Standards of Care for LGBT Youth

Group of diverse studentsLGBT Youth in the U.S. There are approximately 9 million lesbian, gay, bisexual, and transgender (LGBT) people in the U.S., about 3.8 percent of the population (Sears & Badgett, 2012). People are identifying publicly as LGBT at younger ages than in the past. As youth, many LGBT people face harassment, violence, stigma, rejection, and discrimination in their families, schools, employment, and social settings (Quintana, Rosenthal, & Krehely, 2010).

According to a survey of LGBT students and those questioning their sexual orientation/gender identity between the ages of 13 and 20:

LGBT young adults whose parents and foster parents support them have better overall health, mental health, and self-esteem and are much less likely to be depressed, use illegal drugs, think about or attempt suicide (Ryan, 2009).

Positive Outcomes for LGBT Youth. June is LGBT Pride Month, an opportunity to reflect on progress, current challenges in the field, and strategies to address areas of need. Through its ongoing work, AIR recognizes the importance of supporting positive outcomes for LGBT children and youth within child welfare, education, homelessness, juvenile justice, and mental health systems. It is critical that systems serving LGBT youth provide high-quality, effective, culturally competent services.

Ten Standards of Care. AIR senior researchers Jeffrey Poirier and Karen Francis identify key concepts, data, and research as well as the connection between stigma and well-being for LGBT children and youth. They describe ten standards of care that are necessary for organizations and systems to promote positive outcomes for LGBT youth, including:

  1. Conduct regular needs assessments to understand staff capacity and guide/monitor improvement efforts.
  2. Establish and enforce nondiscrimination policies.
  3. Build staff awareness, knowledge, and skills by providing training and professional development opportunities.
  4. Incorporate appropriate intake and data collection processes.
  5. Promote safe, supportive, culturally competent environments.
  6. Implement practices that support preferences and affirm identity.
  7. Promote healthy, supportive peer connections.
  8. Strengthen family connections.
  9. Promote access to affirming services and supports.
  10. Collaborate and foster relationships with other supportive youth and family organizations. (Helfgott & Gonsoulin, 2012)

Assisting Organizations and Systems to Improve Outcomes. At the 2013 Maryland System of Care Training Institutes in 2013, Poirier and Francis presented to family members, youth, community coalitions, service providers, clinicians, administrators, and local and state agency representatives about implementing standards of care to support LGBT children and presented an action planning tool to assist organizations and systems in identifying prioritized strategies, goals, and actions towards implementing these standards of care and incorporating them into day-to-day practice.

Poirier developed the tool for systems of care grantees of the Substance Abuse and Mental Health Services Administration at the U.S. Department of Health and Human Services and other communities. (Visit the Technical Assistance Partnership for Child and Family Mental Health website for more information about this tool.) AIR staff have given numerous similar presentations and community-level trainings across the country on these topics since 2011.

Learn More. AIR develops knowledge and understanding about LGBT youth that takes account of their experiences and needs. We also enhance opportunities for the healthy development, well-being, and safety of LGBT children, youth, and their families by providing workforce training and technical assistance to service providers across systems addressing behavioral health, child welfare, education, juvenile justice, and homelessness. Read more about AIR’s work on LGBT youth.


Helfgott, K.P. & Gonsoulin, S.G. (2012). Standards of care for LGBT youth. In Fisher, S.K., Poirier, J.M. & Blau, G.A. (Eds.), Improving Emotional & Behavioral Outcomes for LGBT Youth: A Guide for Professionals, pp. 141-158. Baltimore, MD: Paul H. Brookes Publishing Co.

Kosciw, J. G., Greytak, E. A., Bartkiewicz, M. J., Boesen, M. J., & Palmer, N. A. (2012). The 2011 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. New York: GLSEN.

Quintana, N.S., Rosenthal, J. & Krehely, J. (2010). On the streets: The federal response to gay and transgender homeless youth. Washington, DC: Center for American Progress.

Ryan, C. (2009). Helping families support their lesbian, gay, bisexual, and transgender (LGBT) children. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.

Sears, B. & Badgett, L. (2012). Beyond stereotypes: Poverty in the LGBT community. Tides/Momentum (4).