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Available evidence suggests that substance use may affect spermatogenesis, secretion of reproductive hormones through the hypothalamic-pituitary-gonadal (HPG) axis, and sexual function 31,32,33,34,35,36

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Among adults aged 18 or older in Quarter 4 of 2020 who received mental health services in the past year, more than half (58.3 percent or 26.6 million people) had appointments moved from in person to telehealth, and 1 in 3 (38.7 percent or 17.7 million people) experienced delays or cancellations in appointments (Figure 60)

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