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July/August 2022Vol. 23, No. 6Supporting and Affirming LGBTQ+ Children, Youth, and Families

Written by the Capacity Building Center for States 

LGBTQ+* (lesbian, gay, bisexual, transgender, queer or questioning, and others) children and youth, particularly transgender youth, are overrepresented in foster care. Studies indicate that about 30 percent of youth in foster care identify as LGBTQ+, compared with 11 percent of youth not in foster care, and that approximately 5 percent of youth in care identify as transgender, compared with 1 percent of youth not in foster care (Youth.gov, n.d.). Affirming and supporting youth is always the right thing to do, and for LGBTQ+ youth, it can be lifesaving (Green et al., 2021; The Trevor Project, 2019; Turban et al., 2020). Even something as seemingly small as using a young person's preferred pronouns can have a tremendous impact on their well-being.
 
The past few years have seen an uptick in anti-LGBTQ+ policies, including those that penalize parents for affirming and caring for their youth. While many county and district attorneys have pledged to decline to prosecute such cases, the damage and fear has already had traumatic effects for the young people who need gender-affirming care and for the families that want to support them. These are in addition to longstanding policies that limit the rights of LGBTQ+ children, youth, and families and fail to protect even the basic safety of LGBTQ+ youth. In fact, only a single state ensures youth in foster care are placed in bedrooms according to their gender identity. LGBTQ+ children and youth already navigating a landscape of harmful policies may find out-of-home care an exceptionally harrowing experience.
 
What Can You Do to Better Support LGBTQ+ Youth and Families?
 
Child welfare professionals can use the following strategies to ensure practice in their agencies supports LGBTQ+ youth and families.
 
Read and Reflect on the Children's Bureau's Guidance
 
In the March 2, 2022, The Family Room blog post, the Children's Bureau outlined its support for LGBTQ+ children and youth. That post and Information Memorandum (ACYF-CB-IM 22-01) describe how to provide safe, affirming care to LGBTQ+ youth and list related provisions in federal law for title IV-B and IV-E agencies. 
 
Agency leaders can explore ACYF-CB-IM-22-01 for resources and guidance regarding the use of federal funds for meeting the needs of LGBTQ+ children, youth, and families, such as using title IV-B funds to assist adoptive families in accessing gender-affirming health care for their children. Additionally, agencies can advocate for families at risk of being separated and can use title IV-E funds to promote family preservation. We must think broadly and innovatively to use federal programs and funds as anchors in serving all families and youth in foster care.
 
Review Resources and Best Practices
 
The following resources can support agencies working to build capacity to support and affirm LGBTQ+ children, youth, and families:
Dedicate Time and Resources to Building a Safe and Supportive Culture
 
Consider how to advance equity for LGBTQ+ youth by cultivating a culture that recognizes the intersectional identities that individuals hold. As with all diversity initiatives, agencies must be sure to include LGBTQ+ individuals when designing and implementing materials, education, training, and policies. 
 
Work to develop and model a culture that is open, accepting, and safe for LGBTQ+ children, youth, families, and staff. Consider how to demonstrate commitment to fostering an affirming environment by approaching different perspectives with curiosity and showing grace and encouragement to those who ask questions. Combine actionable policies and prioritized collaboration with LGBTQ+-affirming community partners to further align your practice and support your workers. 
 
To move forward and create or improve an LGBTQ+-affirming culture, take time to pause and reflect on current practice. Below are a few questions to explore when assessing your agency's policies and values so you might better engage and support LGBTQ+ youth and families in foster care:
  • Are your policies intentional about assessing and providing each LGBTQ+ child's and youth's individualized needs?
  • Are you actively countering barriers to gender-affirming care?
  • Are you vigilant in placing LGBTQ+ children and youth in homes where they are wholly supported and celebrated?
  • Are you providing LGBTQ+ youth with opportunities to participate in activities that support their identity and development?
  • Are you actively building internal capacity to identify, understand, and address issues that LGBTQ+ youth encounter during their child welfare experience?
  • Are you prepared to provide trauma-competent and trauma-informed services?
  • Are you working to provide parents who are struggling to accept their child is LGBTQ+ with appropriate training and services?
  • Are agency staff supported, affirmed, and celebrated as their authentic selves?
  • Do agency materials, including the website, reflect a diverse representation of children, youth, and families?
References
 
Green, A. E., DeChants, J. P., Price, M. N., & Davis, C. K. (2021). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. Journal of Adolescent Health, 70(4), 643–649. https://doi.org/10.1016/j.jadohealth.2021.10.036
 
The Trevor Project. (2019). Accepting adults reduce suicide attempts among LGBTQ youth. https://www.thetrevorproject.org/research-briefs/accepting-adults-reduce-suicide-attempts-among-lgbtq-youth/
 
Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics, 145(2), e20191725. https://doi.org/10.1542/peds.2019-1725
 
 
*A variety of acronyms are used to describe the LGBTQ+ community, such as LGBTQIA2+. LGBTQIA2+ includes lesbian, gay, bisexual, transgender, queer, intersex, asexual, and/or two-spirit. Trans or trans* can be used as inclusive terms for transgender, genderfluid, and other gender identities other than cisgender. There is no single way to reference or define LGTBQ+ people or communities. It is best to use the preferred terminology of the person or people involved.

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