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Providing Services and Supports for Youth
who are Lesbian, Gay, Bisexual, Transgender,
Questioning, Intersex or Two-Spirit
This Practice Brief is for policymakers,
administrators, and providers seeking to learn
more about (1) youth who are lesbian, gay,
bisexual, transgender, questioning, intersex, or
two-spirit (LGBTQI2-S) and (2) how to develop
culturally and linguistically competent programs
and services to meet their needs and preferences.
An estimated 2.7 million adolescents who are
lesbian, gay, or bisexual live in the United States.
Other youth identify themselves as transgender,
intersex, two-spirit, or questioning, or use other
terms (see Box 1).1 These youth frequently
encounter numerous challenges and may feel
isolated, alienated, depressed, and fearful as they
attempt to navigate their emerging awareness of
their sexual and/or gender identity.
Studies indicate that youth who are LGBTQI2-S
are at risk for a number of negative experiences
and outcomes associated with how others react to
their sexual orientation and/or gender identity.2,3
Compared with other youth, youth who are
LGBTQI2-S are two to three times more likely
to attempt suicide..
2 They are more likely than
their peers to suffer from depression and use or
abuse substances.
Youth who are LGBTQI2-S may also be more
likely to experience harassment from other youth
and significant adults in their lives, and to be
subjected to verbal, sexual, and physical abuse and
other forms of trauma. Further, they are more
likely to drop out of school and become homeless.
3. Finally, bullying and rejection by peers and
family members due to a youth’s LGBTQI2-S
identity may exacerbate mental health challenges.
Addressing the needs of youth who are
LGBTQI2-S presents many challenges to childserving agencies. Challenges stem, in part, from
limited knowledge and/or stereotypes about these
youth. Providers can benefit from acquiring a
better understanding about the experiences of youth who are LGBTQI2-S, including discrimination
and stigma. The limited availability of programs and
services that are tailored for these youth and their
families also presents a challenge. These youth may
fear disclosing their identities and, as a result, may be
inhibited from seeking the supports and therapeutic
resources they need. Youth who are afraid to be open
about their identity, or “come out,” may be less likely
to report their experiences and needs to providers and
others in a service system.
Youth who are LGBTQI2-S are part of a distinctive
cultural group. They may share a larger cultural
identity, which includes a defined set of norms, social
events, styles, and use of language. These youth also
come from diverse racial and ethnic backgrounds.
Given these factors, youth who are LGBTQI2-S can be
doubly stigmatized because of their sexual orientation
and/or gender identity and their cultural, racial, or
ethnic identity. The potential for dual discrimination
can further deter these youth from accessing resources.
Thus, it is important to provide services in a culturally
and linguistically competent manner (see Box 2).
System-Level Approaches for
Helping Youth Who Are LGBTQI2-S
and Their Families
Services for youth who are LGBTQI2-S can be
improved by implementing service- and agency-level
interventions that include families and communities.
A comprehensive approach to addressing the needs of
these youth includes:
• integrating services and supports across
child- and youth-serving systems, including
health care providers;
• ensuring appropriate services and supports
are available;
• facilitating access to services;
• delivering culturally and linguistically competent
services and supports;
• delivering quality care without bias or prejudice; and
• monitoring and assessing outcomes.
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