Unique Characteristics and Patterns of Service Use By Sexual and Gender Minority Status Among Youth Experiencing Homelessness

Background and Purpose: Up to 40% of youth experiencing homelessness (YEH) are sexual or gender diverse individuals (SGD). Existing research suggests that SGD YEH have greater mental health needs and higher violence victimization rates than non-SGD (cisgender heterosexual) YEH, but results on utilization of services have been conflicting. Among YEH broadly, patterns of service use based on homelessness characteristics and other risk factors has been observed. However, unique characteristics and service use patterns of SGD YEH is largely unknown. To address this gap, this study explores differences in characteristics and service use patterns by SGD status.

Methods: Participants were 227 YEH (SGD=121, non-SGD=111) recruited from one of three drop-in centers in Los Angeles, California between 2017-2018. Homelessness and risk characteristics included age of first homelessness, duration of current homelessness, duration of lifetime homelessness, reasons for homelessness, and foster and/or carceral system history. Service use included counseling, basic needs, legal, educational, safety, employment, and case management. Comparison of means and Chi-Square analyses assessed differences between SGD and non-SGD participants for each characteristic and service use outcome. Regression analyses were conducted adjusting for age, race, and education.

Results: Approximately 52.2% of participants were categorized as SGD. The sample was predominantly cisgender, Black or African American, and had a high school degree or less. A comparison of means revealed that SGD participants endorsed significantly more reasons for homelessness than non-SGD participants (M=1.68, SD=.12 vs. M=1.28, SD=.07, respectively) and Chi-square analyses showed SGD participants had lower rates of carceral system involvement than non-SGD participants (25.62% vs. 37.84%, respectively). No significant differences were observed between SGD and non-SGD groups for duration of homelessness, types of reasons for homelessness, and foster system history. In adjusted regression analyses significant differences in total endorsed reasons for homelessness (aOR=-0.03, 95% CI=-0.10-0.04) and carceral system involvement (aOR=-0.15, 95% CI=-0.28–0.02) remained. For service use, a comparison of means revealed that SGD endorsed using a significantly greater range of service types than non-SGD (M=5.04, SD=.39, vs. M=2.84, SD=.30, respectively). Chi-square analyses revealed that for each service type, significantly larger proportions of SGD participants endorsed past use compared to non-SGD participants. In logistic regression analyses significance remained (e.g., basic needs: aOR= 2.70, 95% CI=1.50-4.88, p<.001).

Conclusions and Implications: Findings add to the minimal body of research on SGD YEH characteristics and service use patterns. SGD YEH were more likely to use all service types assessed and used a broader range of services than non-SGD YEH. Despite the hardships endured by SGD YEH, SGD-affirming services and the sociopolitical climate in Los Angeles appear to facilitate SGD using an array of services at higher rates than non- SGD YEH. Future research should explore SGD-affirming and un-affirming practices in homelessness services and the potential impact of sociopolitical contexts on service engagement among YEH.