Children’s Bureau Advises Agencies to Provide Supportive Care for LGBTQ Youth

By the Annie E. Casey Foundation

The U.S. Children’s Bureau affirmed its sup­port for LGBTQ and gen­der non­con­form­ing chil­dren and youth, espe­cial­ly those in fos­ter care, in a March 2022 infor­ma­tion mem­o­ran­dum to the nation’s child wel­fare agencies.

The Children’s Bureau advis­es state, trib­al and ter­ri­to­r­i­al agen­cies receiv­ing fed­er­al funds to ensure that their ser­vices and pro­grams for LGBTQ youth are ​“gen­der-affirm­ing, car­ing and sup­port­ive of the whole child.” This includes pro­tect­ing young people’s access to med­ical and emo­tion­al care and pro­vid­ing ​“oppor­tu­ni­ties to par­tic­i­pate in activ­i­ties that fur­ther sup­port their iden­ti­ty, resilience and development.”

LGBTQ Youth in Fos­ter Care

Young peo­ple who are LGBTQ or gen­der non­con­form­ing are over-rep­re­sent­ed in fos­ter care, recent stud­ies say. The Children’s Bureau memo cites a mul­ti­year study in Los Ange­les, which found that LGBTQ youth are 1.5 to two times more like­ly than their peers to be in fos­ter care. Recent research in Cuya­hoga Coun­ty, Ohio, and New York City esti­mates one-third of young peo­ple in those child wel­fare sys­tems iden­ti­fy as LGBTQ, and most are youth of color.

Read our explain­er on LGBTQ terminology

Research finds that LGBTQ youth are more like­ly to expe­ri­ence the trau­ma of rejec­tion by their fam­i­lies, vio­lence, emo­tion­al harm, home­less­ness and high­er sui­cide rates than their peers. For exam­ple, young peo­ple who iden­ti­fy as LGBTQ are more like­ly than oth­ers in fos­ter care to expe­ri­ence at least 10 fos­ter care place­ments, with youth of col­or who are LGBTQ report­ing the high­est rates, accord­ing to a recent data analy­sis of sur­vey results from the Oppor­tu­ni­ty Pass­port® pro­gram — a matched sav­ings pro­gram for old­er youth in fos­ter care cre­at­ed by the Annie E. Casey Foun­da­tion. Its 2018 data is based on sur­veys of pro­gram par­tic­i­pants. Young peo­ple who iden­ti­fy as LGBTQ are more like­ly than oth­ers to have expe­ri­enced home­less­ness or couch surf­ing, and less like­ly to have at least one sup­port­ive adult on whom they can rely for advice or guid­ance, the analy­sis says. Also, they are less like­ly than oth­ers to report at least ​“good” phys­i­cal and men­tal health.

Guid­ance to Child Wel­fare Agencies

Child wel­fare agen­cies ​“must be pre­pared and com­pe­tent to address trau­ma-relat­ed issues that have occurred as a result of the child or youth fac­ing rejec­tion, dis­crim­i­na­tion or harass­ment because they are LGBTQI, espe­cial­ly in their fam­i­ly of ori­gin,” the Children’s Bureau advis­es. When gen­der is a fac­tor in a child’s removal from a fam­i­ly, ​“each title IV‑E agency should be par­tic­u­lar­ly vig­i­lant about plac­ing LGBTQ chil­dren and youth in homes and child-care insti­tu­tions where they are sup­port­ed, safe and can devel­op as a whole per­son.” The Children’s Bureau also address­es the issue of gen­der-affirm­ing med­ical care for youth who are trans­gen­der, firm­ly call­ing on agen­cies to pro­tect young people’s access to med­ical­ly approved care.

“Too often, sys­temic bar­ri­ers and prac­tices are cre­at­ed to deny such chil­dren and youth gen­der-affirm­ing med­ical care, espe­cial­ly to trans­gen­der and gen­der non­con­form­ing chil­dren and youth,” the Children’s Bureau wrote in its memo. ​“The Chil­dren’s Bureau does not sup­port these bar­ri­ers and prac­tices, and we are unequiv­o­cal that they are counter to chil­dren and youth’s best interests.”

Two states cur­rent­ly restrict access to gen­der-affirm­ing med­ical care for young peo­ple and 13 were con­sid­er­ing laws that would do so, says a study released in March 2022 by the Williams Insti­tute of the UCLA School of Law. Gen­der-affirm­ing med­ical care includes med­ical­ly approved and pre­scribed hor­mone ther­a­py for young peo­ple who are transgender.

“Every child and youth who is unable to live with their par­ents should be pro­vid­ed a safe, lov­ing and affirm­ing fos­ter care place­ment, regard­less of the young person’s sex­u­al ori­en­ta­tion, gen­der iden­ti­ty or gen­der expres­sion,” the Children’s Bureau’s memo says.

The Children’s Bureau also advis­es agen­cies about avail­able resources and the need for:

  • fam­i­ly preser­va­tion sup­port — to avoid remov­ing the child from the home — for par­ents who strug­gle with accept­ing their LGBTQ child;
  • train­ing for child wel­fare work­ers and oth­er staff, fos­ter fam­i­lies and kin­ship care­givers to rec­og­nize and address the needs of LGBTQ youth;
  • ser­vices and sup­port to help LGBTQ youth tran­si­tion from fos­ter care to adulthood;
  • part­ner­ships with com­mu­ni­ty orga­ni­za­tions that can pro­vide cus­tomized sup­port; and
  • col­lec­tion and use of data illu­mi­nat­ing the size and needs of their LGBTQ populations.

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