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LGBTQ youth in unstable housing and foster care
Abstract
BACKGROUND AND OBJECTIVES: Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are suggested to be overrepresented in unstable housing and foster care. In the current study, we assess whether LGBTQ youth are overrepresented in unstable housing and foster care and examine disparities in school functioning, substance use, and mental health for LGBTQ youth versus heterosexual youth in unstable housing and foster care.
METHODS: A total of 895 218 students (10–18 years old) completed the cross-sectional California Healthy Kids Survey from 2013 to 2015. Surveys were administered in 2641 middle and high schools throughout California. Primary outcome measures included school functioning (eg, school climate, absenteeism), substance use, and mental health.
RESULTS: More youth living in foster care (30.4%) and unstable housing (25.3%) self-identified as LGBTQ than youth in a nationally representative sample (11.2%). Compared with heterosexual youth and youth in stable housing, LGBTQ youth in unstable housing reported poorer school functioning (Bs = −0.10 to 0.40), higher substance use (Bs = 0.26–0.28), and poorer mental health (odds ratios = 0.73–0.80). LGBTQ youth in foster care reported more fights in school (B = 0.16), victimization (B = 0.10), and mental health problems (odds ratios = 0.82–0.73) compared with LGBTQ youth in stable housing and heterosexual youth in foster care.
CONCLUSIONS: Disparities for LGBTQ youth are exacerbated when they live in foster care or unstable housing. This points to a need for protections for LGBTQ youth in care and care that is affirming of their sexual orientation and gender identity.
... Foster care, also known as out-of-home care for children who have been removed from their families, includes relative and non-relative foster family homes, pre-adoptive homes, and congregate care settings such as shelters, group homes and residential treatment centers. Black youth (Cénat et al., 2021) and lesbian, gay, bisexual, transgender, questioning, and queer (LGBTQ+) youth (Baams et al., 2019) are overrepresented among youth in foster care, stay in foster care longer, and are more likely to live in congregate care than their peers. ...
... Caregivers and child welfare professionals cited discomfort talking with youth of different genders and sexual orientations; lack of training and guidance; and religious and personal beliefs that might differ from the youths' beliefs of what constitutes normal and acceptable behavior. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, overrepresented in the child welfare system, face special barriers with regard to adequate placements and placement stability, caregiver support, and exploration of sexual identity and gender expression (Baams et al., 2019). ...
High levels of intimate partner violence among youth and young adults with history in foster care can perpetuate the cycle of violence and abuse. It is therefore important to understand how the experience of growing up in foster care impacts youths' understanding and formation of intimate relationships. This qualitative study centered the perspectives of young adults and investigated what they learned about relationships through interactions with foster caregivers and child welfare professionals. We conducted semi-structured interviews with 27 young adults and used Consensual Qualitative Research methods to identify critical experiences in foster care and formulate strategies for promoting healthy relationships.
... Despite these challenges, extant research indicates that LGBTQ youth are overrepresented in foster care placements Wilson et al., 2014). For example, Baams et al. (2019) found that just over 30 % of youth living in foster care identified as LGBTQ in a statewide sample of California schools, whereas 11.2 % of youth identified as LGBTQ in a nationally representative sample, indicating a statistically significant overrepresentation of LGBTQ youth in foster care arrangements. No information is available yet about variation within sexual and gender diverse youththat is, whether there are differences in foster care representation between lesbian or gay, bisexual, transgender or gender diverse, and questioning youth. ...
... Foster care representation was also high among heterosexual youth, all of whom identified as transgender or questioning their gender identity in the current sample. This finding is noteworthy because prior studies typically aggregate marginalized sexual orientation subgroups into global LGB categories (e.g., ; McCormick et al., 2017;Baams et al., 2019). ...
Background:
Lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) youth are overrepresented in foster care and report greater substance use during adolescence.
Objective:
Using an intersectional lens, the current study investigates differences in foster care placement and variation in substance use at the intersections of foster care and sexual orientation, gender identity, racial/ethnic identities, and sex assigned at birth.
Participants and settings:
A sample of 121,910 LGBTQ youth (grades 6-12) completed either the Minnesota Student Survey in 2019, the California Healthy Kids Survey from 2017 to 2019, or the 2017 LGBTQ National Teen Study.
Methods:
Youth reported their substance use in the past 30 days (alcohol, binge drinking, cigarette, marijuana), social positions (sexual orientation, gender identity, racial/ethnic identities, sex assigned at birth), living arrangement (foster care or not), and grade in school. Logistic regression was used to examine the main and interaction effects of foster care and social positions on youth substance use.
Results:
Results indicated significant differences in substance use at the intersection of foster care placement and youth social positions. Significant two-way interactions for foster care placement and social positions emerged predicting alcohol, binge drinking, and marijuana use.
Conclusions:
Findings show that LGBTQ youth in foster care are at higher risk for substance use than those not in foster care. Particular support is needed for lesbian, gay, and questioning youth, transgender youth, LGBTQ youth assigned male at birth, and Asian or Pacific Islander LGBTQ youth in foster care.
... In addition to this, LGBTIQ+ people face an increased risk of other housing-related issues, such as discrimination in the housing market, housing instability, and family relationship breakdown-all of which can directly result in homelessness [6][7][8][9]. Furthermore, LGBTIQ+ youth are over-represented in foster care, and when they are placed into out-of-home care settings, they experience greater levels of victimisation and abuse by foster carers, social workers, and peers [10,11]. ...
... Existing literature has reported mixed results about the types of homelessness that LGBTIQ+ youth have experienced; Petry et al. [45] reported LGBTIQ+ youth to be more likely to experience couch-surfing than staying in shelters, whereas Shelton et al. [46] reported that LGBTIQ+ homeless youth were predominantly staying in shelters/hospitals/transitional housing, then rough sleeping, with couch-surfing being the third most prevalent form of homelessness they reported. International literature also highlights the links between foster care and experiences of homelessness amongst LGBTIQ+ communities [4,10,11,47,48]. Existing Aotearoa literature shows high levels of poor mental health, bullying, sexual violence, and drug use amongst youth in care [49,50]. ...
Takatāpui/LGBTIQ+ people’s housing experiences are poorly understood in Aotearoa, New Zealand, including those of young people. We use data from an online survey to investigate experiences of homelessness, involuntary mobility, and housing-related discrimination amongst Takatāpui/LGBTIQ+ youth (n = 334). Multiple linear regression analysis shows a significant relationship between homelessness scores and experience of state care, involuntary mobility, and housing discrimination. Furthermore, these young people had high rates of poverty (57% reporting an annual income below NZD 20,000), involuntary mobility (56%), housing-related discrimination (55%), and lifetime experiences of homelessness (31%). These findings highlight the difficulties that Takatāpui/LGBTIQ+ young people face in the housing market, emphasising the need for targeted programs and policies to meet their needs and prevent homelessness from occurring.
... First, the response rate for the BRFSS, though respectable (~ 50%), has decreased over time (CDC, 2021). The survey sampling also excludes people who are homeless or incarcerated; due to discrimination in housing and criminal justice as well as the effects of marginalization and discrimination (e.g., substance use), particularly among people of color, LGB + people may be overrepresented in these groups (Baams et al., 2019;Gaynor & Blessett, 2022;Lipperman-Kreda et al., 2020), perhaps resulting in an underestimate of LGB + people. Though item refusal on the sexual orientation and gender identity (SOGI) items is low and has decreased over time, there are higher rates of non-response among older, non-English speaking, and Hispanic and Asian respondents (Jesdale, 2021;O'Brien & Blosnich, 2022). ...
IntroductionAccurate population estimates of trends in sexual identity groups are important for understanding cultural change, the range of diversity in sexual orientation, and health disparities rooted in sexual identity.Methods
Data are from the nationally representative Behavioral Risk Factor Surveillance Survey (BRFSS; n = 1.5 million) of US adults from 2014 to 2021.ResultsAn increasing number of US adults identified as lesbian, gay, or bisexual (LGB) between 2014 and 2021. LGB identification increased from 3.4% in 2014–2015 to 5.5% in 2020–2021 among all adults and from 7.6% in 2014–2015 to 15.7% in 2020–2021 among young adults ages 18 to 24. The increase in LGB identification appeared in both “blue” liberal states and “red” conservative states, suggesting a nationwide rather than regional shift.Conclusions
The increase among young adults points to a generational explanation, with more of Gen Z identifying as LGB than millennials at the same age. The increases were largest among bisexual people, women, and White and Hispanic people.Policy ImplicationsThe increased prevalence of LGB + people has implications across a wide range of domains, including healthcare, housing, and schools. In particular, the sharp increase in bisexual women may require particular attention to address the health disparities they experience across the lifespan.
... 47 & 82). With membership in this community being a risk factor for youth for mental illness and suicide, a statewide study of high school youth in California showed that being homeless on top of being a sexual minority increases these risks (Baams et al., 2019). ...
The emergence of social work and macro practice is often associated with the eradication of poverty and prevention of homelessness through the efforts of 19th century settlement houses. Structural violence and social determinants of homelessness are often grounded in unequal social, political, and economic conditions. Health and mental health were affected by the lack of stable housing, causing and increasing the complexity of health and human service needs and services. Furthermore, due to inequities, some populations are inadvertently more likely to face chronic homelessness, which can be mitigated through the role community-engagement and macro practice interventions.
... Unstable housing and transactional sex were consistently selected across all models, suggesting that these variables were highly correlated with increased stimulant use regardless of HIV status. Compared to non-sexual minorities, sexual minorities disproportionately experience unstable housing, often due to homophobia, rejection, and abuse that forces them from their homes (Baams et al., 2019;Romero et al., 2020). Furthermore, stimulants are often used as a form of coping with stressful feelings associated with being unstably housed as well as a means of survival (Johnson & Chamberlain, 2008). ...
Stimulant use is an important driver of HIV/STI transmission among men who have sex with men (MSM). Evaluating factors associated with increased stimulant use is critical to inform HIV prevention programming efforts. This study seeks to use machine learning variable selection techniques to determine characteristics associated with increased stimulant use and whether these factors differ by HIV status. Data from a longitudinal cohort of predominantly Black/Latinx MSM in Los Angeles, CA was used. Every 6 months from 8/2014-12/2020, participants underwent STI testing and completed surveys evaluating the following: demographics, substance use, sexual risk behaviors, and last partnership characteristics. Least absolute shrinkage and selection operator (lasso) was used to select variables and create predictive models for an interval increase in self-reported stimulant use across study visits. Mixed-effects logistic regression was then used to describe associations between selected variables and the same outcome. Models were also stratified based on HIV status to evaluate differences in predictors associated with increased stimulant use. Among 2095 study visits from 467 MSM, increased stimulant use was reported at 20.9% (n = 438) visits. Increased stimulant use was positively associated with unstable housing (adjusted [a]OR 1.81; 95% CI 1.27-2.57), STI diagnosis (1.59; 1.14-2.21), transactional sex (2.30; 1.60-3.30), and last partner stimulant use (2.21; 1.62-3.00). Among MSM living with HIV, increased stimulant use was associated with binge drinking, vaping/cigarette use (aOR 1.99; 95% CI 1.36-2.92), and regular use of poppers (2.28; 1.38-3.76). Among HIV-negative MSM, increased stimulant use was associated with participating in group sex while intoxicated (aOR 1.81; 95% CI 1.04-3.18), transactional sex (2.53; 1.40-2.55), and last partner injection drug use (1.96; 1.02-3.74). Our findings demonstrate that lasso can be a useful tool for variable selection and creation of predictive models. These results indicate that risk behaviors associated with increased stimulant use may differ based on HIV status and suggest that co-substance use and partnership contexts should be considered in the development of HIV prevention/treatment interventions.
... Youth who did not reside with family members were more likely to be in the negative profile than any other profile. Living arrangement could be related to the negative reactions from family members, as previous research documents that family rejection is linked with neglect and parental abandonment, contributing to overrepresentation of LGBTQ youth in unstable living or housing circumstances (Baams et al., 2019). Finally, youth who reported that at least one other family member was LGBTQ were almost three times as likely to experience very positive family reactions than negative reactions. ...
Family members' reactions to youth identity disclosure are important predictors of well-being for lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) youth. To better understand potential variation within and across families' current reactions, this study established latent profiles of family level reaction patterns and examined predictors and outcomes associated with these patterns. In 2011-2012, LGBTQ youth (N = 447, Mage = 18.8) rated their mother's, father's, brother's, and sister's reactions to their LGBTQ identity and reported their own depressive symptoms and self-esteem. Latent profile analysis tested patterns of family members' reactions. Most participants reported either moderately positive reactions (49.2%) or very positive reactions (34.0%) from all family members, though 16.8% of youth reported negative reactions from all family members. Youth social positions and demographic factors predicted profile membership: transgender youth, youth-assigned male at birth, older age at first disclosure predicted membership in the negative family reaction profile, whereas gay youth, having a parent and/or sibling with an LGBTQ identity, coresidence with either mothers, fathers, or siblings, and more years since first disclosure predicted membership in the very positive family reaction profile. Multiracial youth and younger youth were more likely to be in the moderately positive family reaction profile. Youth in families characterized by negative reactions had higher depressive symptoms and lower self-esteem compared to those who reported moderately positive or very positive reactions. Findings underscore the interconnectedness of family members' reactions and suggest that interventions for LGBTQ youth with rejecting and/or less accepting family members may need to target the entire family system. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
... In interviews conducted among youth aging out of foster care, researchers found that most participants cited professionals such as child welfare workers as key supportive adults during their transition to adulthood (Collins et al., 2010;Paul, 2020;Rosenberg, 2019). As LGB youth in foster care are more likely to experience placement instability (Baams, Wilson, & Russell, 2019), caseworkers are reported by youth as an individual in their stable support network for LGBTQ youth (Paul, 2020). According to Paul (2020), caseworkers knowledgeable about LGBTQ issues can provide specific forms of support surrounding romantic relationships and gender identity while providing positive experiences for youth (Paul, 2020). ...
Research with youth has demonstrated that a hopeful mind-set is associated with resilience and well-being and is influenced by our supportive caregivers and adults. Lesbian, gay, and bisexual (LGB) youth experience a very high frequency of adverse childhood experiences (ACE) and may lack supportive caregivers throughout their foster care experience. This study tests the theory that child welfare caseworkers are a source of hope among LGB youth in foster care. Quantitative analysis was used to examine differences in ACE exposure and differences in the caseworker as a source of hope. LGB youth with eight or more ACEs have a significant positive association with hope in their caseworkers than non-LGB youth. ARTICLE HISTORY
... Households which follow heteronormative ideologies are a source of distress for the LGBTQ youth (Castellanos, 2016). Homeless LGBTQ youth report heteronormative attitudes, stigma, and discrimination at home which lead to significant physical and mental health concerns, including engagement in risky sexual behavior, substance abuse and family conflict due to disclosure of sexual orientation (Corliss et al., 2011;Rhoades et al., 2018;Baams et al., 2019). ...
The coronavirus disease (COVID-19) pandemic has led to a significant change in the way healthcare is dispensed. During the pandemic, healthcare inequities were experienced by various sections of society, based on gender, ethnicity, and socioeconomic status. The LGBTQ individuals were also affected by this inequity. There is a lack of information on this topic especially in the developing countries. Hence this issue requires further exploration and understanding. Previous literature briefly explored the mental, physical, and emotional turmoil faced by the LGBTQ community on a regular basis. They feared rejection by family and friends, bullying, physical assault, and religious biases. These issues prevented them from publicly speaking about their sexual orientation thereby making it difficult to collect reliable data. Although they require medical and psychological treatment, they are afraid to ask for help and access healthcare and mental health services. Being mindful of these difficulties, this article explores the various underlying causes of the mental health problems faced by LGBTQ individuals, especially, in the Indian subcontinent. The article also examines the status of healthcare services available to Indian sexual minorities and provides recommendations about possible remedial measures to ensure the well-being of LGBTQ individuals.
... LGBTQ youth are overrepresented in the child welfare system, with up to 30% of youth in foster care self-identifying as LGBTQ, compared to 11% of youth in a nationally representative sample (Baams et al., 2019). Rejection from family, strained parental relationships, and psychological and physical abuse related to their sexual identity are thought to be contributing factors to child welfare involvement. ...
Youth in foster care experience disproportionate rates of abusive relationships, teen pregnancy, and sexually transmitted infections (STIs). Extant research points to the need for interventions at multiple levels of the social ecology, however, there is a lack of evidence to guide the development of coordinated interventions for youth, foster parents, and child welfare professionals. The Texas Foster Youth Health Initiative (TFYHI) convened a multidisciplinary learning community to build a foundation for intervention development. The intentional learning and innovation process engaged several groups of stakeholders: young adults with lived experience (n = 41), foster parents (n = 14), and child welfare professionals (n = 52). Interviews, community listening sessions, and reflection exercises were designed to capture tacit and experiential knowledge and explore challenges and desired outcomes from different perspectives. Based on a thematic analysis of stakeholder perspectives, we identified overarching needs to normalize conversations about sexuality and relationships and shift away from risk-based and stigmatizing approaches. We also identified key strategies for designing coordinated interventions targeting youth, foster parents, and child welfare professionals: (1) Reflect on values about sexuality and relationships. (2) Validate youths’ need for connection. (3) Focus on strengthening youth-adult relationships and ongoing conversations. (4) Build healthy relationship skills including communication about consent, condom use, and contraception. (5) Identify teachable moments and model problem solving. (6) Use interactive approaches for sharing health information and empower youth to choose methods that fit their needs.
... These experiences suggest a profound impact on the mental and physical health of LGBTQIA+ youth in care. For instance, Baams et al. (2019) reported poorer mental health, higher substance use, and worse school functioning for LGBTQ youth, which was exacerbated when they lived in unstable housing or foster care (for a comprehensive overview of research on mental health in LGBT youth, see Russell & Fish [2016]). ...
This chapter examines the special needs and challenges faced by LGBTQIA+ youth in residential child and youth care settings. The authors review data about LGBTQIA+ youth in care and describe two European programs that are striving to provide a secure, welcoming, and affirming living environment for LGBTQIA+ youth in child welfare systems. The Audre Project probed perspectives of LGBTQIA+ youth in residential and foster care placement as well the views of practitioners. Cornerstones Youth Care has been implementing an LGBTQIA+ focus within its Raising the Village model. The Raising the Village model is a framework for improving the quality of out-of-home care to young people through focusing decision-making around the individual young person and the carers and professionals involved.
Revitalizing Residential Care for Children and Youth: Cross-National Trends and Challenges addresses the question of how societies with developed welfare and social service systems assess current needs and future directions in their residential child and youth care sectors. This includes dealing with historical concerns raised about the placement of children and youth in residential care settings, as well as identifying innovative strategies that offer new pathways for the integration of this often-neglected sector of service within the broader area of child welfare. Each of the 16 countries selected for inclusion is examined through a common matrix that provides information about the current policy context, key trends and initiatives, characteristics of children and youth served, preparation of residential care personnel, promising programmatic innovations, and present strengths and challenges. Individual country analyses are supplemented by regional exemplars of innovative residential programs and practice in areas such as family engagement, helping youth with the transition from care to community, promising model programs, and reflections on recent policy reform initiatives. In addition to takeaways from each country, the book’s closing chapter identifies specific implications for policy reform, empirical research, and residential program innovation. What sets this book apart is its systematic cross-national appraisal of residential care for children and youth with an eye toward identifying innovative policies and practices undergirded by research. In so doing, it offers a unique contribution to the international child welfare literature.
... CASP Quality Scores.Baams et al., 2019;Capous-Desyllas & Mountz, 2019;Dettlaff et al., 2018;González Á lvarez et al., 2021;Greeno, Matarese, & Weeks, 2021;Griffiths, Holderfield-Gaither, Funge, & Warfel, 2021;Paul, 2020; Sherriff, Hamilton, Wigmore, & Giambrone, 2011; Wilson & Kastanis, 2015 16-14 12 Bermea, Rueda, & Toews, 2018; Brandon-Friedman, Pierce, Wahler, Thigpen, & F ...
Background and objectives
The experiences of lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) youth in foster and residential social care have largely been overlooked in research, practice and policy. This scoping review aims to identify and synthesize the existing empirical research concerning the health and well-being needs of LGBTQ+ youth in care.
Methods
Following a six-stage approach to scoping reviews, a computerized search was conducted from a total of eight electronic databases: PubMed, Web of Science (Core Collection), Scopus, CINAHL Plus, PsychINFO, Sociological Abstracts, Social Care Online (SCIE), and OpenGrey. Search parameters comprised of three domains (LGBTQ+ status, age, and social care interventions). Data synthesis included thematic analysis, as well as critical appraisal using Critical Appraisal Skills Programme (CASP) criteria. Of the initial 1,962 sources identified, 22 studies met the search and quality criteria and were included in the final review.
Results
Overall, the evidence base is limited with most studies originating from the USA (77 % of included papers). The findings indicate that LGBTQ+ youth experience poorer physical and mental health, and also poorer well-being outcomes compared to non-LGBTQ+ youth while in foster and residential social care. Racial or ethnic minority LGBTQ+ youth, lesbian/bisexual girls, and trans and nonbinary youth face particular challenges, and social care systems appear especially ill-equipped to meet the needs of transgender and nonbinary youth.
Conclusion
While the evidence base continues to grow, there remains a need for high quality research including longitudinal and life course studies in various contexts and countries to generate robust empirical evidence in this area. The implications for practice and policy include policy shifts, mandatory and comprehensive competency-based education and training, as well ongoing coaching regarding anti-LGBTQ+ and heteronormative bias within this system.
... Other studies show overrepresentation of LGBTQ youth in foster care (30.4%) and having unstable housing (25.3%) compared with the non-LGBTQ community (11.2%; Baams et al., 2019). Not surprisingly, disparities in younger life may extend into later life. ...
Purpose:
The LGBTQIA+ communities experience distinct health disparities and inequities in health outcomes. Healthcare providers must be conscious of these factors to facilitate optimal, person-centered care. This narrative briefly covers health disparities in the LGBTQIA+ community and posits strategies to promote inclusive care.
Methods:
Current literature and clinical best practices from several authoritative sources on LGBTQIA+-specific issues and gender-affirming care were reviewed. Sources included several LGBTQIA+-specific healthcare organizations, national healthcare provider organizations, and federal agency policy statements. Inclusive terminology and healthcare practices are included.
Results:
Healthcare providers must educate themselves on caring for gender- and sexual orientation-diverse populations to optimize the health status of these communities. It is essential that providers examine their own potential biases and maintain an openness to learning about LGBTQIA+ communities.
Conclusions:
Healthcare providers have a responsibility to not only understand issues specific to LGBTQIA+ individuals but also advocate for these groups. As nurses, we must continue to support public health policies that seek to end disparities and ensure health equity for all.
Clinical relevance to the practice of rehabilitation nursing:
Rehabilitation nurses are caring for more diverse populations than ever before and must understand how to provide compassionate, individualized care. Although this article focuses on the LGBTQIA+ community, the principles discussed are applicable across all populations.
... Third, continued research can help us to understand both the strengths and challenges of SGM people experiencing homelessness (i.e., avoid a deficit orientation; Vaughan & Rodriguez, 2014) and use intersectional analyses (Crenshaw, 2017) that account for compounding effects of multiple forms of marginalization within and in addition to SGM identities (e.g., racial identity, immigration status). Fourth, although the current study focused on SGM adults, it will be important to continue exploring the links between homelessness and juvenile justice involvement among SGM youth as well (Baams et al., 2019;Choi et al., 2015)-especially given that early intervention could help promote healthy development and prevent long-term problems. ...
Sexual and gender minority (SGM) individuals experience high rates of homelessness and criminal justice system involvement, underscoring the need for supportive housing services. To explore the service needs of this population, we interviewed providers (n = 11) and clients (n = 10) from eight supportive housing organizations working with SGM populations in Los Angeles County, California, USA. We used the Consolidated Framework for Implementation Research to synthesize interview responses into themes (by domain and cross-cutting). Takeaways included the need for investment in systems of care for vulnerable SGM populations; the particular marginalization of Trans individuals and providers that serve them; the roles of supportive housing staff, residents, and leadership in cultivating an affirming environment; the prevalence of discrimination and stigma within supportive housing programs and broader society; and the complex interrelationships among SGM identity, homelessness, and criminal justice system involvement. These findings have important implications for supportive housing services and related policy.
... Currently, there are many children falling through the cracks in an overcrowded foster system. These children could use a loving family, particularly sexual and gender minority youth who experience higher rates of homelessness (Baams et al., 2019;Keisling & Sloan, 2018;Wilson et al., 2014). Knowing that same-sex families are seven times more likely to adopt or foster children (Goldberg & Conron, 2018), we owe it to our youth to provide a quality relationship with a caring family, no matter their family structure. ...
Despite the Obergefell v. Hodges (2015 Obergefell v. Hodges. (2015). 135 S. Ct. 2071. [Google Scholar]) Supreme Court decision allowing same-sex marriage, the current political climate has emboldened state legislatures in the United States to push for anti-LGBTQ adoption legislation, some citing that LGBTQ couples have a negative effect on children. This meta-analysis synthesized data from 32 studies on 6 developmental outcomes (child gender role behaviour, gender identity, sexual orientation, cognitive function, psychological adjustment, and quality of parent–child relationship). The overall effect size of having same-sex parents on the developmental outcomes of the children was positive and significantly different from that of heterosexual parents. Moderator analyses found that location, socioeconomic status, type of relationship, date of publication, and the child's sexual preference were significant. We provide implications for practitioners and policy, as well as recommendations for future research in this area.
... In comparison, older youth are more commonly removed due to behavioral problems, substance use, and parental rejection of a child's LGBTQ + identity (Rosenberg & Abbott, 2019). Studies indicate that approximately 15-34% of youth in care identify as LGBTQ compared to 3-11% in the general population (Baams et al., 2019;Detlaff et al., 2018;Gates, 2011;Kann et al., 2016;Sandfort, 2019;Scannapieco et al., 2018;Wilson & Kastanis, 2015). There are also disproportionately more youth of color in foster care than in the general population. ...
This exploratory, qualitative study evaluated the impact of the Critical Ongoing Resource Family Education Teen Edition (CORE-Teen) post-licensure foster parent training curriculum designed to support foster/kinship caregivers caring for youth ages 12–20 years in the foster care system. A pilot study of the curriculum was implemented in three states (Florida, Pennsylvania, and Tennessee). Five semi-structured focus groups (three groups received CORE Teen training and the other two did not) were conducted with a total of 61 foster parents to explore the differences in parenting knowledge and practices among foster parents trained in CORE Teen versus those who were not. A thematic content analysis of the transcripts from the focus groups revealed three themes: (1) understanding what is considered normal teen behavior; (2) understanding and managing teen trauma and mental health; and (3) recommendations for building foster parents’ skills to prepare for their role. Overall, CORE Teen-trained foster/kinship caregivers seemed to have deeper insight into normal teen behaviors, as well as how trauma and mental health challenges can underlie challenging behaviors. CORE Teen foster/kinship caregivers also seemed more satisfied with the training they had received to prepare them for caring for teens. The CORE Teen training curriculum offers promise for building the unique skills that foster/kinship caregivers need in order to effectively care for older youth in the foster care system.
... The discrimination that LGBT people are exposed to has an important relationship with the heteronormative structure in society (Kara, 2020). The existence of heteronormativity (acceptance of heterosexuality as a social and natural norm or the cultural structure that includes this acceptance) manifests itself in all areas of society, excluding and marginalizing what is not itself (Baams et al., 2019). These structures that are felt in every period of life systematically continue, limiting LGBT people's access to education, healthcare, and social services, especially the right to life (Alpert et al., 2017;Biçmen & Bekiroğulları, 2014;Conron & Wilson, 2019). ...
The study aims to measure the effects of emotion-based group work containing approaches from the intergroup emotions theory on LGBT people where live in Turkey to provide emotion regulation and improve psychosocial functioning. 20 LGBT people (10 participants in experimental group, 10 participants in control group) were included for group work. The Need for Affect Scale (NAS) was implemented to both groups before and after the group work. After the group work, significant differences were found between the experimental and control groups. It was observed that emotion-based group work was effective in increasing the expression and the experience of LGBT people’s positive emotions and improved their psychosocial functioning.
Takatāpui/LGBTIQ_ people's experiences of homelessness remain poorly understood in Aotearoa New Zealand. Using data from semi-structured interviews with eight people who identified as Takatāpui/LGBTIQ+ and had experienced homelessness, this paper explores their experiences while homeless. The analysis showed the necessity of strength of character, how Takatāpui/LGBTIQ+ people presented a different self in order to be accepted, the different strategies used to survive, the importance of implementing boundaries for self-protection , and missed points of intervention and support. Our findings show how participants were failed by the housing support system, and had to rely on themselves and their communities during periods of homelessness.
This chapter is a summary of the literature, context, and need undergirding Dr. Anneliese Singh’s keynote (titled “Queer and Trans Resilience: Moving from Affirmation to Liberation in Our Collective Healing”) at the 2021 Chautauqua Conference exploring the theme of “Resilience of LGBTQ+ Families: Pride and Celebration.” In this chapter, the authors describe key constructs related to affirmative and liberatory helping approaches with queer and 2STNB (two-spirit, trans, nonbinary) people, as well as the implications for these approaches including strength-based perspectives, family resilience, policy and practice intersections, and future directions.KeywordsQueerTransLiberationCounselingResilience
There is a dearth of scientific evidence on the lives of LGBTQIA+ youth in out-of-home care, particularly about their experiences of resilience. Moreover, no studies until now have inquired about the perspective of their care professionals on LGBTQIA+ young people’s resilience resources. The purpose of this study was to explore the care professionals’ perspectives and roles in resilience among LGBTQIA+ youth in out-of-home care. We carried out 21 in-depth interviews with care professionals with experience working with LGBTQIA+ youth in out-of-home care. Results showed that: 1) some professionals conceived resilience as the result of the youth’s traits, particularly their strength and their LGBTQIA+ pride; 2) most professionals mentioned the relevance of conversations with youth as a way to achieve their SOGIESC affirmation; 3) professionals stressed the importance of supportive and affirmative relationships between youth and professionals; 4) although some professionals were unsure about the relevance of care agencies’ SOGIESC specific practices and policies to help youth confront their adversities, other professionals stressed its importance to increase the wellbeing and resilience of LGBTQIA+ youth. The results of this study highlight the significant role of care professionals to foster the resilience of LGBTQIA+ youth in out-of-home care.
Falar sobre identidade é sempre uma tarefa intrigante e deveras difícil, já
que a identidade é um fenômeno que envolve múltiplos níveis e reconhecimentos (Galinkin & Zauli, 2011). E quando a identidade diz respeito a crianças, o
tema torna-se mais profundo por conta das peculiaridades dessa fase do desenvolvimento, sobretudo, porque as variáveis que integram o processo de forma-
ção da identidade possuem grande potencial influenciador em todo processo.
A condição social da criança é uma delas, pois, se uma criança estiver em situação
de vulnerabilidade social certamente terá impactos significativos na formação
de sua identidade, ou se pertencer a uma “raça” desvalorizada terá os mesmos
prejuízos, podendo estes impactos serem potencializados se a criança tiver uma
identidade racial desvalorizada e estiver em situação de vulnerabilidade social.
De modo que buscou-se investigar se a socialização praticada pelos profissionais
Serviços de Convivência e Fortalecimento de Vínculos – SCFV promove o fortalecimento da identidade racial de crianças em situação de vulnerabilidade social.
Abordar diferentes facetas da Psicologia em um só trajeto é um interessante desafio entre a especificidade e a integralidade. Percorrer da saúde e desenvolvimento humano à psicologia social, entrelaçando questões sociais relevantes, exige outro importante esforço. Tudo isso, de modo bem concatenado e fundamentado, pode ser encontrado neste livro. Pesquisas
em Psicologia, Saúde e Sociedade traz para os leitores, estudantes e
pesquisadores, variadas temáticas de estudo em Psicologia, visando a informar e bem formar perspectivas de compreensão e ação para variados interesses.
Los niños, niñas y adolescentes (a partir de este momento referidos como infancia y adolescencia) LGTBIQ+ están sobrerrepresentados en los sistemas de protección a la infancia y a la vez resultan invisibles para muchas personas que desarrollan su labor profesional en estos contextos. Esta infancia y adolescencia a menudo se enfrentan a desafíos durante su estancia en centros de acogimiento residencial relacionados con la falta de respuesta de los sistemas de protección a las necesidades específicas interconectadas con su orientación sexual y/o identidad/expresión de género. Estas necesidades incluyen, entre otras, atender a las experiencias de discriminación y acoso vividas por estas personas durante su acogimiento, las cuales se han relacionado con impactos negativos en la salud física y mental de la infancia y la adolescencia LGTBIQ+ a largo plazo. Esto, en combinación con necesidades adicionales como el apoyo para la articulación de su identidad y orientación sexual, señala la importancia de examinar y entender las experiencias de esta población.
El proyecto FIRMUS se inicia en octubre del 2021 con el propósito de recabar información sobre las experiencias de la infancia y la adolescencia LGTBIQ+ que han vivido en recursos residenciales de la red del Sistema de Atención a la Infancia y la Adolescencia de Cantabria. Asimismo, se pretendía explorar las percepciones, conocimientos y experiencias de las y los profesionales responsables del cuidado de estas personas.
El objetivo final de este proyecto es proporcionar una línea base de conocimiento que permita desarrollar en los centros de acogimiento residencial, y en el conjunto del Sistema de Atención a la Infancia y la Adolescencia de Cantabria, entornos más inclusivos y afirmativos de la infancia y la adolescencia LGTBIQ+, especialmente a través del fortalecimiento de las habilidades profesionales de las diferentes figuras que ofrecen atención directa a este grupo.
FosterCARE training is a behaviorally based, empirically supported program developed to provide foster parents with skills for interacting effectively with youth (aged 2–18) with trauma histories. In this paper, we suggest that the trauma-informed skills, wide age range, and focus on parent–child interactions inherent within the FosterCARE model could provide a promising foundation to serve LGBTQIA+ foster youth and their families. This article describes potential additions to the FosterCARE model and provides the rationale for the use of a FosterCARE-LGBTQIA+ module. Recommendations for thefuture pilot testing of the FosterCARE LGBTQIA+ module using an evidence-based framework are included, with limitations discussed.
Transgender and gender diverse (TGD) children and adolescents are an increasingly visible yet highly stigmatized group. These youth experience more psychological distress than not only their cisgender, heterosexual peers but also their cisgender, sexual minority peers. In this review, we document these mental health disparities and discuss potential explanations for them using a minority stress framework. We also discuss factors that may increase and decrease TGD youth's vulnerability to psychological distress. Further, we review interventions, including gender-affirming medical care, that may improve mental health in TGD youth. We conclude by discussing limitations of current research and suggestions for the future.
Expected final online publication date for the Annual Review of Clinical Psychology, Volume 19 is May 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Introduction:
The objective of this study was to determine the rates and trends in the reporting of preferred language, socioeconomic factors, sexual orientation, and gender identity in published pediatric clinical trials.
Methods:
A cross-sectional study of pediatric clinical trials conducted in the U.S. published from January 1, 2011 through December 31, 2020 in 5 general pediatric and 5 general medical journals with the highest impact factor in their respective fields was performed. Outcomes were reporting of preferred language, socioeconomic factors, sexual orientation, and gender identity. In late 2021, descriptive statistics and logistic regression to understand how reporting of preferred language and socioeconomic factors changed over time were performed.
Results:
Of 612 trials, 29.6% (n=181) reported preferred language. Among these, 64.6% (n=117 of 181) exclusively enrolled participants whose preferred language was English. From 2011 to 2020, there was a relative increase in the reporting of preferred language (8.6% per year, 95% CI=1.8, 16.0). Socioeconomic factors were reported in 47.9% (n=293) of trials. There was no significant change in the reporting of socioeconomic factors (8.2% per year, 95% CI= -1.9, 15.1). Only 5.1% (9 of 179) of published trial results among adolescent participants reported any measure of sexual orientation, and 1.1% (2 of 179) reported gender identity.
Conclusions:
Preferred language, socioeconomic factors, sexual orientation, and gender identity were infrequently reported in pediatric clinical trial results despite these characteristics being increasingly recognized as social determinants of health. To achieve more inclusiveness and to reduce unmeasured disparities, these characteristics should be incorporated into routine trial registration, design, funding decisions, and reporting.
Parent-child relationships are extremely important for sexual and gender minoritized youth as they and their families navigate the challenges of “coming out” and living in a highly heteronormative and often homonegative and transnegative society. This chapter presents the current terminology for and demography of LGBTQ youth in the United States; discusses the unique experiences of LGBTQ children and their parents, including child and parent reactions to the coming out process and its reverberations through the family system; reviews the emerging scientific literature on parenting effects on LGBTQ child health and well-being; and considers the implications for policy and clinical practice that support parents of LGBTQ youth in ways that foster nurturance, advocacy, and the health and well-being of both youth and parents.
Parenting is a critical influence on the development of children across the globe. This handbook brings together scholars with expertise on parenting science and interventions for a comprehensive review of current research. It begins with foundational theories and research topics, followed by sections on parenting children at different ages, factors that affect parenting such as parental mental health or socioeconomic status, and parenting children with different characteristics such as depressed and anxious children or youth who identify as LGBTQ. It concludes with a section on policy implications, as well as prevention and intervention programs that target parenting as a mechanism of change. Global perspectives and the cultural diversity of families are highlighted throughout. Offering in-depth analysis of key topics such as risky adolescent behavior, immigration policy, father engagement, family involvement in education, and balancing childcare and work, this is a vital resource for understanding the most effective policies to support parents in raising healthy children.
How are children affected when states prohibit child welfare agencies from discriminating against same‐sex couples who wish to foster or adopt? This question stands at the heart of a debate between governments that seek to impose such antidiscrimination requirements and child welfare agencies that challenge them on religious freedom grounds. Yet until now there has been no reliable evidence on whether and how antidiscrimination rules for these agencies impact children. We have conducted the first nationwide study of how child outcomes vary when states adopt such antidiscrimination rules for child welfare agencies. Analyzing 20 years of child welfare data (2000–2019), we estimate that state antidiscrimination rules both (1) modestly increase children's success at finding foster and permanent homes, and (2) greatly reduce the average time to place children in such homes. These effects vary among subgroups, such that children who are most likely to find a home are generally not affected by state antidiscrimination requirements, whereas children who are least likely to find a home (primarily older children and children with various disabilities) benefit substantially from antidiscrimination measures. We estimate that the effect of antidiscrimination rules is equivalent to 15,525 additional children finding permanent homes and 360,000 additional children finding foster homes, nationwide, over a period of 20 years. Overall, the project offers two key contributions: First, it provides empirical grounding for some of the most heated constitutional and political battles of the culture wars. Second, it advances empirical legal studies by bringing machine learning causal inference to law.
Campus-based support programs serve an important function for students who have experienced foster care at some point in their lives, often providing necessary supports to students so that they can be successful in a college setting. These programs offer supports that aid in student retention and completion of degrees, thus increasing their chances for better outcomes later in life. One area which has been less explored in the literature that focuses on campus-based support systems for students aging out of foster care is that of the experiences of sexual and gender minorities (SGM), or members of the LGBTQ + population. Currently SGM are overrepresented in foster care populations and are misunderstood and stigmatized by society in general. As a result, they often arrive on college campuses with both strengths and challenges which are not well understood. This narrative literature review aims to provide necessary information regarding the experiences of SGM/LGBTQ + young people as well as recommendations to foster more sensitive and effective responses to these students on college campuses.
Sexual orientation and gender identity change efforts (SOGICE) are harmful practices, yet who suggests them to young people and what impacts are associated with these suggestions have received limited attention in the literature. The present study explored whether certain suggesters, and the frequency of categories of suggesters (including religious leaders, family members, and health professionals), were associated with suicidality and non-suicidal self-injury (NSSI). The study also explored whether particular demographics of young people were more likely to report SOGICE experiences. Data were collected through an online survey of New Zealand gender- and sexuality-diverse youth. The sample (n = 3948) had an age range of 14–26 (mean age = 18.96), and approximately half (52.4%) were transgender or gender-diverse. Odds of suicidality and NSSI were highest when religious leaders suggested SOGICE and when more than one type of suggester was reported. SOGICE was more likely to be reported by transgender and gender-diverse youth, statutory care- and homelessness-experienced youth, and young people reporting current material deprivation. Implications for targeted mental health services and education for young people and the community are discussed.
The US child welfare system has a long history of racial disproportionality and subsequent disparities. These disparities have been perpetuated by discriminatory laws and policies in our federal and state governments, coupled with a system of care that is fraught with the risk of biases in child welfare practices and procedures. Child psychiatrists should have a knowledge base of these inequities to help ensure culturally and trauma-informed care for child welfare involved youth and families. As physician leaders with knowledge of child development, child psychiatrists can also help inform inclusive legislation, policies, and programs.
The LGBTQ group includes Lesbian, Gay, Bisexual , Transgender and Queer community who are considered as gender and sexual minority. In this paper, these community together have been referred to as transgender people for the convenience of the discussion. They do not identify themselves with the mainstream of heterosexual paradigms of sexuality and are at increased risk for both psychological and social concerns. The situation becomes worsened during lockdown. The intended purpose of this study is to understand the tragic life of transgender people amid the pandemic due to corona virus disease of 2019. The study employs both quantitative and qualitative approach to study the challenges transgender people face during COVID-19 pandemic with special emphasis on effect of social exclusion on their mental health. The study aims to present a holistic picture of the challenges related to physical and mental health, barrier to health care and financial crisis. The main crux of this paper is to highlight their self-healing techniques which remained to be the only strength and inspiration for their survival during the outbreak of this deadly virus.
Background
Research on the experiences of LGBTQIA+ youth in out-of-home care has mainly focused on these youth's adversities and the resulting negative impact on their wellbeing. Little is known about the ways through which LGBTQIA+ youth in out-of-home care are resilient to these adversities. To date, a review study on resilience in this population is lacking.
Objective
To map and synthesize the existing research on resilience among LGBTQIA+ children and youth in out-of-home care. Specific goals were to summarize and analyze 1) the general characteristics of the existing studies, and 2) the resilience resources found at the individual, relational, sociocultural, and ecological levels.
Methods
We carried out a scoping review examining empirical published academic literature.
Results
The 14 studies included in this scoping review indicated that resilience studies among LGBTQIA+ youth in out-of-home care are mainly qualitative, cross-sectional, US-based, and were centered on gay youth. Studies suggested that resilience resources were mostly focused at the socio/relational level (e.g., foster family acceptance) with fewer studies at the individual (e.g., LGBTQ positive identity), and community levels (e.g., LGBTQ centers). Importantly, no studies explored the interaction of resilience resources across these different domains.
Conclusions
Resilience among LGBTQIA+ youth in out-of-home care remains understudied and the results of this scoping review point to specific research gaps. Recommendations are provided for research, practice, and policy.
Nondisclosure of lesbian, gay, bisexual, transgender, asexual, or otherwise queer (LGBTQA) identities in the workplace is both common and stressful to those who do not disclose. However, we lack direct evidence that nondisclosure of LGBTQA identity affects worker productivity. In two surveys of LGBTQA-identified scientists, we found that those who did not disclose LGBTQA identities in professional settings authored fewer peer-reviewed publications-a concrete productivity cost. In the second survey, which included straight and cisgender participants as a comparison group, we found that LGBTQA participants who disclosed their sexual orientation had publication counts more like non-LGBTQA participants than those who did not disclose, and that all three groups had similar time since first publication given their academic career stage. These results are most consistent with a productivity cost to nondisclosure of LGBTQA identity in professional settings, and suggest a concrete need to improve scientific workplace climates for sexual and gender minorities.
LGTBQ+ youth in foster care need unique support and acceptance; however, few case workers and caregivers receive specialized training. To address this, the Connecting: Sexual Orientation and Gender Identity Expression (SOGIE) eLearning was developed. This evaluation assesses whether attitudes and behavioral intentions regarding LGBTQ+ youth improved as a result of this training. Caregivers and child welfare professionals showed growth in many areas, including how important they felt it was to learn strategies and skills to support LGBTQ+ youth, as well as their confidence to care for LGBTQ+ youth. The Connecting: SOGIE eLearning is a promising tool for child welfare systems.
Sexual and gender minorities, for example, lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth, are overrepresented in the child welfare system and an increasing number of LGBTQ people are becoming foster parents. The objective of this scoping review is to provide an overview of the existing empirical research on the practices of child welfare services towards LGBTQ individuals (i.e., youth, carers and foster parents). The review followed the methodology framework outlined by the Joanna Briggs Institute (JBI). The electronic databases MEDLINE, Embase,PsycINFO, Web of Science, PubMed and Idunn were searched to identify studies appropriate for inclusion. There were 45 studies that met the inclusion criteria;24 concerned LGBTQ youth, 10 encompassed foster parents, while nine had the ser-vice perspective as the primary focus. The studies originated from the USA (k=34), the UK (k=6), Australia (k=2) and the Netherlands (k=1). Of the included studies,28 were qualitative, 14 were quantitative, and three studies used mixed method approach. The findings indicate that LGBTQ youth are overrepresented in the child welfare system and that LGBTQ youth and foster parents often face stigma and discrimination. The results reveal a gap in the current knowledge about social workers' attitudes, knowledge and experiences regarding working with LGBTQ individuals.
Are empirical data and results of research by social scientists relevant to court decisions in foster care cases, and if so, how? How should they be brought to the court's attention? These questions arose in the context of Fulton v. City of Philadelphia (2021), a recent U.S. Supreme Court case that posed the question of whether a religiously based foster care agency could refuse to provide service to LGBTQ+ prospective foster parents on the grounds of religious beliefs, and still accept public funds. Empirical evidence is relevant to the evaluation of at least three propositions related to foster care that were raised in Fulton: (1) There is a need for qualified prospective foster parents; (2) LGBTQ+ adults are at least as likely as others to be interested in becoming foster parents and they are likely to become competent foster parents; and (3) If sufficient numbers of qualified prospective foster parents cannot be found, children are likely to suffer. Consideration of the evidence reveals that each of these three propositions is supported by factual evidence. In the United States today, there is a definite need for competent foster parents, and competence as a foster or adoptive parent is not associated with parental sexual orientation. Moreover, LGBTQ+ adults may be more likely to show interest in becoming foster parents, on average, than their heterosexual peers. If LGBTQ+ adults are not permitted to become foster parents, some children are very likely to remain without homes, and in this way, will suffer. If the best interests of children are to prevail, then child welfare agencies should search out, welcome, and support LGBTQ+ prospective foster parents, rather than turning them away. Ways of bringing the findings from research to the attention of the court are also discussed.
Written through a constant exchange between LGBTQIA+ young people, researchers, professionals and foster families, this book offers a valuable tool to improve the practice with LGBTQIA+ youth at a personal, organizational, and policy levels. This book shows the powerful influence of relationships and networks for the LGBTQIA+ young person growing up in child protection and welfare systems.
LGBTQIA+ youth need meaningful connections with individuals within their communities in order to be able to heal, learn, and be authentically themselves. Child welfare professionals have a crucial role in creating these connections and cultivating supportive environments, free of additional trauma, where LGBTQIA+ young people can feel valued and loved.
Objective
This study explored how college freshmen, particularly those affected by health inequities, are affected by COVID-19 and whether they would use a university-created online wellness intervention for help.
Participants
Nine-hundred and eighty-nine freshmen at a large southeastern university.
Method
Students responded to an online survey regarding their anxiety, worry, number of life disruptions, perceived resilience and their use of the online intervention during the pandemic (June to mid-September 2020).
Results
During COVID-19, Latinx, Black, women and non-heterosexual students reported significantly greater worry, daily life disruptions than their non-Latinx, white, male and heterosexual counterparts. Women and non-heterosexual students also reported greater anxiety and less resilience. Additionally, Latinx students reported using the university’s online intervention for help during COVID-19 more than others. Overall, freshmen, especially Black and women students, reported the online intervention would help them with struggles.
Conclusions
Universities should identify unique worries faced by students during a health crisis and provide institutional support. Practical implications are discussed.
This study explored workforce opinions toward LGBTQ youth and the LGBTQ community. A total of 1,196 child welfare employees answered a series of surveys measuring their attitudes, perception of climate, knowledge, and behaviors toward LGBTQ. Findings suggest that child welfare workers have adequate knowledge about the LGBTQ community and responses indicate the workforce has some potential to engage in supportive behaviors toward youth, but do not believe the child welfare climate is protective or supportive for LGBTQ youth and reported they “don’t know” how they feel about the LGBTQ population. Implications for practice and policy are presented.
The current study compared the abuse experiences of 108 sexual minority and heterosexual former foster youth who received scholarships through the Orphan Foundation of America. Participants used an anonymous online survey to answer questions regarding their history of physical and sexual abuse. All participants who reported a history of sexual abuse also completed the Trauma Related Beliefs questionnaire (TRB; Hazzard, 1993). Differences across sexual orientation were observed in sexual, but not physical, abuse rates and in the Self-Blame/Stigmatization subscale of the TRB. Specifically, sexual minority participants reported more incidents of sexual abuse, as well as higher scores on the TRB subscale, than did heterosexual participants. These results suggest that sexual orientation is relevant to the experience of abuse among children in the child welfare system.
Objective:
Data from the United States indicate pronounced and persistent racial/ethnic differences in the rates at which children are referred and substantiated as victims of child abuse and neglect. In this study, we examined the extent to which aggregate racial differences are attributable to variations in the distribution of individual and family-level risk factors.
Methods:
This study was based on the full population of children born in California in 2002. Birth records were linked to child protective service (CPS) records to identify all children referred for maltreatment by age 5. Generalized linear models were used to compute crude and adjusted racial/ethnic differences in children's risk of referral, substantiation, and entry to foster care.
Results:
As expected, stark differences between Black and White children emerged in the rates of contact with CPS. Black children were more than twice as likely as White children to be referred for maltreatment, substantiated as victims, and enter foster care before age 5. Yet, there were also significant differences across racial/ethnic groups in the distribution of socioeconomic and health factors strongly correlated with child maltreatment and CPS involvement. After adjusting for these differences, low socioeconomic Black children had a lower risk of referral, substantiation, and entry to foster care than their socioeconomically similar White counterparts. Among Latinos, before adjusting for other factors, children of U.S.-born mothers were significantly more likely than White children to experience system contact, while children of foreign-born mothers were less likely to be involved with CPS. After adjusting for socioeconomic and health indicators, the relative risk of referral, substantiation, and foster care entry was significantly lower for Latino children (regardless of maternal nativity) compared to White children.
Conclusions:
Race and ethnicity is a marker for a complex interaction of economic, social, political, and environmental factors that influence the health of individuals and communities. This analysis indicates that adjusting for child and family-level risk factors is necessary to distinguish race-specific effects (which may reflect system, worker, or resource biases) from socioeconomic and health indicators associated with maltreatment risk. Identifying the independent effects of these factors is critical to developing effective strategies for reducing racial disparities.
Lesbian, gay, and bisexual youngsters, aged 14-21 and living at home, were studied for patterns of disclosure of sexual orientation to families. Three-quarters had told at least one parent, more often the mother than the father. Those who had disclosed were generally more open about their sexual orientation than those who had not, and few of the nondisclosed expected parental acceptance. Those who had disclosed reported verbal and physical abuse by family members, and acknowledged more suicidality than those who had not "come out" to their families.
This study compares participation in deviant subsistence strategies, street victimization, and lifetime prevalence of five mental disorders (conduct disorder, major depressive disorder, post-traumatic stress disorder, alcohol abuse, and drug abuse) among heterosexual males and females (n = 366) and gay, lesbian, and bisexual (n = 63) homeless and runaway adolescents from the first wave of a longitudinal study of homeless youth in four Midwestern states. The results indicate that gay, lesbian, and bisexual adolescents were more likely to have been physically and sexually abused by caretakers, we more likely to engage in risky survival strategies when on their own (including survival sex), were more likely to be physically and sexually victimized when on the streets, and were more likely to meet criteria for mental disorder than were their heterosexual counterparts.
Children in foster care show elevated need for mental health services, and there is some evidence of greater unmet need among racial/ethnic minority youth compared to Caucasian youth. This paper reviews the evidence for racial/ethnic disparities in mental health service use among children in foster care, including previously published data, as well as new, unpublished data, and examines the extent to which the disparities persist when the effects of other service use predictors are accounted for. Potential explanations for racial/ethnic disparities in service use are also explored, including cultural differences in help seeking and factors associated with decision-making processes in child protective service systems.
Objectives:
To identify patterns of childhood adversity in a sample of adolescents and assess disparities in these experiences for lesbian, gay, bisexual, transgender, and questioning adolescents and by level of gender nonconformity.
Method:
By using the cross-sectional, statewide, anonymous 2016 Minnesota Student Survey, 81 885 students were included in the current study (50.59% male; mean age = 15.51). Participants were enrolled in grades 9 and 11 in a total of 348 schools.
Results:
Four patterns of childhood adversity were identified with sex-stratified latent class analyses (entropy = 0.833 males; 0.833 females), ranging from relatively low levels of abuse (85.3% males; 80.1% females) to polyvictimization (0.84% males; 1.98% females). A regression analysis showed that compared with heterosexual adolescents, gay, lesbian, bisexual, and questioning adolescents were more likely to be classified into profiles characterized by polyvictimization (odds ratio [OR] 1.81-7.53) and psychological and/or physical abuse (OR 1.29-3.12), than no or low adversity. Similarly, compared with nontransgender adolescents, transgender adolescents were more likely to be classified into profiles characterized by patterns of polyvictimization (OR 1.49-2.91) and psychological and/or physical abuse (OR 1.23-1.96). A higher level of gender nonconformity predicted a higher likelihood of being classified into each adversity profile compared with the no or low adversity profile (OR 1.14-1.45).
Conclusions:
Sexual minority adolescents and adolescents with high levels of gender nonconformity are vulnerable to experience adversity. The disparities for lesbian, gay, bisexual, transgender, and questioning adolescents and adolescents with high gender nonconformity highlight the variation in patterns of childhood adversity that these youth are at risk of experiencing. The findings reveal the need for further research on the benefits and harm of screening for childhood adversity by physicians and pediatricians.
This paper uses administrative data from fiscal years 2002–2013 from the state of Texas to estimate racial disparities in foster care placement. The mean predicted probability of foster care placement is 2.5 percentage points higher for Black children relative to White children, and there is not a statistically significant difference in the predicted probability of foster care placement between Hispanic children and White children. Results from non-linear Oaxaca-Blinder decompositions show racial disparities in risk factors for child maltreatment do not explain the disparity in foster care placement; rather it is racial disparities in the effects of risk factors that are the main contributors. Discerning the respective roles of racial disparities in maltreatment risk factors as compared to racially biased decision-making can help to inform solutions to racial disparities in foster care entry. This research can provide guidance as to what extent resources should be focused on alleviating poverty versus training child welfare workers to recognize and eliminate decision-making bias; of course these ought to be complementary undertakings.
In this article, we address theories of attachment and parental acceptance and rejection, and their implications for lesbian, gay, bisexual, and transgender (LGBT) youths’ identity and health. We also provide 2 clinical cases to illustrate the process of family acceptance of a transgender youth and a gender nonconforming youth who was neither a sexual minority nor transgender. Clinical implications of family acceptance and rejection of LGBT youth are discussed.
In this article, we review theory and evidence on stigma and minority stress as social/structural determinants of health among lesbian, gay, bisexual, and transgender (LGBT) youth. We discuss different forms of stigma at individual (eg, identity concealment), interpersonal (eg, victimization), and structural (eg, laws and social norms) levels, as well as the mechanisms linking stigma to adverse health outcomes among LGBT youth. Finally, we discuss clinical (eg, cognitive behavioral therapy) and public health (eg, antibullying policies) interventions that effectively target stigma-inducing mechanisms to improve the health of LGBT youth.
Problem:
Sexual identity and sex of sexual contacts can both be used to identify sexual minority youth. Significant health disparities exist between sexual minority and nonsexual minority youth. However, not enough is known about health-related behaviors that contribute to negative health outcomes among sexual minority youth and how the prevalence of these health-related behaviors compare with the prevalence of health-related behaviors among nonsexual minorities.
Reporting period:
September 2014-December 2015.
Description of the system:
The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-related behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors related to unintended pregnancy and sexually transmitted infections, including human immunodeficiency virus infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma and other priority health-related behaviors. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. For the 2015 YRBSS cycle, a question to ascertain sexual identity and a question to ascertain sex of sexual contacts was added for the first time to the national YRBS questionnaire and to the standard YRBS questionnaire used by the states and large urban school districts as a starting point for their YRBS questionnaires. This report summarizes results for 118 health-related behaviors plus obesity, overweight, and asthma by sexual identity and sex of sexual contacts from the 2015 national survey, 25 state surveys, and 19 large urban school district surveys conducted among students in grades 9-12.
Results:
Across the 18 violence-related risk behaviors nationwide, the prevalence of 16 was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of 15 was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. Across the 13 tobacco use-related risk behaviors, the prevalence of 11 was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of 10 was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. Similarly, across the 19 alcohol or other drug use-related risk behaviors, the prevalence of 18 was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of 17 was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. This pattern also was evident across the six sexual risk behaviors. The prevalence of five of these behaviors was higher among gay, lesbian, and bisexual students than heterosexual students and the prevalence of four was higher among students who had sexual contact with only the same sex or with both sexes than students who had sexual contact with only the opposite sex. No clear pattern of differences emerged for birth control use, dietary behaviors, and physical activity.
Interpretation:
The majority of sexual minority students cope with the transition from childhood through adolescence to adulthood successfully and become healthy and productive adults. However, this report documents that sexual minority students have a higher prevalence of many health-risk behaviors compared with nonsexual minority students.
Public health action:
To reduce the disparities in health-risk behaviors among sexual minority students, it is important to raise awareness of the problem; facilitate access to education, health care, and evidence-based interventions designed to address priority health-risk behaviors among sexual minority youth; and continue to implement YRBSS at the national, state, and large urban school district levels to document and monitor the effect of broad policy and programmatic interventions on the health-related behaviors of sexual minority youth.
Empirical research is needed to support ongoing efforts to improve services for sexual and gender minority youth in foster care. Further, data on the presence of sexual and gender minority youth within the child welfare system are needed to encourage counties that have not yet begun to engage in any efforts to address the unique needs and barriers to permanency for these youth. The current study reports on the findings of the Los Angeles Foster Youth Survey (LAFYS) which was designed to assess the proportion of youth placed in the Los Angeles County public child welfare system who are LGBTQ and to examine their experiences in communities, schools, and foster care. Findings indicate that approximately 19% of Los Angeles foster youth are LGBTQ. This proportion of youth is significantly higher than estimates of adolescent and young adult sexual and gender minority identification rates in the general population. Further, analyses also indicate that sexual and gender minority youth in this study are less satisfied with their child welfare system experience, are more likely to experience homelessness, are moved around to more placements, and are experiencing higher levels of emotional distress compared to their non-LGBTQ counterparts.
The California Student Substance Use Survey marks a milestone in the state's efforts to monitor, understand, and prevent adolescent substance use and abuse. Chapter 1 presents the methodology. This survey follows a shift in California policy to a written parental consent requirement. Sample characteristics, consent procedures, and methods of data analysis are presented and discussed. Alcohol, still the most heavily used drug among teens, is presented and discussed in Chapter 2. Chapter 3 provides data on "Illicit Drug Use." Data on prevalence, heavy use, cessation attempts, first drug use, problems, perceived harm, and perceived availability to teens are discussed in both chapters. Chapter 4, "Level of Involvement," covers the range of use. Chapter 5 provides information on prevention and intervention efforts. Chapter 6 discusses tobacco use and prevention. Chapter 7 provides conclusions and implications for prevention and intervention programs. Despite some fluctuations over the last decade, adolescent use of alcohol, tobacco, and other drugs remains as common among the actively consented sample in the current survey as that of the mid 1980s. An executive summary is included. Appendixes are: (1) "Supplementary Trend Tables"; (2) "The Effect of Active Consent on Response Rates"; (3) "Upper-Grade Survey Instrument." (EMK)
Although the number of youth in foster care who are gay, lesbian, bisexual, transgender, or questioning (GLBTQ) is not known, these youth have a range of unique placement and services needs that are often not well addressed. In a qualitative study conducted by Children's Rights and partnering legal organizations in New York City, the experiences of youth in congregate care settings (group and residential treatment centers) were examined, including the experiences of GLBTQ youth. Three key areas emerged as of concern for GLBTQ youth: the appropriateness of congregate care placements for them, the extent to which their service needs were being met, and the safety of GLBTQ youth in congregate care settings.
We compared the likelihood of childhood sexual abuse (under age 18), parental physical abuse, and peer victimization based on sexual orientation.
We conducted a meta-analysis of adolescent school-based studies that compared the likelihood of childhood abuse among sexual minorities vs sexual nonminorities.
Sexual minority individuals were on average 3.8, 1.2, 1.7, and 2.4 times more likely to experience sexual abuse, parental physical abuse, or assault at school or to miss school through fear, respectively. Moderation analysis showed that disparities between sexual minority and sexual nonminority individuals were larger for (1) males than females for sexual abuse, (2) females than males for assault at school, and (3) bisexual than gay and lesbian for both parental physical abuse and missing school through fear. Disparities did not change between the 1990s and the 2000s.
The higher rates of abuse experienced by sexual minority youths may be one of the driving mechanisms underlying higher rates of mental health problems, substance use, risky sexual behavior, and HIV reported by sexual minority adults.
We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults.
On the basis of previously collected in-depth interviews, we developed quantitative scales to assess retrospectively in young adults the frequency of parental and caregiver reactions to a lesbian, gay, or bisexual sexual orientation during adolescence. Our survey instrument also included measures of 9 negative health indicators, including mental health, substance abuse, and sexual risk. The survey was administered to a sample of 224 white and Latino self-identified lesbian, gay, and bisexual young adults, aged 21 to 25, recruited through diverse venues and organizations. Participants completed self-report questionnaires by using either computer-assisted or pencil-and-paper surveys.
Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence.
This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults. Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.
A study was conducted with 45 self-identified gay, lesbian, bisexual, transgendered, and questioning (GLBTQ) youth and agency staff at the two known gay-affirming child welfare agencies in the United States: Green Chimneys GLBTQ Programs in New York City and Gay and Lesbian Social Services in Los Angeles, California. The study examined the question, "What are the challenges presented in ensuring permanency, safety, and well-being for gay and lesbian youth in a gay-affirming child welfare environment?" Guided by the framework outlined in the Child and Family Services Reviews National Standards, which support better outcomes for children and youth, the investigators sought to explore the challenges of ensuring permanency, safety, and well-being for this population, as these challenges were identified by the agency staff and youth who live and work in either of these two gay-affirming programs.
An analysis of the current state of foster care and a discussion of specific measures for enhancing the accountability of the child welfare system and improving how children and families experience foster care.
To investigate prevalence of mental disorder and comorbidity among homeless and runaway adolescents in small to medium sized cities in four Midwestern states.
The study presents lifetime, 12-month prevalence, and comorbidity rates for five mental disorders (conduct disorder, major depressive episode, posttraumatic stress disorder, alcohol abuse, and drug abuse) based on UM-CIDI and DISC-R structured interviews from the baseline interviews of a longitudinal diagnostic study of 428 (187 males; 241 females) homeless and runaway adolescents aged 16-19 years (mean age = 17.4 years, SD = 1.05). The data were collected by full-time street interviewers on the streets and in shelters in eight Midwestern cities of various populations. Separate logistic regression models were used to investigate factors associated with meeting criteria for any disorder and two or more disorders.
Lifetime prevalence rates were compared with rates for same-aged respondents from the National Comorbidity Survey (NCS). Homeless and runaway adolescents were six times more likely than same-aged NCS respondents to meet criteria for two or more disorders and were from two to 17 times more likely to meet criteria for individual disorders than.
Homeless and runaway adolescents in small and mid-sized Midwestern cities report significant levels of mental disorder and comorbidity that are comparable and often exceed that reported in studies of larger magnet cities.
Providing stable housing for runaway and homeless youth is a major function of a transitional living program. This article introduces the focus of one program working with LGBTQ youth in New York City and discusses some issues to consider when working with this population. The article also presents data associated with young people's lives after discharge. In any discussion of outcomes, both reason for discharge and length of stay play important roles in whether or not an exit is safe. Regardless of these two elements, the places youth move to when leaving programs are crucial to their safety and well-being. The exit can be safe even when a young person is discharged early from a program. This article presents types of exits, as well as status of employment and school enrollment at exit. Some youth and staff-identified lessons gained in the program also are discussed in detail. Types of aftercare services sought by discharged youth are specified. This article also describes any differences in outcomes for youth with and without foster care experience.
Needs assessments require staff with the necessary expertise to design the study, collect the data, analyze the data, and present results. They require money, time, and persistence, because the people one wishes to assess often are difficult to access. This article argues for the centrality of a well-done needs assessment when developing services for LGBTQ youth. Needs assessment methodology and adjunctive uses of the needs assessment data also are discussed. The authors present a needs assessment of LGBTQ youth living in out-of-home care in San Diego, California, as an example of the purpose, practicality, and power of a comprehensive needs assessment. The needs assessment identified several issues, as well as additional data supporting the project's necessity. The data also identified the most significant obstacles youth face in accessing housing and supportive services. Through the data collection process, non-LGBT housing providers better understood their need for additional training, and housing and city leadership communities obtained and spread knowledge of the project.
This article reports on results of a one-day public health survey conducted in six states by homeless youth providers to measure and compare risk factors between lesbian, gay, and bisexual (LGB) homeless youth and non-LGB homeless youth. This article intends to inform the child welfare field on existing gaps in services and areas where more training and technical support is necessary in providing services to homeless LGB youth. The findings point to substantial differences within the homeless youth sample and demonstrate that in addition to the public health risks young people face merely by being homeless, the risks are exacerbated for those who self-identify as lesbian, gay, or bisexual. The article informs child welfare providers and policymakers about the substantial vulnerability of LGB youth beyond that of non-LGB homeless youth and the need to fund programming, training, technical assistance and further research to specifically respond to the complex needs of this population.
This article describes the Model Standards Project (MSP), a collaboration of Legal Services for Children and the National Center for Lesbian Rights. The MSP developed a set of model professional standards governing the care of lesbian, gay, bisexual and transgender (LGBT) youth in out-of-home care. This article provides an overview of the experiences of LGBT youth in state custody, drawing from existing research, as well as the actual experiences of youth who participated in the project or spoke with project staff. It will describe existing professional standards applicable to child welfare and juvenile justice systems, and the need for standards specifically focused on serving LGBT youth. The article concludes with recommendations for implementation of the standards in local jurisdictions.
Youth who are homeless and gay, lesbian or bisexual (GLB) are one of the most disenfranchised and marginalized groups in our society. The purpose of this study is to examine and compare HIV in GLB homeless youth with their heterosexual counterparts. Participants for this study included 268 youth involved in treatment outcome studies with substance abusing homeless youth. Results suggest that GLB youth have greater HIV risks and that these risks are greater among bisexual females. In examining the predictors of sexual health risks, survival sex emerged as the most significant. Survival sex was high among females regardless of their sexual orientation and also among gay males. Implications of these findings suggest that a greater emphasis needs to be paid to preventive interventions among this population.
This study examines the possible role of race/ethnicity in the decision to remove children from their caregivers and place them in foster care following a substantiated allegation of maltreatment. The population in this study is 137,300 (50,066 White, 65,392 Hispanic, and 21,842 Black) children who had at least one substantiated child maltreatment referral between January 1, 1999 and December 31, 2000. We employed logistic regression analyses to determine the effect of the ethnicity of a child with a substantiated allegation on placement into foster care. We find that Black children in California are more likely than White or Hispanic children to be removed from their caretaker and placed in foster care, even when other factors (e.g., age, reason for maltreatment, neighborhood poverty) are taken into account.
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The overrepresentation of lesbian, gay, bisexual, questioning, gender nonconforming and transgender youth within the child welfare to juvenile justice crossover population.
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Special Report: 3.4% of US Adults Identify as LGBT
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Lesbian, gay, bisexual and transgender youth: an epidemic of homelessness
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Guidebook to the California Healthy Kids Survey. Part II: survey content - core module
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Serving our youth: findings from a national survey of services providers working with lesbian, gay, bisexuals and transgender youth who are homeless or at risk of becoming homeless
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Copyright © 2019 by the American Academy of Pediatrics. All rights reserved. Print
the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois,
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