In NYC Foster Care, One in Three Youths Identify as LGBTQAI+

November 13, 2020

One in three youths in the New York City foster care system identify as LGBTQAI+, according to a new study from researchers at Columbia University Vagelos College of Physicians and Surgeons, who also report that sexual and gender diverse youths in the system have more negative experiences and greater risk for depression than non-LGBTQAI+ youth.

Theo G.M. Sandfort

The study, led by Theo G.M. Sandfort, PhD, professor of clinical sociomedical sciences in the Department of Psychiatry, was commissioned by the New York City Administration for Children’s Services (ACS) to learn more about LGBTQAI+ youth experiences in order to further strengthen the agency’s work in supporting this community. 

Based on the report’s finding, New York City’s ACS has issued a multi-pronged action plan to share the study’s findings with key stakeholders and address the unique needs of LGBTQAI+ youth in foster care.

We spoke with Sandfort, whose career has focused on the implications of sexual and gender diversity, about the findings and what we still need to know in order to improve the health and well-being of LGBTQAI+ youths in foster care. 

Were you surprised by the results?

I was not shocked, but I was surprised to find such a high number of foster youths identify as sexual and gender diverse. It’s important to remember that this study is just a snapshot. We don’t know what’s happening to these youths over time. Experiencing same-sex attraction during adolescence does not necessarily mean that a youth will come out as lesbian or gay, while some youths might discover these feelings at a later age. It’s also important to realize that sexual and gender development goes on, it doesn’t stop after we interview them.

I also wasn’t aware of the overrepresentation of ethnic and racial minorities among foster youth. I find that intriguing. The proportion of white youth overall in foster care is incredibly low. The proportion of white LGBTQAI+ youth in foster care is even lower. The study shows that the whole child welfare system reflects how society deals with children in trouble and that there is a racial and ethnic dimension to that.

Why do you think so many youths in foster care are gender diverse?

Youths don’t become gay, lesbian, or transgender because they’re in foster care. Rather, being in foster care likely has something to do with the fact that they are LGBTQAI+.

When you ask an LGBTQ kid about whether sexual orientation or gender has anything to do with being in foster care, they will likely say no. We found that out when we prepared for this study. 

We know that there are youths who, at an early age, exhibit behaviors that may signal their sexual orientation before they are even aware of it. For example, gay boys may not know that they’re gay. But the parents may think that because he behaves in a way that sets him apart from other boys. Parents do not always know how to deal with that, and that can lead to tensions and conflicts that push the child out of the family. We did not explore this with our survey.

How are gender diversity and foster care linked to mental health risk? 

I was one of the first researchers to document that sexual orientation is a risk factor for mental health disorders, such as depression. Now that is common sense, but when we did that study 20 years ago, the gay and lesbian communities were very upset because we didn’t want to be portrayed as sick.

Of course, you have to see the mental health risk in the context of the society in which LGBTQ people lived. Even now there is still homophobia, and living your life as an LGBTQ person is not always so simple.

In this study, we see that there are also differences in mental health risks that may be related to the foster care system. For instance, we found that sexual and gender diverse youth have greater risk than other youth in the foster care system in that they are criticized more often and their connection to their family is poorer—they run away from home much more frequently while in foster care—though these differences are not black and white. 

How can the study help foster youth and families?  

The study doesn’t tell ACS or families what to do. It points out that there is something that needs attention. The New York City’s child welfare system is of course aware of this. They already have a policy requiring foster families to undergo training about sexual and gender diversity. But nobody has ever looked to see if this policy is working, if it is having an impact. 

The data we collected and the insights that come out of the study reinforce there is still work to be done and give them the opportunity to strengthen their efforts.

What would you like to see happen?

I would like to see foster parents develop more empathy, greater understanding, and greater ability to address the needs of sexual and gender diverse youth when confronted with them.

The other thing is that the city is responsible for these kids. They have to know whether their needs are met. And you can think, ‘Well, why would LGBTQ youth have different needs than straight, cisgender youth?’ Of course, discovering that you are different leads to different needs. What works for straight kids doesn’t necessarily work for gay kids. The ACS needs to have a better understanding of what these kids really need—including practical things, like gender-neutral bathrooms, as well as emotional and social support.

What research questions do you want to address next?

First, we need to find out the trajectory of the kids that enter foster care, and what role does sexuality or gender—or ethnicity and race, for that matter—play in that trajectory. If the goal is to make sure that kids don’t have to enter the system, then we have to find out what it is that made them get there.

I would also be interested in what we can do with foster parents to ensure that they are more accepting and supportive of LGBTQ kids. And that will be much more about developing an intervention and having a theory about why that intervention might work and then subsequently evaluating that intervention systematically.