Providing culturally competent care for LGBTQ+ youth Ideas on making mental health facilities and non=profits accessible and safe for young queer people.

What is the experience of lgbt youth? According to a recent study over half of young people 13-26 identify as something other than cisgender and heterosexual. (1) So we know there is a growing number of LGBTQ+ young people. HRC (Human Rights Campaign) did a study of 10,000+ LGBT identified young people aged 13-17 and it paints a picture of the contemporary experiences of queer youth(2). 42% of LGBT youth say the community in which they live is not accepting of LGBT people. LGBT youth are twice as likely as their peers to say they have been physically assaulted. 26% of LGBT youth say their biggest problems are not feeling accepted by their family, trouble at school/bullying, and a fear to be out/open. 22% of non-LGBT youth say their biggest problems are trouble with class, exams, and grades.

What is the experience of lgbt youth? Roughly three quarters of LGBT youth say they are more honest about themselves online than in the real world. 9 out of 10 LGBT youth say they are out to their close friends and 64% say they are out to their classmates. 75% of LGBT youth say that most of their peers do not have a problem with their identity as LGBT. 92% of LGBT youth say they hear negative messages about being LGBT. Top sources are school, the internet, and their peers. 68% of LGBT youth say they hear negative messages about being LGBT from elected leaders. LGBT youth out to their immediate families are more likely to report being happy than those who are not out.

Risk factors for LGBTQ+ youth LGBTQ+ people experience disproportionate rates of issues with mental health, addiction, and houselessness. LGBTQ+ youth are particularly vulnerable: May lack natural supports May experience bullying and harassment Many have other marginalized identities as well as being LGBTQ+ We live in a heteronormative and cisnormative society that doesn’t validate their identities Some trans people experience gender dysphoria which can be distressing or traumatic Social services may be inaccessible to LGBTQ+ people

Barriers to care for LGBTQ+ youth Providers who don’t know how to provide culturally competent care or hold biases against LGBTQ+ people Facilities that are set up according to a gender binary such as residential facilities organized by gender Paperwork and forms that are set up according to a gender binary such as forms that require people to check one of two boxes to describe their gender Lack of LGBTQ+ specific services or inability to access them safely

Making physical space accessible Consider adding LGBTQ+ magazines to waiting areas or putting up a cheesy poster about LGBTQ+ inclusion or having a rainbow flag at your desk. Find ways to physically signal to LGBTQ+ clients that staff are on their side. Consider carefully the bathroom situation in your office or facility. If there are gendered single stall bathrooms get them changed to gender neutral bathrooms. If there are single stall or gender neutral bathrooms in the building put up signs to signal how to easily locate them. Is there a safe place for gender non-conforming people to use the bathroom? What can you do to create that space if it doesn’t already exist?

Residential facilities We assign roommates based on gender identity. Not sexual orientation or gender assigned at birth. This means that generally transmen would be roommates with cismen and transwomen would be roommates with ciswomen. Check in with trans and GNC clients about roommate situations and ask them what would make them most comfortable and safe and follow their lead. Check in with and support trans people in residential settings. It’s not uncommon for people to experience transphobia from roommates and other residents. Make sure GNC people have safe access to bathrooms/locker rooms/shower facilities.

paperwork A lot of paperwork require people to fit into one of two boxes in regards to gender. If it isn’t completely necessary do not ask clients to disclose their gender. If it’s necessary, provide more options. Make sure paperwork does not assume someone is heterosexual and cisgender. For example, sometimes paperwork will say “if a woman” then list questions related to menstruation or pregnancies. But there are also men and non-binary people who experience menstruation and pregnancies. Oftentimes intake paperwork is a client’s first experience with an organization. If it assumes their non-existence it’s going to make that person feel unseen and disrespected as their first interaction with the organization.

paperwork Accurate and accessible Accurate and accessible Inaccurate and inaccessible Accurate and accessible Gender: ☐male ☐ female Gender: ☐transwoman ☐ciswoman ☐transman ☐cisman ☐genderqueer ☐other: ________ Accurate and accessible Gender: ☐ woman ☐ man ☐ transgender ☐ other: _______

staff Providing culturally competent care to queer people starts with staff Invite speakers to train staff on LGBTQ+ topics Make LGBTQ+ training part of standard staff training or advocate for that to happen Have conversations with peers and coworkers who are engaging in homophobia/transphobia Hire queer people/encourage the hiring of queer people Create or advocate for the creation of specific non-discrimination policies regarding the treatment of LGBTQ+ staff and clients Take complaints of homophobic/transphobic treatment extremely seriously

Changing ourselves Most of the work we need to do to provide culturally competent care to queer people is work we need to do with ourselves Find ways to engage with queerness for example engaging with content created by queer people Personally spend time purposefully learning about queer history and social justice struggles Understand and confront personal biases and prejudices Unlearn discomfort around non-normative identities Be willing to be corrected without being defensive

Take aways Providers need to take it upon themselves to educate themselves and their peers about how to speak to and about trans and GNC people. Confront your privileges, biases, or areas of ignorance based on gender and sexuality Providers need to look at the services they provide and the spaces they take place in from the perspective of a trans or GNC person and make alterations to insure accessibility. Paying close attention to gendered spaces like bathrooms. Providers need to make paperwork reflect the reality of variation in gender and sexuality. Support queer people making space and creating healing for themselves whenever possible.

Sources/contact info (1) https://www.ditchthelabel.org/research-papers/the-valentine-study/ (2) https://www.hrc.org/youth-report/view-and-share-statistics Alex Kestrel - justkestrel4@gmail.com (608) 669-6422 Funding for this conference was made possible by NITT-HT grant, CFDA 93.243 from SAMHSA.  The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.