Identifying and Serving LGBTQ Youth: Case Studies of Runaway and Homeless Youth Program Grantees. I. Introduction

02/14/2014

Research suggests that young people who are lesbian, gay, bisexual, transgender, or questioning their sexuality (LGBTQ) face a disproportionate risk of homelessness. Available data on youth homelessness are limited and not nationally representative, but studies of homeless youth served by individual providers or in local areas have found that 6 to 35 percent identify themselves as LGBTQ (Substance Abuse and Mental Health Administration 2011).1 In comparison, analyses of data from the National Longitudinal Study of Adolescent Health found that 7.4 percent of boys and 5.3 percent of girls in grades 7–12 reported same-sex romantic attraction, and results of a recent nationally representative survey of U.S. adults indicate that approximately 3.4 percent identify as LGBT (Russell et al. 2001; Gates and Newport 2012). According to a study of a representative sample of high school students in one state, lesbian, gay, and bisexual youth and heterosexual youth who have same-sex sexual partners are 4 to 13 times more likely than exclusively heterosexual youth to be homeless (Corliss et al. 2011). Providers serving homeless youth also report that LGBTQ youth are overrepresented among the youth they serve. Respondents to a national nonrepresentative survey of providers estimated that LGBTQ youth comprise 40 percent of their clientele, on average (Durso and Gates 2012).

Homeless LGBTQ youth also might be more likely than their heterosexual counterparts to experience victimization, engage in high-risk sexual behaviors, and have poor mental health. Several studies have found that lesbian, gay, and bisexual youth are more likely than heterosexual youth to (1) have been physically or sexually victimized, (2) engage in survival sex or sex work, (3) have attempted suicide, (4) use illicit substances, and (5) have greater mental health concerns (Cochran et al. 2002; Van Leeuwen et al. 2006; Ray 2006; Toro et al. 2007; Tyler 2008). Although these studies are not representative of the entire homeless youth population, considered together, they suggest that LGBTQ homeless youth are at high risk of poor outcomes.

In response to these indications of higher prevalence of homelessness among LGBTQ youth and potentially greater risks for those experiencing homelessness, government and private organizations have suggested approaches for enhancing services for LGBTQ youth in out-of-home care (see, for example, National Alliance to End Homelessness et al. 2009; Wilber et al. 2006; Ray 2006; SAMHSA n.d.). Common suggestions include the following:

  • Establishing nondiscrimination, antiharassment, and confidentiality policies that address sexual orientation and gender identity, and creating safe and inclusive agency environments
  • Enhancing LGBTQ cultural competency among staff through training and other supports
  • Providing flexible and tailored programming for LGBTQ youth, including interventions that focus on family acceptance and reunification
  • Addressing the unique health and shelter needs of transgender clients
  • Establishing connections with other community organizations serving LGBTQ youth
  • Collecting data on LGBTQ youth receiving services and using these data to educate decision makers and assess patterns in service provision and outcomes

Some agencies serving homeless youth have already accomplished one or more of these suggested steps. Agencies that serve primarily LGBTQ homeless youth operate in several large cities and tailor many services to this population.2 The Williams Institute’s Homeless Youth Provider Survey (HYPS) gathered information from 354 organizations nationwide on their experiences providing services to homeless LGBTQ youth. Approximately 24 percent of services and activities offered by agencies responding to the survey targeted LGBTQ clients (Durso and Gates 2012).3 In addition, 85 percent of survey respondents agreed with the statement, “I am very knowledgeable about LGBT homeless youth,” indicating they believe themselves competent to work with this population (Durso and Gates 2012).

Yet much remains to be learned about whether and how agencies serving runaway and homeless youth (RHY) implement practices to address the specific needs or circumstances of LGBTQ youth. To better understand provider experiences serving LGBTQ RHY, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S. Department of Health and Human Services (HHS), in collaboration with the Office of Planning, Research and Evaluation (OPRE) in the Administration for Children and Families (ACF), HHS, sponsored case studies of local agencies receiving grants from ACF’s RHY Program. The purpose of the study, conducted by Mathematica and its subcontractor, the Williams Institute, was to learn about programs’ strategies for identifying and serving LGBTQ RHY, the challenges programs face in understanding and addressing the needs of this population, and potential areas for future research.

The study addressed four sets of questions:

  1. What are providers’ approaches to collecting and using data on the sexual orientation and gender identity of the youth they serve? What information do providers collect, and when? Do providers use data on sexual orientation or gender identity to tailor services to individual clients or assess program performance? What challenges do providers experience in collecting data on LGBTQ RHY?
  2. What do providers perceive to be the key needs and capacities of LGBTQ RHY? How do programs assess these needs and capacities? Do program staff perceive differences in needs and capacities of LGBTQ and non-LGBTQ youth?
  3. What strategies do providers implement in working with LGBTQ RHY? How, if at all, do organizations tailor their services to LGBTQ RHY? What successes and challenges have providers experienced providing services to these youth?
  4. What research gaps affect providers’ ability to understand and meet the human service needs of LGBTQ RHY? What data or information are needed to provide services more effectively to this population?

The study aimed to document agency experiences and staff perspectives among a select group of RHY Program grantees, rather than to identify best practices in serving LGBTQ RHY.

Two government initiatives related to services for LGBTQ youth inform the study questions. The first is the United States Interagency Council on Homelessness (USICH) Framework to End Youth Homelessness, which prioritizes improving (1) data collection and quality; and (2) providers’ capacity to serve especially vulnerable groups, including LGBTQ youth (USICH 2013). (We describe the USICH Framework in more detail later in this chapter.) The second initiative is an OPRE project to develop a research agenda on the human service needs of LGBT populations.4 The case studies provided an opportunity to gather input from providers on research priorities related to LGBT populations, especially homeless youth.

Key Terms: Sexual Orientation, Gender Identity, Gender Expression, and Transgender

According to the American Psychological Association (2011):

  • Sexual orientation refers to “the sex of those to whom an individual is sexually and romantically attracted” and generally includes the categories lesbian, gay, bisexual, and heterosexual.
  • Gender identity refers to “one’s sense of oneself as male, female, or transgender.”
  • Gender expression is “the way a person communicates gender identity to others through behavior, clothing, hairstyles, voice, or body characteristics.”
  • Transgender is a broad term describing people whose self-identified gender or gender expression does not correspond to their biological sex or sex assigned at birth.

 

Next, we describe the RHY Program and other key federal efforts related to youth homelessness, site selection criteria and characteristics of the four case study sites, data collection methods, and the organization of the rest of the report.


1 The ages of young people in these studies vary. For this study, we adopt the definition of youth that the U.S. Interagency Council on Homelessness (USICH) uses: people up to 24 years old. The Runaway and Homeless Youth Program of the Administration for Children and Families, U.S. Department of Health and Human Services serves youth up to 22 years old.

2 Examples include the Ali Forney Center and Green Chimneys in New York City; the Ruth Ellis Center in Detroit, Michigan; and the Gay and Lesbian Community Center in Los Angeles, California.
3 A total of 381 people, representing 354 agencies, responded to the survey.
4 For more information on this project—the Research Development Project on the Human Service Needs of LGBT Populations—please visit http://www.acf.hhs.gov/programs/opre/research/project/research-developme....

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