As a wealthy nation, Canada enjoys one of the highest standards of living in the world. Yet there are truths about our country that are unfathomable: we have an unaddressed homelessness crisis among lesbian, gay, bisexual, transgender, queer, questioning, and two-spirit (LGBTQ2S) youth; widespread homophobia and transphobia are a daily reality; and, because of this, LGBTQ2S youth experiencing homelessness often report feeling safer on the streets than in shelters (Abramovich, 2016).
National data on the prevalence of LGBTQ2S youth experiencing homelessness are lacking; however, it was estimated almost two decades ago that 25%–40% of youth experiencing homelessness identify as LGBTQ2S (Josephson & Wright, 2000). Recent data on the prevalence of youth homelessness in Canada include the National Youth Homelessness Survey, the first pan-Canadian study of young people experiencing homelessness, which involved 1,103 respondents from 47 different communities across 10 provinces and territories (Gaetz, O’Grady, Kidd, & Schwan, 2016). The survey reported that 30% of young people self-identified as LGBTQ2S and 6% self-identified as transgender, two-spirit, or non-binary. Identity-based family conflict resulting from a young person coming out as LGBTQ2S is a major contributing factor to youth homelessness and the main cited cause of homelessness among queer and trans youth (Abramovich, 2012; Abramovich & Shelton, 2017; Choi, Wilson, Shelton, & Gates, 2015; Cochran, Stewart, Ginzler, & Cauce, 2002).
The Diagnostic and Statistical Manual of Mental Disorders (DSM) classified homosexuality as a mental disorder until 1973 (Cooper, 2004). The DSM-5 continues to pathologize and label those who fall outside of the gender binary with “gender dysphoria,” formerly called “gender identity disorder” in the DSM-IV. The pathologization of identities that do not fit into heteronormative and cisnormative2 categories has led to stereotypes, stigma, homophobia, and transphobia, all of which negatively impact the health and well-being of LGBTQ2S individuals (Meyer, 2003).
Minority stress theory (Meyer, 2003) indicates that gender and sexual minority individuals often experience chronic stressors related to their stigmatized identities, such as victimization and discrimination (Russell & Fish, 2016). The added stress and stigma of not having a safe place to call home make it especially difficult for LGBTQ2S youth experiencing homelessness, and negatively impacts their mental health, resulting in a dramatically high risk of mental health issues, including depression, anxiety, substance use, and suicide (Cull, Platzer, & Balloch, 2006; Frederick, Ross, Bruno, & Erickson, 2011; Quintana, Rosenthal, & Krehely, 2010).
LGBTQ2S youth experiencing homelessness are a diverse population of young people with intersecting identities. Intersectionality impacts their lives and mental health because they are frequently subjected to multiple forms of discrimination and marginalization, such as homophobia, transphobia, and racism, making it especially difficult to access housing, support, and healthcare services.
This chapter focuses on solutions and implications for practice and provides concrete intervention components and implementation considerations. It is meant to support practitioners in creating safe, inclusive, affirming, and LGBTQ2S–competent programs and services. The quotes presented in this chapter were collected through a qualitative, participatory, film-based study, which focused on LGBTQ2S youth homelessness and access to mental health services, and are shared as a way to exemplify the impact of the issues presented.
It is not enough to encourage young people to be themselves and promise them “it gets better”; we have an ethical and moral responsibility to make it better now.
We cannot afford to wait.