Identifying and Serving LGBTQ Youth: Case Studies of Runaway and Homeless Youth Program Grantees. III. Assessment and Perceptions of Needs and Capacities of Lgbtq Runaway and Homeless Youth


The USICH intervention model for homeless youth identifies screening and assessment of youth as a first step toward targeting services appropriately. Assessments identify risk factors, which are “problematic symptoms, behaviors, and associations” that may contribute to poor outcomes, and protective factors, which are “positive skills, attitudes, behaviors, and associations” that counteract the effects of risk (U.S. Interagency Council on Homelessness 2012).9 According to the model, assessments should help providers determine how long a youth has been homeless (because a longer time on the streets is likely to put youth at higher risk), the risk factors that services should mitigate, and the protective factors that should be enhanced.

LGBTQ homeless youth may experience different patterns of risk from other homeless youth. One study of homeless youth in Seattle, for example, found that LGBT youth exhibit mental health or behavioral issues at higher rates than heterosexual youth, including such traits as delinquency, aggression, and withdrawn behavior (Cohran et al. 2002). Another survey found that lesbian, gay, and bisexual (LGB) youth in six states were more likely than non-LGB youth to engage in survival sex and substance abuse (Van Leuuwen et al. 2006). LGBTQ youth also may be more likely to experience rejection by parents, which contributes to youth homelessness (Quintana et al. 2010). According to existing research, transgender people, including youth, appear to face widespread discrimination in employment and housing, and tend to have difficulty accessing safe and appropriate shelter when homeless (Grant et al. 2011; Mottet and Ohle 2003).

LGBTQ youth may also benefit from protective factors in distinct ways. Support of friends and family may be especially important for youth who are sexual minorities. According to one study, this type of support positively affects measures of well-being among LGB youth, with family support, in particular, associated with reduced mental distress (Shilo and Savaya 2011). In another study, perceptions of social support, a sense of being connected to other people, and self-esteem in being part of a larger community (such as the LGBT community) were linked to psychological well-being among LGB youth (Detrie and Lease 2007). An emerging area of research focuses on the potential for resiliency—the ability to overcome challenges or trauma—to lessen the psychological harm that LGBT victims of harassment or violence may experience.

Our discussions with agency staff explored approaches to conducting assessments of homeless youth and addressing issues of sexual orientation and gender identity in this process. To better understand service provider perceptions, we also asked staff about the risks or needs exhibited among LGBTQ youth they serve, and how, in their experience, they compare between LGBTQ and non-LGBTQ youth. We found the following:

  • Assessment tools may help staff explore risks or needs related to LGBTQ identity, but these issues are more often addressed during less structured discussions with youth.
  • Many staff felt that homeless youth face similar types of risks, regardless of sexual orientation and gender identity. Nevertheless, some types of risks—emotional distress and poor mental health, substance abuse and sexual risk behavior, and problems with family and personal relationships—were perceived to be particularly salient or frequent among LGBTQ youth.
  • According to staff reports, some LGBTQ youth encounter barriers to accessing services or resources that may enhance protective factors, including health and employment. These barriers may be especially high for transgender youth.

9 Risk factors specified in the USICH model include (1) trauma, (2) emotional distress, (3) sexual risk behavior, (4) family problems, (5) criminal or delinquent behavior, and (6) substance abuse. Protective factors specified include (1) family cohesion and support, (2) school engagement or employment, (3) survival skills, (4) positive connections, (5) positive future expectations, (6) decision-making skills, (7) self-esteem and self-efficacy, and (8) health.

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