Agencies’ experiences collecting information on sexual orientation and gender identity of youth highlight factors that may affect data completeness and accuracy. They also suggest issues for policymakers and other stakeholders to consider when interpreting sexual orientation and gender identity data on RHY.
Community context, agency reputation, and youths’ personal interactions with staff appear to influence whether youth answer questions on sexual orientation and gender identity. Staff at one agency noted that youth in their service area generally do not have difficulty responding to questions on sexual orientation or gender identity. Staff speculated that the agency’s urban location and its reputation as welcoming to LGBTQ people likely contribute to youths’ comfort revealing their LGBTQ identities. Staff from several agencies affirmed that a clearly welcoming environment encourages LGBTQ youth to seek services and increases the likelihood they will be open about issues of sexual orientation and gender identity. Training in LGBTQ issues, which may give staff members more comfort addressing these topics, may also support youth reporting of sexual orientation or gender identity. In contrast, staff working at another agency noted that community mores appeared to discourage youth from revealing their sexual orientation and gender identity, even to staff who identify as LGBTQ. In all sites, staff highlighted the importance of establishing a rapport with youth to facilitate communication on sensitive issues, including sexual orientation and gender identity.
Concerns about risk of disclosure make some staff reluctant to collect data on sexual orientation and gender identity. Although staff across agencies generally agreed that collection of data on sexual orientation and gender identity could be useful for service provision, they voiced differing opinions about whether an agency ought to collect this type of information. Some staff members reported few concerns about collecting, documenting, or disclosing sexual orientation or gender identity data, as long as agency guidelines on confidentiality were followed. However, one agency director noted that a tension exists in administrative data collection between the public’s desire for information and the agency’s interest in maintaining the privacy of its clients. A few staff members across agencies voiced the view that reporting data on the sexual orientation and transgender identity of youth served should be optional for programs, since clients may not feel safe sharing this information.
A minority of staff at RHY providers and their partner agencies expressed concern that information, particularly on youth under age 18, could be disclosed outside the agency. For example, a representative of one partner agency serving homeless minors noted that the agency could be required to release information in case files to parents or child welfare officials without the consent of the youth involved. Such disclosure could create problems for young people whose families might not accept their sexual orientation or gender identity, or for youth referred to a child welfare agency perceived to be unsupportive of LGBTQ youth. Staff members at another agency described their service area as socially conservative and voiced concern that disclosure of a youth’s sexual orientation or gender identity could result in harassment by others in the community. For that reason, staff preferred not to push youth to share such information.
The presentation of questions on sexual orientation and gender identity affects how data are collected and can be interpreted. Staff from an agency that incorporates sexual orientation and gender identity questions on its intake form affirmed that the inclusion of such questions encourages routine collection of these data. In agencies without clear protocols for asking about sexual orientation or gender identity, staff members’ skills influence whether and how these data are collected. One direct service provider observed that the absence of specific sexual orientation and gender identity questions on the agency’s intake or assessment forms places the burden on the staff member to initiate a conversation and phrase questions appropriately. The success of the process then relies heavily on the provider’s comfort level with, and knowledge of, LGBTQ issues.
When agencies include sexual orientation and gender identity questions on forms, they do not always use similar question formats. Some agencies include an “other” category, for example, to accommodate those who wish to avoid labels or embrace a fluid concept of sexuality. In addition, questions and response options in agency forms are not always consistent with items in RHYMIS. Agencies’ current approaches may support identification of individual LGBTQ clients and estimates of the size of the LGBTQ population served at the agency level. However, because agencies do not use standardized questions or response categories, and response modalities to these questions vary (questions may be self-administered or asked by staff during an interview), caution is required in comparing reported proportions of LGBTQ youth among agencies or aggregating data across them.
Information on LGBTQ identification and information gathered after initial intake sessions or assessments is not likely to be recorded in agencies’ management information systems (MIS). Agencies that record information on sexual orientation and gender identity usually do so during intake sessions or initial assessments with youth. Some youth seeking services might not wish to disclose their sexual orientation or gender identity during early contacts with staff, and others might not yet be developmentally ready to articulate their sexual orientation or gender identity. Therefore, agency information systems are not likely to reflect information on sexual orientation and gender identity shared after these early contacts. Moreover, staff in three of the four case study agencies reported that it is not uncommon for LGBTQ-identified youth to change how they describe their sexual orientation or gender identity while they participate in services. Staff adjusted to these transitions (for example, by changing pronouns used to refer to a youth). However, they usually did not update any demographic data initially collected from youth and stored in their agency’s records or MIS.
The accuracy of RHYMIS data on the number of LGBTQ youth served is uncertain and might vary widely among agencies. Staff in sites that collect and record information on sexual orientation, gender identity, or both believed that statistics reported to RHYMIS accurately indicate the number of youth willing to disclose their LGBTQ identity during intake sessions. However, they noted that RHYMIS data probably underreport the number of LGBTQ youth served, because (1) not all programs within agencies include intake processes that address sexual orientation and gender identity and (2) youth were not always willing to provide responses to questions on LGBTQ identity. In sites that do not have systematic processes for collecting or recording information on sexual orientation or gender identity, data on LGBTQ identification reported in RHYMIS are also likely to be incomplete and based on staff estimates.