The Prevalence and Experience of LGBTQ+ Youth in a Midwestern Foster Care System: The Cuyahoga Youth Count

Background and Purpose: The QIC-LGBTQ2S is a project funded by the United States Department of Health and Human Services, Administration for Children, Youth, and Families, Children’s Bureau, and led by the Institute for Innovation and Implementation. The project is designed to develop, implement, and evaluate evidence-informed programs for LGBTQ+ children and youth in foster care. Four child welfare agencies were selected by the Institute as local implementation sites to help implement and evaluate promising models in practice settings. Cuyahoga County, Ohio, one of the selected sites, was interested in designing and implementing methods to collect sexual orientation, gender identity and expression (SOGIE) data. Cuyahoga County and the QIC-LGBTQ2S set out to determine the proportion of youth in the county’s foster care program that identified as LGBTQ+ to get better insights into their experiences in care, and identify conditions that could affect their permanency, stability, and well-being.

Methods: The Institute adapted the questionnaire used in the 2014 Los Angeles Foster Youth Survey (LAFYS; Wilson et al., 2014). Youth were eligible to participate in the survey if they: 1) were between the ages of 12–21, 2) had an open child protective services case in Cuyahoga County, 3) were in foster care, and 4) and were not in juvenile detention. Cuyahoga County had over 900 youth in their care that met these criteria. The Institute contracted with an outside vendor to conduct the interviews over the phone. To increase access to the survey, both an electronic survey distributed via a text invitation and a phone survey conducted by an interviewer were offered. We assessed for LGBTQ+ prevalence as well as disparity differences in experiences between LGBTQ+ and non-LGBTQ+ youth.

Results: This study found that approximately one-third (32%) of youth in Cuyahoga County’s foster care system identified as LGBTQ+. For selected disparity results, more LGBTQ+ youth (67.6%) indicated they had not been treated well by the foster care system when compared to non-LGBTQ+ youth (44.7%) and reported they could be themselves less frequently when compared to non-LGBTQ+ youth. LGBTQ+ youth were more likely to be hospitalized for emotional and physical health reasons and were more likely to report adverse experiences in group home settings when compared to non-LGBTQ+ youth. For youth who did identify as LGBTQ+, their family was more likely to know their status when compared to their social workers.

Conclusions and Implications: The Cuyahoga Youth Count study was the first of its kind to be conducted in a midwestern state, where the body of available data on this population is extremely limited. The finding that nearly one-third of all youth in this study identify as LGBTQ+ reinforces the need for child welfare agencies to collect SOGIE data of all children and youth, as well as instituting agency policies, training, and practice shifts to strengthen culturally responsive practice. Findings also suggest that child welfare agencies should require congregate care settings to receive training on supportive and affirming SOGIE practices.