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

Posted April 11, 2022
By the Annie E. Casey Foundation
An LGBTQ youth stands outdoors, smiling at the camera. The young adult wears a black t-shirt and has closely cut brown hair.

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.

About the Children’s Bureau

The Children’s Bureau admin­is­ters child wel­fare under the U.S. Depart­ment of Health and Human Ser­vices. It is a part­ner of the Annie E. Casey Foun­da­tion, Casey Fam­i­ly Pro­grams and Pre­vent Child Abuse Amer­i­ca in Thriv­ing Fam­i­lies, Safer Chil­dren, a first-of-its-kind nation­al effort work­ing across pub­lic, pri­vate and phil­an­thropic sec­tors to cre­ate con­di­tions that strength­en fam­i­lies and devel­op more just and equi­table child wel­fare sys­tems. The goal is to pro­mote fam­i­lies’ health, well-being and eco­nom­ic suc­cess by sup­port­ing alter­na­tives to pre­vent fam­i­ly separation.

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