Agencies are taking steps to meet the needs of LGBTQ RHY, based on guidance issued by advocacy and professional organizations, staff expertise, and experience working with this population. However, much remains to be learned about the characteristics and experiences of LGBTQ RHY, including how many LGBTQ youth are homeless, the reasons they become homeless, and the nature of risk and protective factors among them. Moreover, limited data sources currently exist to explore these issues. Staff in study sites identified many specific information gaps and potential directions for future research. In addition, the case studies point to several issues regarding data collection and services for LGBTQ RHY for policymakers and program managers to consider.
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A. Data Gaps and Research Needs
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We asked staff in case study agencies to identify the kinds of information and research that might help them understand the characteristics and experiences of LGBTQ RHY more completely and provide effective services to this population. Staff recommended future research in six general areas: (1) the size of the LGBTQ RHY population in local areas, (2) characteristics of subpopulations of LGBTQ RHY youth, (3) risk and protective factors among LGBTQ RHY, (4) factors contributing to LGBTQ youth homelessness, (5) experiences of LGBTQ youth involved in multiple systems, and (6) service models that focus on LGBTQ RHY.
Size of the LGBTQ RHY population in local areas. According to agency staff, community-level data on the number of RHY who identify as LGBTQ would help agencies understand whether they are reaching this population successfully. These data also may help them gauge whether current services align with the characteristics of the local RHY population. New efforts to enumerate the homeless population may provide some of this information. For example, HUD requires that communities receiving funding conduct annual point-in-time counts of the number of homeless people in shelters and transitional housing and, every other year, of people who are unsheltered. In 2013, these counts will be reported by age categories, including under age 18 and ages 18 to 24, for the first time. In addition, the federal Youth Count! initiative, which is testing strategies for developing accurate counts of unaccompanied homeless youth, may eventually provide the resources to help communities and agencies to gather accurate data. The Youth Count! initiative includes a focus on highly vulnerable subpopulations and has provided guidance to participating cities on asking youth questions about their sexual orientation and gender identity.
Characteristics of subpopulations of LGBTQ youth. Agency staff members expressed an interest in better understanding the characteristics, experiences, and needs of transgender youth (including transgender youth of color) and LGBTQ RHY of color in general. Although staff perceived these subpopulations to be at particularly high risk of poor outcomes, little is known about the proportion of the RHY population these youth comprise, the specific risk factors prevalent among them, or their outcomes. Researchers studying these subpopulations often encounter challenges related to limited sample sizes, but qualitative studies with relatively small numbers of participants may still shed light on potentially distinct circumstances or needs among transgender RHY and racial or ethnic minority LGBTQ RHY. In addition, staff suggested that research would be helpful on the particular challenges that LGBTQ RHY in rural areas face. Understanding how these youth navigate such barriers as a lack of transportation and few nearby LGBTQ organizations may help providers better reach and serve them.
Risk and protective factors among LGBTQ RHY. Staff members pointed to three risk factors that appear to be prevalent among LGBTQ RHY and could be better understood. First, agency staff indicated a need for additional information on the types and severity of mental health disorders among LGBTQ RHY and appropriate services for addressing them in the context of RHY programs. Second, LGBTQ RHY may be at higher risk than non-LGBTQ youth for human trafficking and sexual exploitation. Staff suggested that more research is needed to understand the prevalence of these problems, which youth are most at risk, and why youth enter into relationships that are considered exploitative. This information might help practitioners and researchers identify strategies to prevent youth from being exploited. Third, staff noted that additional information is needed on the prevalence of relationship violence among LGBTQ RHY. Research exploring factors that put LGBTQ youth at risk for intimate partner violence, level of conflict management skills among LGBTQ RHY, and strategies to promote violence prevention would be helpful. In addition, research on promoting resilience among LGBTQ RHY would support efforts to enhance protective factors among these youth.
Factors contributing to LGBTQ youth homelessness. Studies of youth who have run away from home suggest that family stability or lack of parental support, disengagement from school, depression, and substance abuse are among the factors that directly or indirectly increase youths’ risk of running away. (Tucker et al. 2011; Tyler et al. 2011). However, it is not known how family, environmental, and individual factors might affect the likelihood of running way for LGBTQ youth specifically. Although family rejection due to sexual orientation or gender identity is believed to contribute to homelessness among LGBTQ youth, a few staff members at case study agencies noted that is not always the case in their experience. These staff shared anecdotes of LGBTQ RHY who remained connected to their families, who did not reject them based on sexuality or gender identity, but simply could not provide for them. Additional research on the reasons LGBTQ youth become homeless would help providers identify and address the potentially varied and distinct factors contributing to this problem.
Experiences of LGBTQ youth involved in multiple systems. Homeless youth may be involved in several public systems, especially the juvenile justice and child welfare systems. Staff in case study agencies indicated a need for information on the frequency of involvement in more than one system among LGBTQ RHY and youths’ experiences in these programs. For example, it may be useful to understand whether LGBTQ youth perceive some systems to be more safe and welcoming, or how youths’ interactions with staff in one system—such as developing a supportive relationship with a case manager—may influence their outcomes in another. It may also be helpful to learn more about any linking of efforts across systems to serve LGBTQ RHY. For example, research could explore whether aligning training for LGBTQ cultural competency across systems addresses concerns among RHY staff that other agencies may not be welcoming of LGBTQ youth.
Service models and administrative strategies that focus on LGBTQ RHY. Agency staff frequently expressed a need for intervention models targeting LGBTQ RHY and information on the effectiveness of these interventions in various service contexts (for example, urban or rural areas). Staff mentioned a particular interest in models for promoting family engagement and reunification and positive youth development among LGBTQ youth. In addition, staff noted that it would be helpful to identify models that ameliorate risks and enhance protective factors among transgender RHY and LGBTQ RHY of color. With respect to administrative strategies, some staff members noted that additional information on LGBTQ cultural competency training for RHY providers would be helpful. According to these staff members, it would be useful to identify how frequently such training should be delivered and strategies for helping staff retain cultural competency skills after training.
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B. Issues for Policymakers and Practitioners to Consider
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The case study findings point to four issues related to serving LGBTQ RHY for policymakers and practitioners to consider: (1) ensuring consistency and accuracy in collecting data on clients’ sexual orientation and gender identity, (2) providing guidance on management and analysis of these data, (3) providing technical assistance to agencies whose service areas lack extensive LGBTQ resources, and (4) developing and evaluating interventions relevant to LGBTQ RHY.
Ensuring consistency and accuracy in data collection. Data collection practices in case study agencies indicate that not all RHY Program grantees systematically collect and record information on sexual orientation and gender identity. Among case study agencies that do collect these data, the content of questions on agency forms varies. As a result, comparisons of data across organizations are likely to be difficult. In addition, agencies collect information at different times. To improve the consistency and accuracy of administrative data on these topics, it may be beneficial to offer providers guidance on preferred content for questions about sexual orientation and gender identity and recommended methods for asking them. This advice could draw on recommendations for survey questions addressing these topics (see, for example, Sexual Minority Assessment Research Team 2009). In addition, clear communication to RHY program staff about why this information is needed would likely promote more consistent data collection efforts.
Providers also may need to consider whether separate processes are necessary to collect data for administrative purposes (for example, to understand the demographics of an agency’s clientele overall) and for guiding service provision. This distinction might help agencies collect more accurate counts of LGBTQ youth served. For example, one representative of a partner agency suggested that agencies might address youths’ potential reticence to share information on LGBTQ identity by collecting data through an anonymous online questionnaire administered to youth seeking assistance. This mode would allow an agency to gather data on the number of youth who identify as LGBTQ without youth being asked to disclose the information to a staff member during an initial intake session or assessment. To help staff plan services appropriately, they could record in individual case files any information gathered later about a youth’s LGBTQ status.
Management and analysis of data on LGBTQ identity. In addition to standardized practices for asking questions on sexual orientation and gender identity, agencies may benefit from guidance on when this information should be recorded in case records, as well as on when and to whom it should be disclosed. This type of guidance could help address program staff members’ concerns about the risk of disclosure, which may discourage them from collecting data on LGBTQ status. Procedures for RHY programs could be modeled on existing guidance for child welfare professionals (Wilber 2013).
Among case study agencies that collect demographic data on youth, none analyze these data to explore whether services received differ among demographic groups. Such analyses could help agencies identify and address disparities that may exist between LGBTQ and non-LGBTQ youth or among subpopulations of LGBTQ youth. Agencies might not examine data in this way because (1) they lack the staff resources, (2) disaggregating service data by demographic group is not the agency’s general practice, or (3) their data systems do not support these types of analyses. Programs might benefit from examples of how disaggregated data can be used for assessing service delivery. They might also require assistance building capacity for internal data management and analysis.
Technical assistance for agencies whose service areas lack extensive LGBTQ resources. Developing cultural competency among staff members and identifying community resources to help serve LGBTQ RHY were particularly challenging for agencies in places without an extensive network of LGBTQ organizations. One option for addressing this challenge is to offer technical assistance or training on LGBTQ issues regularly and make it easily accessible via online participation. Another would be to create opportunities for RHY providers to share information on strategies for serving LGBTQ RHY, perhaps by creating an online repository for documents on best practices.
Developing and evaluating interventions targeting LGBTQ youth. RHY providers will likely benefit from specification, dissemination, and evaluation of models for serving LGBTQ youth effectively. FYSB is providing support for identifying LGBTQ-specific interventions through grants to help build capacity among RHY providers in serving LGBTQ youth. Rigorous evaluations of interventions targeting LGBTQ RHY could help identify models that are effective for these populations.
Evaluations of program models targeting LGBTQ RHY might explore whether the models are most effective when offered as separate program components or as modifications to services available to RHY in general. Studies might also address the effectiveness of tailoring specific types of services, such as family reunification support or individual counseling, to the particular needs and circumstances of LGBTQ RHY.
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C. Themes in Study Findings
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The case studies suggest that approaches to identifying and serving LGBTQ youth are likely to range widely among RHY providers. Key themes in study findings include the following:
- Among practitioners we interviewed, there did not appear to be general agreement on the need or approaches for collecting and using information on clients’ sexual orientation and gender identity. Recommendations for collecting these data while respecting youths’ privacy and additional information on the potential uses of the data could help providers take steps to better understand the LGBTQ RHY population.
- Staff perceive that LGBTQ youth generally face risk factors similar to those of non-LGBTQ youth but also note that the frequency of these risks and circumstances contributing to them may differ for the two populations. In addition, transgender youth and LGBTQ youth of color may face distinctive patterns of risk. These issues could be explored further through future research.
- Some recommended steps for serving LGBTQ RHY may be implemented more readily than others. For instance, adopting policies prohibiting discrimination based on sexual orientation and gender identity may be relatively easy for agencies to accomplish, but establishing safer and more welcoming environments, increasing cultural competency among staff, and linking LGBTQ youth to appropriate services may require more sustained effort. In addition, some practitioners appear to be uncertain about the appropriateness of targeting a specific subpopulation of RHY by tailoring services or developing programs especially for them. As agencies are encouraged to address the needs of LGBTQ RHY, providers may benefit from support for implementing practices that have been recommended to promote positive outcomes among these youth.
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