A Cascade of Affirming Conversations: Aligning Child Welfare Practice with LGBTQ+ Affirmative Policy and Research

Background and Purpose

LGBTQ+ youth are significantly overrepresented in child welfare systems and face increased risks of adverse childhood experiences, family rejection, and identity-based harm. While LGBTQ+ affirmative practice can mitigate further harm, consistently aligning social work practice with these findings remains challenging. This study bridges empirical research and frontline decision-making to support child protection workers in implementing LGBTQ+-affirming responses at key junctures in child welfare investigations. The aim of this study was to explore affirming practices utilized in child welfare, identify opportunities to strengthen affirmative practice in child welfare, and generate a decision-making tool to ensure affirmative integration across the system.

Methods

Five semi-structured virtual focus groups were conducted with 43 members of Ontario’s Children’s Aid Societies (CAS), child welfare professionals representing rural and urban child welfare agencies and a range of organizational roles. Participants' identities included members of the LGBTQ+ community (70%) as well as racial or ethnic minorities (45%). The focus groups encouraged participants to reflect on their integration of LGBTQ+ affirming considerations into decision-making, assess barriers to affirming care, and share existing strategies. Constructivist grounded theory (Charmaz, 2014) guided analysis, with coding conducted by four trained analysts, including three with professional experience in child welfare. Open and axial coding and constant comparison (Strauss & Corbin, 1998) were used to develop themes. Ontario’s Child Protection Standards were used as a sensitizing framework to synthesize the decision-making tool. Member checking was conducted through a collaborative review of the tool with sector experts and LGBTQ+ former foster youth.

Results

The analysis generated a core category of ‘systematizing LGBTQ+ affirmation in child welfare practice’, capturing the need to embed affirming approaches at multiple points of system interaction. This process was underpinned by four interconnected themes: (1) Promoting education and awareness—while some workers had foundational knowledge, participants highlighted that affirming care was not consistently integrated into daily decisions without dedicated training; (2) Supporting siloed champions—many agencies relied on individual staff or informal committees to lead LGBTQ+ initiatives, who struggled to garner buy-in and shift practice cultures without organizational mandates; (3) Improving data collection systems—documentation tools often lacked fields for chosen names, pronouns, or identity-related risks, resulting in limited visibility and accountability; and (4) Assessing caregivers’ affirmation—Participants described difficulties identifying ambivalence and microaggressions, noting that risk assessments rarely prompted structured evaluation of caregiver support. These findings informed the co-creation of ‘A Cascade of Affirming Conversations’, a tool mapping affirming decision-making prompts onto Ontario’s mandated child protection standards. Early feedback suggests the tool supports greater consistency, reflective supervision, and clarity in practice.

Conclusion and Implications

This study underscores the need to shift from ad hoc efforts to systematized, agency-wide models of affirming care. The tool provides specific, trauma-informed prompts aligned with standards with the aim to reduce harm and improve outcomes for LGBTQ+ youth. A detailed description of the decision-making tool will be shared. Tools aligned with frontline realities and policy can help bridge the gap between equity goals and everyday decision-making, embedding shared responsibility for supporting LGBTQ+ youth.