While the Runaway and Homeless Youth Act, or RHYA, waits for congressional reauthorization, too many unaccompanied homeless youth go without critical services and shelter every night. Approximately 40 percent of them are lesbian, gay, bisexual, or transgender—or LGBT—many of whom face additional barriers to services and heightened health and safety risks while homeless. Fortunately, the U.S. Department of Health and Human Services’ Administration for Children and Families, or ACF, can act independently to make an immediate difference for LGBT homeless young people.
In April 2014, ACF proposed new performance standards and other guidelines for service providers that receive funding to serve runaway and homeless youth. LGBT advocates and homelessness experts subsequently provided a series of recommendations to further strengthen the federal response to youth homelessness. By issuing four key improvements to existing policy in the final rules, ACF can offer a road map that ensures all young people receive the tools they need to survive and exit homelessness, regardless of their sexual orientation or gender identity.
1. Require nondiscriminatory and culturally and linguistically appropriate services
Like other youth, LGBT young people who are homeless need basic services such as food, shelter, health care, counseling, and education and career development. Many service providers have adopted common-sense policies and practices to ensure that LGBT young people have equal access to available resources. In other places, however, discrimination means that LGBT youth receive substandard services—or sometimes, no services at all. Transgender youth in particular may be turned away from services that are gender specific; assigned rooming that is inconsistent with their gender identity; or given inadequate accommodations, such as sleeping space on floors or in storage rooms, despite the availability of best practices and solutions for these situations. By explicitly prohibiting discrimination on the basis of sexual orientation and gender identity or expression, ACF can ensure that federal funds support services that are accessible to the youth who need them.
All LGBT homeless young people have unique personal stories and sets of identities that shape the way they interact with the world around them, including their race, religion, language, and cultural background. Service providers must be prepared to meet young people where they are in a way that reflects their understanding of themselves and their communities. ACF can go beyond the baseline of nondiscrimination by establishing guidelines for culturally and linguistically appropriate care, such as making key information accessible to individuals with varying levels of education, English proficiency, and health literacy. Such guidelines would create a useful resource for providers in designing services that are responsive to the diverse needs of young people and that celebrate them for who they are.
2. Broaden the definition of family
A high percentage of LGBT youth who are homeless have experienced family conflict or rejection that may make an immediate return to parents or guardians detrimental to their physical, mental, or emotional health. Indeed, half of the homeless youth interviewed in one study cited fear of being turned over to their parents, the police, or child welfare services as one reason they did not take advantage of available services. ACF can prioritize the safety of homeless young people by allowing providers greater flexibility in deciding when to engage families of origin or share sensitive information about the youth.
Additionally, LGBT young people whose relationships with families of origin are strained or nonexistent may still have positive relationships with other individuals who act as family and could provide support, guidance, mentorship, or housing. By expanding the definition of family to include these chosen families, ACF can create more space for providers to work with youth and important people in their lives to strengthen relationships, provide services such as counseling and home-based support, and find housing solutions that best meet the needs of young people.
3. Promote access to health care
Homeless LGBT youth face significant challenges to their health and well-being. For instance, one survey of service providers found that two-thirds of their young LGBT clients had mental health issues, such as depression or anxiety, and that more than half had dealt with alcohol or substance abuse. LGBT young people report considering and attempting suicide at higher rates than their peers. HIV risk is also elevated among homeless and LGBT youth. The situation is especially dire for transgender young people, who often struggle to locate culturally competent providers where they can access hormones and other health care. More than half of service providers serving homeless LGBT youth noted that their transgender clients had worse physical and mental health than their peers.
By clarifying that RHYA funding supports mental and behavioral health services, including suicide prevention, and appropriate referrals for health care coverage, ACF can communicate to providers the importance of offering a range of health services and linkages to care. Navigating the enrollment process for health insurance can be daunting for LGBT young people who are experiencing homelessness. Providers that are already interacting with youth have a unique opportunity to assist them in enrolling for coverage and maintaining access to health care or in making appropriate connections to experts for assistance with obtaining coverage.
4. Foster youth resiliency
Homelessness is a challenging time in the lives of LGBT young people, but it does not define them. As with their peers, homeless youth benefit from a strength-based approach that promotes a sense of safety, belonging, self-worth, control over their own lives, and interpersonal connection. By requiring providers to integrate a positive youth development framework into their programs, ACF can support providers in engaging youth as capable individuals with complex needs, goals, and identities.
Such a model is especially important for LGBT young people, who may internalize some of the widespread stigma surrounding both homelessness and their sexual orientations or gender identities. In particular, LGBT young people may have few affirming spaces in which to work through issues such as sexual health, body image, personal acceptance, harm reduction, self-care, and positive support networks. Providers who create a supportive environment for LGBT youth to explore their own concerns and strengths and plan for their next steps can help foster resiliency among members of this community, ultimately creating a foundation for LGBT young people to achieve the futures they envision for themselves.
Together, advocates, researchers, young people, and policymakers are making strides toward addressing homelessness among LGBT youth. By acting on existing research and issuing new regulations that tackle key barriers for LGBT young people, ACF can take the next critical step in creating an effective response to LGBT youth homelessness.
Hannah Hussey is a Research Associate for LGBT Progress at the Center for American Progress.