All Youth Are Not Created Equal: Research & Lessons Learned on the Front Lines of Triaging the Trauma and Acute Needs of Homeless Ethnic Minority Lgbtq Youth

Background: This study examined quantitative intake survey data from ethnic minority, homeless lesbian, gay, bisexual, transgender and queer (LGBTQ) youth residing at Trinity Place, a long-term transitional shelter in New York City (NYC). There is an estimated 8,000 homeless LGBTQ youth in NYC yet fewer than 250 shelter beds for such a population. Rates of experiencing trauma, mental health, substance abuse and sexual risk remain disproportionately high. Social workers must provide immediate shelter while simultaneously determining where to target additional interventions. Consequently, an exploration of where to focus intervention efforts is warranted. Building on the shelter’s 10 years of serving this population, researcher/practitioners investigated such questions to “ensure healthy development” for some of the most marginalized youth.

Methods: Data were collected from May 1, 2012 through April 1, 2016 using a cross-sectional survey design. The survey was administered by shelter social work staff in English. The sample consisted of all homeless LGBTQ youth admitted during the data collection period (N = 78). Most were African American (46.2%) and Latino (20.5%). 19.2% identified as transgender. The mean age was 21.

All data was entered, cleaned, and some variable transformations were completed in SPSS. Data analyses completed include: frequencies, descriptive statistics, t-tests and examining associations between key variables including demographics and individual behavior. Due to the sample size, the Fisher’s Exact Test was selected when examining significant relationships using the Chi-Square Test.

Results: The analysis revealed the most commonly reported acute health and social needs were related to mental health, trauma and sexual risk. More transgender youth reported ‘ever being depressed’ (92.9% vs 58.1%, p≤.01) and anxious (57.1% vs 29.0%, p≤.06) compared to cisgender youth. Approximately one third (31.3%) of ethnic minority youth reported suicide attempts and were more likely than whites to report depression as a ‘very serious’ or ‘extreme’ problem compared to white youth (p≤.01). However, only 19.0% (p≤.03) reported prior psychiatric hospitalization compared to 55.6% of whites. Ethnic minority youth also reported high rates of verbal (79.1%) and physical (60.9%) abuse by a parent or direct caregiver and a quarter (25.0%) reported sexual abuse by a family member. 26.6% reported participation in sex work. Of those, 53.3% reported using a condom ‘less than always’ during sex work. Additionally, when engaging in sexual activity, they reported using a condom or other barrier ‘less than always’ 58.8% of the time while drunk or high, and two-thirds (66.7%) with a partner they thought was cheating on them.

Implications: The findings suggest shelter staff should direct intervention efforts toward mental health, trauma and sexual risk. Despite disproportionate risk, homeless ethnic minority LGBTQ youth remain under-researched and little is known about those entering transitional shelters. Considering high demands social workers face to provide shelter, targeting interventions and future studies toward specific risk areas is essential in both clinical and research contexts.