In general, staff in case study agencies did not perceive major differences in the types of risks faced by LGBTQ and non-LGBTQ RHY. However, they did indicate that certain risks may be especially frequent among LGBTQ RHY or have distinctive contributing factors. For example, staff at one agency explained that they provide services using a trauma-informed perspective to understand how experiences of violence, abuse, and other adverse experiences shape all youths’ thoughts, feelings and behaviors. Although all RHY are likely to have experienced trauma, among LGBTQ RHY, these experiences may be connected with negative responses to the youths’ sexual orientation or gender identity from family, peers, and others.
Agency staff considered several risk factors to be salient for LGBTQ RHY. Although data are not available to confirm whether these risks affect LGBTQ youth disproportionately in case study agencies, staff perspectives concur with findings from existing research (summarized in the introduction to this chapter). Risk factors highlighted by staff include the following:
- Emotional distress, poor mental health, and substance abuse. Staff in all case study agencies perceived that LGBTQ RHY often contend with issues related to mental health. At two sites, staff reported that LGBTQ youth are more frequently referred than other youth for mental health treatment. Emotional distress among LGBTQ RHY may be a result of life trauma intensified by negative reactions from family and community to disclosure of sexual orientation, gender identity, or both. Staff noted that LGBTQ RHY appear to be likely to exhibit signs of depression, heightened anger and issues with conflict resolution, and uncertainty around identity development. Staff also reported that LGBTQ RHY frequently experience problems with drug or alcohol abuse, a perception consistent with findings from previous research.
- Sexual risk behavior and sexual exploitation. A few staff members noted a propensity among LGBTQ RHY to engage in risky sexual behavior and face exposure to sexually transmitted infections, a perception supported by analyses of data from the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System (Kann et al. 2011). This pattern may be linked to a general tendency among youth to take risks, but studies also have found an association between stressors related specifically to gay, lesbian, or bisexual sexual orientation (such as social isolation or victimization) and high-risk sexual behavior and other problem behaviors (Rotheram-Borus et al. 1995). Similar factors may contribute to problems LGBTQ RHY experience related to sexual exploitation, including human trafficking, which staff at one agency perceived to be more common among LGBTQ youth than other youth they serve.
- Family problems, relationship issues, and intimate partner violence (IPV). Staff in all agencies indicated that LGBTQ RHY are likely to have endured family and social rejection, sometimes directly linked to their sexual orientation or gender identity. However, a few expressed caution about assuming that family conflict is the primary driver of LGBTQ youth homelessness, which can also result from families’ difficult economic circumstances or parents’ personal issues. LGBTQ RHY may also have general difficulty forming trusting relationships, according to some staff, possibly because of experiencing IPV, an absence of adult role models, or efforts to avoid disclosing their sexual orientation or gender identity. Some staff members highlighted IPV, in particular, as a problem among LGBTQ RHY. Indeed, results of one study of violence and abuse within dating relationships among a sample of 5,647 middle- and high-school youth in three states confirms this impression. The study found that lesbian, gay, and bisexual youth were at elevated risk for dating violence victimization and perpetration, compared to their heterosexual peers, and that transgender youth were more likely than non-transgender male or female youth to be victimized and to perpetrate violence (except psychological abuse) (Dank et al. 2013).
Staff also mentioned risks relevant to subpopulations of LGBTQ youth, particularly transgender youth and youth of color. Staff in one agency felt that it was sometimes difficult when working with transgender youth to balance youths’ understandable focus on gender transition with the need to address other concerns, including housing and employment. Transgender youth also were perceived to be at particular risk of emotional distress resulting from discrimination or harassment, both by peers and within the larger community.
Staff in two agencies noted that LGBTQ youth of color face particular obstacles related to family and community acceptance. Staff shared the impression that minority racial and ethnic communities may be more likely to be connected to cultural or religious institutions that are not supportive of LGBTQ people and that LGBTQ youth in these communities may be likely to experience rejection by families and others as a result. These impressions echo findings in other research indicating that LGBTQ youth who are racial or ethnic minorities encounter challenges in family and community relationships. One study of Latino and non-Latino LGBT young adults, for example, found that Latino families, immigrant families, and families with high religious involvement were less likely to be accepting of LGBTQ youth (Ryan et al. 2010). In another study, representatives of schools and community organizations working with LGBT youth of color in Los Angeles indicated that gay, bisexual, and transgender male youth may have difficulty accessing services in racial or ethnic minority communities where religious organizations are prominent providers, due to stigma or prejudice (Durso et al. 2013).
According to agency staff, experiences among LGBTQ youth have the potential to support development of protective factors or personal capacities. In particular, resiliency among LGBTQ homeless youth may increase as they learn to contend with discrimination. Staff perceived LGBTQ youth to be “survivors” who develop self-protection skills after experiencing stigma and rejection. LGBTQ youth may also build resiliency by successfully connecting with other youth who share their sexual orientation or gender identity.