Documenting Challenges Facing Homeless Sexual Minority Youths and Moving Toward Effective Interventions

Background and Purpose: Sexual minority youths comprise a disproportionate number of homeless youths (Kruks, 2001). A report issued by the National Gay and Lesbian Task Force (Ray, 2006) has estimated that between 20% and 40 % of all homeless youths identify as gay, lesbian, bisexual or transgendered (GLBT). More than 32 studies regarding homeless sexual minority youths have been published (Gattis, 2009). This study contributes to the literature by examining the roles that contextual variables play in explaining disparate outcomes between homeless sexual minority youths and heterosexual youths. Likewise, when compared to heterosexual and cisgendered homeless youths, sexual minority youths who are homeless face heightened risk of mental health and substance use issues, sexual risk behavior, and discrimination (Cochran, Stewart, Ginzler, & Cauce, 2002; Tyler, Whitbeck, Hoyt, Cauce, 2004; Milburn, Ayala, Rice, Batterham, Rotheram-Borus, 2000). The purpose of this study was to investigate the psychosocial problems (i.e., as they relate to mental health, substance use, sexual risk behaviors, and discrimination) associated with homeless sexual minority youths. A key study aim was to compare these youths to homeless heterosexual youths, and to examine the contextual risk factors associated with their psychosocial problems with an emphasis on future intervention planning.

Methods: Individuals ages 16-24 were recruited from three drop-in programs serving homeless youths in downtown Toronto (N=147). Inclusion criteria required participants to have not had a stable place to live for at least seven days in the past month. Structured survey interviews were conducted with each participant. Dependent variables substance use, mental health (suicide and depression) and sexual risk were modeled by sexual orientation identity. The contextual variables included school engagement, family, peers, stigma related to homelessness and discrimination based on sexual orientation.

Results: Bivariate analyses indicated that homeless sexual minority youths (n=66) fared more poorly than their homeless heterosexual counterparts (n=81) overall, with statistically significant differences on mental health, substance use and sexual risk behaviors, as well as contextual factors such as peers, family communication, stigma, and discrimination. Results of multiple regression analyses indicated that sexual identity moderated the relationship between negative peers and three psychosocial behaviors: sexual risk behaviors (b=-0.11,t=-2.07,p=0.04), condom use (b—0.07,t=-2.92, p<0.005) and substance use (b=-0.06,t=-3.19, p=0.002). Among sexual minority youths, having peers who engaged in negative behaviors was associated with increased risky behaviors, but for homeless heterosexual youths, there was no effect between negative peers and their sexual risk behaviors, condom use, and substance use. Results also indicated that sexual identity did not moderate the relationship between other contextual factors (i.e., family communication, stigma, or discrimination) and psychosocial outcomes such as mental health, substance use, and sexual risk behaviors.

Conclusion and Implications: Study findings suggest several ways to move the field forward including developing peer based interventions for substance use and condom use among homeless sexual minority youths. Preliminary results regarding individuals involved in Q-Block, an innovative transitional living program for homeless sexual minority youths in Milwaukee, will be discussed.