Amending the Runaway and Homeless Youth Act to Accommodate the Needs of Homeless LGBTQ Youth

Homelessness creates conditions of vulnerability and risk for millions of youth in the United States. While lesbian, gay, bisexual, transgender, and questioning youth compose a significant percentage of the youth homeless population, the programs that adequately address the needs of sexual minorities faced with homelessness are sparse. Yet, research reveals that LGBTQ youth face physical and mental health challenges at rates exceeding those of their heterosexual peers. While the Runaway and Homeless Youth Act, which was reauthorized in 2008, provides significant resources to meet the needs of homeless youth throughout the United States, the act must be expanded to specifically target the needs of LGBTQ youth in order to meet the needs of a population that is especially vulnerable to the risks that are associated with homelessness in youth populations.

Overview of Problems Facing Homeless Youth

Homelessness among youth is a widespread and persistent problem in the United States. According to Beharry (2012), it is estimated that between 1.5 and 2 million American youth under the age of 18 years experience homelessness annually (p. 154). Data from the Department of Housing and Urban Development (HUD) reveals that on “any given night” as many as 100,000 individuals between the ages of 18 and 24 are homeless (2012, p. 154). Further, on any given night, it is estimated that 8,000 minors, under the age of 18, experience homelessness (2012, p. 154). To be certain, the stable rates of youth homelessness ensure that there are thousands of homeless youth in need of daily assistance from social service agencies.

In order to address the needs of homeless youth, it is important to assess how homelessness is defined by policymakers. According to the legal definition borrowed from the McKinney-Vento Act, an individual is homeless when he or she lacks fixed, regular, or adequate shelter during the nighttime (2012, p. 154). Further, the HUD definition provides that youth are homeless when they have unstable housing situations, live unaccompanied by an adult in a housing unit in which they do not have a lease on or ownership of, or have moved three or more times within a 90 day period (2012, p. 154). Young individuals who live in shelters, hotels, bus stations, or cars all qualify under the definition of homelessness (2012, p. 154). The merit of these definitions is that they enable social service agencies to identify youth who live in unstable conditions that would merit the conditions of homelessness.

Homeless youth are at high risk for developing problems relating to physical and mental health. Risky sexual behavior among homeless youth particularly leads to high risk of developing health problems. For example, the rate of developing sexually transmitted infections (STIs) varies between 8 percent to 40 percent for homeless youth (2012, p. 155). Further, young homeless women are between 2.3 and 7.8 percent more likely to have been pregnant (2012, p. 155). Inconsistent access to quality food causes significant health risks for homeless youth. It is estimated that the rates of obesity among youth facing homelessness are as high as 50 percent (2012, p. 155). This high rate is believed to be caused by the reliance among homeless youth on fast food restaurants and soup kitchens for their daily calorie needs (2012, p. 155). Additionally, homeless youth are at a higher risk of developing severe medical problems, such as hepatitis A, lice, scabies, and tuberculosis (2012, p. 155). Significantly, homeless youth are afflicted by psychiatric conditions at rates that are twice that of their peers who are not homeless (2012, p. 155). Increased rates of mental illness are accompanied by an increased substance use rate between 70 percent to 90 percent among homeless youth (2012, p. 156). Yet, while the health risks faced by homeless youth in general are significant, the problems faced by LGBTQ youth warrant special consideration by policymakers.

Overview of Issues Facing LGBTQ Youth

In general, homeless LGBTQ youth face many of the same negative health conditions as their heterosexual peers. However, there is significant evidence to suggest that LGBTQ youth are especially vulnerable to the risks imposed by homelessness. According to survey estimates, anywhere between 20 percent and 40 percent of homeless youth in the United States identify as lesbian, gay, bisexual, or transgender (2012, p. 155). Yet in many large municipalities, such as Miami-Dade County, there are no public or private programs that attempt to screen for LGBTQ homeless youth and target their specific needs (Alonso, 2003, p. 53). Research demonstrates that the lack of intervention for LGBTQ youth results in missed opportunities to address physical and mental health problems that impact this population disproportionately.

As Cochran et al. (2002), there are many areas where LGBTQ homeless youth parallel the heterosexual homeless youth population. As they note, LGBTQ youth were likely to run away from home for similar reasons as heterosexual youth (Cochran et al., 2002, p. 773). Approximately 59 percent of LGBT youth cited family conflict as their reason for leaving home while 51 percent cited the desire for freedom and 48 percent cited family conflict as their reason for running away from home (Cochran et al., 2002, p. 773). The influence that sexual orientation played upon an LGBTQ individual’s decision to leave home varies between studies. According to Cochran et al., 14.3 percent of youth in a survey indicated that dispute over their sexual orientation influenced their decision to leave their home (Cochran et al., 2002, p. 774). However, Gattis (2010) estimates that as high as 26 percent of homeless LGBTQ youth reported that conflict with parents regarding their sexual orientation was the reason for their homelessness (p. 92). Thus, it can be determined that many LGBTQ youth carry issues pertaining to their sexual orientation with them when they are first faced with homelessness.

There are further differences between LGBTQ homeless youth and heterosexual homeless youth when it comes to the conditions that led to their homelessness. For example, LGBTQ youth were more likely to report leaving home because of alcohol use in their home (Cochran et al., 2002, p. 774). Additionally, a higher percentage of LGBTQ youth reported that they left home as a result of physical abuse (Cochran et al., 2002, p. 774). Compared to 63 percent of heterosexual homeless youth who reported family members with substance abuse problems, 75 percent of LGBTQ youth reported family members with severe substance abuse problems (Van Leeuwen, 2006, p. 160). This is significant considering the higher incidents of substance abuse among homeless LGBTQ youth. In one survey of homeless LGBTQ youth, respondents reported using substances more frequently than their heterosexual counterparts within a 6-month period (Cochran et al., 2002, p. 774). The difference in use of cocaine, crack, speed, and methamphetamines was especially significant between homeless sexual minorities and homeless heterosexual youth (Cochran et al., 2002, p. 774). While 27 percent of heterosexual youth reported consuming more than five drinks in one sitting, 42 percent of LGBTQ homeless youth reported excessive drinking (Van Leeuwen, 2006, p. 160). Further, while heterosexual homeless youth reported using an average of five substances, LGBTQ youth reported using seven or more different substances (2006, p. 162). As these findings suggest, LGBTQ youth face unique circumstances within their home environment that impacts the health choices that they make once they are homeless.

Further, the sexual orientation of youth impacts their vulnerability of being exploited and victimized. As a whole, homeless youth are more vulnerable than non-homeless youth to becoming victims of hate crimes, including robbery, rate, and assault (Cochran et al., 2002, p. 773). Often, the higher incidents of sexually risky behavior engaged in by homeless youth are connected with sexual victimization. For example, homeless youth are more likely to engage in prostitution or “survival sex,” which is the performance of sexual favors in exchange for money, drugs, or living accommodations (Cochran et al., 2002, p. 773). LGBTQ youth are especially vulnerable to involuntary sexual victimization. It is determined that male LGBTQ homeless youth are more vulnerable than their heterosexual counterparts to being sexually victimized, especially after their third month of homelessness (Cochran et al., 2002, p. 774). By contrast, female LGBTQ youth are more likely than their heterosexual counterparts to become sexually victimized immediately upon becoming homeless (Cochran et al., 2002, p. 774). Also, LGBTQ homeless youth reported being victimized by approximately 7 more individuals than their heterosexual peers (Cochran et al., 2002, p. 774). The increased risk of sexual victimization is just one factor that increases the rates of adverse physical and mental health experienced by homeless LGBTQ youth.

In addition to becoming victims of crime or exploitation, LGBTQ youth are more likely to engage in risk behavior upon becoming homeless. LGBTQ youth reported a higher number of lifetime sexual partners than their heterosexual peers (Cochran et al., 2002, p. 775). Additionally, LGBTQ youth were twice as likely as their heterosexual peers to report having unprotected sex “all of the time” (Cochran et al., 2002, p. 775). Yet, discussed previously, it is uncertain to what extent the victimization of LGBTQ youth contributes to the increased risky sexual practices among the population. As Van Leeuwen et al. (2006) conclude from a survey spanning eight cities in the United States, 44 percent of surveyed youth reported exchanging sex for money, food, shelter, or clothing, while only 26 percent of heterosexual homeless youth reported the same activities (p. 160). However, one positive finding of the survey revealed that 84 percent of homeless LGBTQ youth reported receiving HIV testing compared to 65 percent of heterosexual homeless youth (2006, p. 160). As this figure suggests, LGBTQ might be receptive to services that specifically accommodate their needs when public services providers make them available.

Finally, issues pertaining to mental health are important to consider when evaluating the needs of LGBTQ youth. According to Van Leeuwen et al., 62 percent of homeless LGBTQ youth have attempted suicide while only 29 percent of homeless heterosexual youth reported having attempted suicide (2006, p. 160). As Gattis theorizes, the stressful social environments faced by LGBTQ youth because of the stigma of their sexual orientation, the prejudices and discrimination they face, the expectations of rejection they face, and the internalized homophobia they experience are among the factors that exacerbate the negative mental health outcomes faced by the population (Gattis, 2010, p. 92). Thus, interventions that specifically cater to the challenges and experiences of LGBTQ youth have the potential to be effective in reducing the physical and mental health risk disparities that exist.

Analysis of the Runaway and Homeless Youth Act

The current policy that exists to address the problems faced by homeless youth across the United States is the Runaway and Homeless Youth Act, Title III of the Juvenile Justice and Delinquency Prevention Act of 1974, which was reinstated by Congress on October 8, 2008. The Act seeks to improve the coordination between federal programs that exist to serve runaway and homeless youth (“Runaway and Homeless Youth Program,” 2012). Further, the Act authorizes the Secretary of Health and Human Services to make grants available to public and nonprofit entities that provide services for homeless youth (2012). Funding can be allocated to areas that include the provision of short-term shelter for youth, street-based services, drug abuse education and prevention services, and testing for STIs (2012). The finding provided by the Runaway and Homeless Youth Act is essential to enabling social service providers to extend their services because of the high costs that are involved with meeting the needs of homeless youth. According to estimates, shelter programs, which served a total of 37,648 youth cost an average of $1,282 per youth, while transitional living programs cost an average of $14,726 per youth (Dunn & Krehely, 2012). However, while the Act serves to significantly expand outreach to homeless youth, its main weakness is that it fails to address the specific concerns held by LGBTQ youth.

Considering the high proportion of homeless youth who are LGBTQ and the high risks experienced by homeless LGBTQ youth, it is critical that the Runaway and Homeless Youth Act be expanded in order to target the needs of this population. As Dunn and Krehely recommend, Congress can ensure that the Act addresses the risks faced by LGBTQ youth by first ensuring that a statement of nondiscrimination is adopted that included sexual orientation and gender identity in order to ensure that recipients of grant aid do not discriminate against LGBTQ youth (2012). Additionally, it is recommended that Congress require grant recipients to include planning documents to demonstrate their ability to meet the special needs of LGBTQ youth (2012). By requiring the submission of planning documents, service providers will become familiar with the needs of their LGBTQ clients and be more ready to respond to those needs. Finally, it is recommended that the Act include the establishment of programs that will alleviate family conflicts that lead to homelessness among LGBTQ youth (2012). Because conflict over sexual orientation and substance abuse are major factors that lead to LGBTQ youth homelessness, targeted preventative measures can help reduce the rates of homelessness in the population. By amending the Runaway and Homeless Youth Act, local and state organizations that receive federal grant aid across the country will become better equipped to address the disparities that exist between LGBTQ and heterosexual homeless youth populations.

Conclusion

While homeless youth are exposed to significant physical and mental health risks, homeless LGBTQ youth experience risk factors that exacerbate their risks. Substance abuse in the home, stigmatization for their sexual orientation or gender identity, and conflict with parents over their sexual orientation or gender identity are among the issues that are unique to LGBTQ youth. As the research reveals, these factors contribute to significant disparities between LGBTQ and heterosexual youth in several areas of well being. Sexual victimization, drug use, and mental health problems are among the problems that LGBTQ homeless youth experience at significantly higher rates. Because LGBTQ youth account for as high as 40 percent of the homeless youth population, it is essential that their needs are focused upon by social services providers. By expanding the Runaway and Homeless Youth Act to focus upon the needs of LGBTQ youth, local and state organizations will be provided with more effective tools for anticipating and meeting the needs of homeless LGBTQ youth across the country.

References

Alonso, A. G. (2003). A program design for homeless gay, lesbian, bisexual, and transgender youths. (Order No. 3100808, Carlos Albizu University). ProQuest Dissertations and Theses, 176-176 p. Retrieved from http://search.proquest.com/docview/305211235?accountid=14068. (305211235)

Beharry, Meera S.,M.D., F.A.A.P. (2012). Health issues in the homeless youth population. Pediatric Annals, 41(4), 154-6.

Cochran, B. N., Stewart, A. J., Ginzler, J. A., & Ana, M. C. (2002). Challenges faced by homeless sexual minorities: Comparison of gay, lesbian, bisexual, and transgender homeless adolescents with their heterosexual counterparts. American Journal of Public Health, 92(5), 773-7.

Dunn, M., & Krehely, J. (2012). Runaway and homeless youth act should include gay and transgender: These youth experience homelessness at much higher rates. Center for American Progress. Retrieved from http://www.americanprogress.org/issues/lgbt/news/2012/05/10/11572/

Runaway and homeless youth program authorizing legislation. (2012, April 18). Family and Youth Services Bureau. Retrieved from http://www.acf.hhs.gov/programs/fysb/resource/rhy-act

Van Leeuwen, J.,M., Boyle, S., & Salomonsen-Sautel, S., D, N. B. (2006). Lesbian, gay, and bisexual homeless youth: An eight-city public health perspective. Child Welfare, 85(2), 151-70. Retrieved from http://search.proquest.com/docview/213810231?accountid=14068