Foster Care Experience and Suicide Risk Among LGBTQ Youth

Background:

LGBTQ youth are at elevated risk for suicide compared with their straight/cisgender peers. This risk stems from minority stress, including experiences of victimization and rejection. Victimization and rejection from caregivers can also result in involvement in the foster care system, which is associated with greater suicide risk among youth in general. Despite the overrepresentation of LGBTQ youth among youth in foster care, there are few studies examining how a foster care history relates to suicide risk among LGBTQ youth. This study examines relationships between foster care history and suicide attempts among LGBTQ youth, as well as demographic risks and protective factors.

Methods:

Data were collected from an online survey conducted between December 2019 and March 2020 of 40,001 LGBTQ youth recruited via targeted ads on social media. Logistic regression models were used to examine 1) the association of foster care involvement with past-year attempted suicide, 2) disproportionality in foster care history by age, gender identity, and race/ethnicity, and 3) the association of youth reporting their schools to be LGBTQ-affirming with a past-year suicide attempt among those with a history of foster care and among those who were never in foster care.

Findings:

LGBTQ youth who reported foster care history had three times greater odds of reporting a past-year suicide attempt compared to those who had not been in foster care (aOR=2.98, p<.001). Transgender and nonbinary youth and youth of color had greater odds of reporting foster care history than their cisgender LGBQ and White peers.

LGBTQ youth who reported foster care history had nearly four times greater odds of being kicked out, abandoned, or running away due to treatment based on their LGBTQ identity compared to those who were never in foster care (aOR=3.77, p<.001).

Among LGBTQ youth with a history of foster care, those who reported attending an LGBTQ-affirming school had more than 50% lower odds of reporting a past-year suicide attempt compared to those who attended a school that was not LGBTQ-affirming (aOR=0.45, p<.001). Although LGBTQ-affirming schools were protective for LGBTQ youth in general, they had even greater protective effects for LGBTQ youth with a history of foster care compared to those who were never in foster care (aOR=0.63, p<.001).

Conclusions:

Given the intersection of foster care and suicide risk among LGBTQ youth, child welfare agencies should establish policies for identifying and supporting LGBTQ youth in care, including developing practices to ensure foster care placements are LGBTQ-affirming.

Our data reflect national trends on the disproportionate involvement of youth of color in foster care, particularly those who are Black or Native/Indigenous. National conversations around racism should focus on ensuring our systems of care and policies are addressing and rectifying these disparities.

Finally, our data highlight the power of LGBTQ-affirming schools for all youth, but particularly for those who have a history of foster care. This suggests that schools are a promising location of intervention for social workers to support LGBTQ youth in foster care.