2020; Wallach et al., 2020). Given the layered stigmas that participants faced, it is no

24

wonder LGBTQ+ individuals experience barriers to healthcare access across a host of health

conditions (Utamsingh et al., 2015; Wallach et al., 2020).

Second, these interviews suggest that intersectional stigma messages rely on common

tactics that may associate stigma features with one another to gain traction. Participants’

intersectional stigma experiences reflects all four features of stigma communication, which

emerged in participant responses (Smith, 2007): labels (“homos,” [slur words]), marking

(being crazy about anal sex, promiscuity, transmitting viruses), responsibility (irresponsibly

spreading viruses for the sake of their pleasure, carelessly harming others, defying national

interests), and peril to the community (spreading homosexuality, and AIDS and COVID-19

risks) (see Table 3). Uniquely, the expression of these stigma message features consistently

relied on connections between layers of identity. As participants recounted their stigma

experiences, it became clear that underlying the specific stigma transmitted during the

COVID-19 outbreak was the sexuality stigma and discrimination that LGBTQ+ individuals

still face daily. Future work should seek to document how people spread stigmatizing

messages that call on multiple stigmatizing narratives.

Table 3. Intersectional Stigma Communicated to LGBTQ+ People During and After the

COVID-19 Outbreak

Intersectional Stigma Communicated to LGBTQ+ People During and After the

COVID-19 Outbreak

Stigma Communication

Component Example

Labels “homos,” [slur words]

Marking being crazy about anal sex, promiscuity, transmitting viruses

Responsibility irresponsibly spreading viruses for the sake of their pleasure,

carelessly harming others, defying national interests

Peril to the community spreading homosexuality, and AIDS and COVID-19 risks

The connection between layered stigma experiences and negative health outcomes

also affirms the need for intersectional perspectives in stigma research. LGBTQ+ individuals

often identified themselves as second-class citizens and suffered from depression and suicidal

thoughts. Much research has documented stigma’s connection to negative health outcomes,

25

including depression, stress, internalized queerphobia, and suicidal ideation (Bozinoff et al.,

2018; Cho & Sohn, 2016; Lee et al., 2019). This study provides empirical evidence that

intersectional stigmatization can contribute to LGBTQ+ individuals’ psychological burdens

during the pandemic (Kline, 2020; Salerno et al., 2020).

This study illuminates the fear and discrimination that LGBTQ+ people living in

South Korea regularly experience, which was worsened during the COVID-19 pandemic.

Participants in our study commonly experienced risks of being outed, witch hunts, verbal

abuse, violence, and losing their jobs. During the pandemic, LGBTQ+ people in Korea were

exposed to risks of being outed and losing their family, friends, peers, colleagues, and even

jobs because of the public health measures and risk communication. These participants

emphasized that Korean LGBTQ+ individuals are systematically vulnerable to discrimination

in employment and housing because of no legal or policy protection (e.g., anti-discrimination

laws) (W. Lee et al., 2019), especially during the pandemic. LGBTQ+ people in the military,

public organizations, and education were more vulnerable of losing jobs than others, while

young LGBTQ+ people (e.g., in colleges) also feared being outed. This study extends the

prior research by demonstrating how traditional Confucianism-based culture, mandatory

military service, and anti-LGBTQ+ Christianity groups can stigmatize and reinforce sexuality

stigma in Korea (Adamczyk & Cheng, 2015; Youn, 2018).

Finally, intersectional sexuality studies should also examine the unique experiences of

subgroups in the queer community. Lesbian, bisexual, transgender, and other queer

individuals in the study lamented that gays were more stigmatized because more people were

aware of them. Alternatively, lesbian participants shared that they feel higher threats of being

outed than gay participants. It is important not only to study the queer community, but to

recognize that subgroups in the queer community face different access barriers. Transgender

individuals often experience higher levels of discrimination (Kattari et al., 2016). Progress for

26

LGBTQ+ issues must both unite the queer community, yet not overlook the unique

experiences of its subgroups.

Reducing Stigma and Promoting Public Health (RQ2 and RQ3)

Given the severe intersectional stigmas and discrimination, results revealed that

removing personal blame and identity disclosure risks is key to encouraging LGBTQ+

populations to get testing, tracing, and treatment. Stigma inevitably incites fear of disclosing

COVID-19 symptoms or status (Abdelhafiz & Alorabi, 2020; Murray et al., 2021) and has

led to discrimination (Corrigan & Watson, 2002), which may discourage testing and

treatment. Many participants in this study confirmed that the perception that LGBTQ+ people

were at fault, either individually or as a group, for the spread of COVID-19 led to fear of

being outed and the urge to hide from society. Reducing stigma about disease transmission

begins with a cognitive reframe. Rather than sending media messages that mention

“bathhouses,” or neighborhood, or call out “people who were at the gay bar [name],”

governments and media organizations need to be more thoughtful with their language choices

(Dhanani & Franz, 2021; Labbé et al., 2022; Lim, 2020; Wallach et al., 2020), including

spaces and places (Taggart et al., 2022). Media organizations can adopt and enforce human

rights reporting guidelines. By never circulating these stigmatizing ideas, message senders

could dampen transmission of stigma and COVID-19.

Many LGBTQ+ participants stated that public health authorities lacked understanding

and sensitivity; participants also shared that public health authorities’ responses improved

after consultation with LGBTQ+ human rights groups. Governments around the world may

want to partner, consult, and collaborate with local stigmatized groups for effective risk

communication to ensure their healthcare access (Gato et al., 2021; Kline, 2020), as also

suggested by best practices in risk communication (Liu et al., 2021; Seeger, 2006).

27

Additionally, most study participants found it helpful that LGBTQ+ communities

used various tailored, in-group communication channels, such as dating apps, LGBTQ+

community websites, and social media, to support each other. Participants also found it

helpful that LGBTQ+ communities used messages with hope, compassion, empowerment,

and community benefit, such as ‘get tested for your partner, family, and community,’ ‘we’re

in this together,’ ‘don’t blame each other,’ and ‘stay positive although you tested positive.”

Governments and communities need to identify preferred, trusted messengers (i.e.,

communication channels and information sources) and messages to effectively communicate

with stigmatized groups (Lim et al., 2022; Liu et al., 2021; Nan et al., 2022). By using trusted

in-group messengers, public health authorities will be able to build the social capital, trust,

and the network and lower stigmatization (An & Lee, 2019; Nan et al., 2022; Utamsingh et

al., 2015). Future research can systematically examine such risk communication messages,

channels, and sources across different cultures and communities (e.g.,).

Finally, the results of this study provide practical steps for public health authorities

and media outlets that respect privacy and reduce discrimination. As LGBTQ+ individuals in

this study shared, getting tested for the virus initially brought with it a risk of being outed.

Public health authorities eventually corrected their mistakes and stopped labeling LGBTQ+

communities as sites of transmission, but the (stigma) damage was done. As their locations

and privacy were compromised, LGBTQ+ people faced an impossible choice: get tested to

protect others or isolate themselves to avoid violence and discrimination. Some LGBTQ+

individuals got tested despite the risks to their livelihoods in order to protect their friends,

family, and colleagues. However, none should have had to choose.

By anonymizing the testing procedure, governments could avoid disclosing a person’s

stigmatizing identity or symptoms (Abdelhafiz & Alorabi, 2020; Murray et al., 2021) and

encourage stigmatized groups to engage in infectious disease testing and treatment. Public

28

health authorities could question and remove their heteronormativity (Utamsingh et al., 2015)

and create separate risk communication protocols for stigmatized groups. The results also

highlight the need for legal and policy measures, such as anti-discrimination laws, which

governments can adopt to help and protect stigmatized groups (Logie & Turan, 2020;

Nyblade et al., 2019; Rao et al.,2019). Currently, no laws or policies protect LGBTQ+

individuals in Korea from discrimination in employment and housing (W. Lee et al., 2019).

In sum, Table 4 presents the recommendations.

Table 4. Recommendations To Reduce Stigma and Promote Public Health

Recommendations To Reduce Stigma and Promote Public Health

1 Anonymize the testing and treatment procedures – Remove identity disclosure risks.

2 Remove personal blame – Avoid calling out particular groups, locations, or using

symbols associated with the groups.

3 Partner, consult, and collaborate with stigmatized groups.

4 Use trusted, preferred, in-group messengers (i.e., communication channels and

information sources).

5 Use messages with hope, compassion, empowerment, and community benefit.

6 Media organizations can adopt human rights reporting guidelines.

7 Review and remove their heteronormativity and create risk communication protocols

for stigmatized groups.

8 Establish legal and policy measures, such as anti-discrimination laws, to prevent

discrimination.

Limitations

Like any qualitative study, this study has limitations. The results are not generalizable

to other countries or contexts, although some implications may be applicable to other

contexts (e.g., mental health, disability) with stigmatized minority (Tracy, 2010). Although

we collected the data during the pandemic, participants still may have a retrospective bias

(e.g., Fischhoff et al., 2005; Lim et al., 2019). Lastly, most of our participants identified

themselves as gay, lesbian, and bisexual; we had few gender-fluid, transgender, or pansexual

participants. Future studies can further address the diversity of LGBTQ+ groups and their

experiences with stigma as well as other infectious diseases (e.g., SARS, MERS,

monkeypox).

29

Conclusion

This study is one the first empirical studies that examine the intersection of these

stigmatized identities among LGBTQ+ individuals in South Korea during the pandemic. This

study also identified how organizations can help stigmatized groups overcome stigma and

engage in public health behaviors. This study answers a call for more work that embraces an

intersectional approach (Turan et al., 2019) and communication to help stigmatized groups

(Drapalski et al., 2021; Lefebvre et al., 2020). This study can inform governments,

communities, and media about how to better communicate to help stigmatized groups engage

in testing, tracing, and treatment (Dhanani & Franz, 2021; Islam et al., 2021; Wallach et al.,

2020).

30

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Appendix. Semi-Structured, In-Depth Interview Guide

Introduction

1. Tell me about yourself.

Internalized/external Stigma towards groups

2. What does it mean to be an LGBTQ person in Korea?

1. Probe: How do others think about LGBTQ people in Korea?

2. Probe: How do you feel about it?

3. Have you been afraid that your identity is disclosed by others? Why?

COVID-19 and group stigma: Changes

4. How did you feel about the COVID19 outbreak in Itaewon?

5. How did the COVID19 change how “others” think LGBTQ people?

6. How did the COVID19 change how “you” think LGBTQ people?

COVID-19 and group stigma: Get tested

7. Would LGBTQ people in Itaewon/nationwide get tested? Why?

8. What makes LGBTQ people get tested?

9. What hinders LGBTQ people get tested?

10. Who do LGBTQ people want to hear from about getting tested? In other words, who

would LGBTQ people listen to about getting tested?

11. What efforts, if at all, have been made among LGBTQ+ communities regarding

COVID-19 risks?

COVID-19 government tracing and messages responses

12. [Showing messages] How did you feel when reading these government messages?

13. What has the government done well in communicating with LGBTQ people?

14. What could the government have done better in communicating with LGBTQ people?

15. How can we motivate the LGBTQ+ groups to get tested?

Reducing stigma

16. How can we reduce these negative attitudes toward LGBTQ people?

Wrap-up

17. Is there anything you want to share?