LGBTQ Youth are at Increased Risk of Negative Outcomes in the Foster Care System

But Cuyahoga County is on the front lines of finding a solution

click to enlarge Sonia Emerson stands before the Ohio City LGBT historical marker. - Photo by Yoshi Andregolo, Split Creative
Photo by Yoshi Andregolo, Split Creative
Sonia Emerson stands before the Ohio City LGBT historical marker.

Sonia Emerson was only 2 years old when she entered the Cuyahoga County foster care system because her biological parents were no longer able to care for her. She spent the next seven years growing up in the system before joining the ranks of the lucky ones, as far as foster care is concerned, when she was adopted at the age of 9.

That stability, along with the promise of a safe and nurturing environment, was short lived, as Sonia was physically and sexually abused by her adoptive parents. According to the Youth Today organization, Sonia is not alone: Foster children are 10 times more likely to experience sexual abuse than biological children.

At the age of 12, she entered the foster system again, landing in the home of a religious Shaker Heights family. That stay, too, was brief. And awful, in a way she hadn't experienced so far in her travels, a way that presented injury and an array of new obstacles in a life filled with too many already.

"I had discussed with my respite foster mom that I was a lesbian and she was not comfortable with that," Emerson says. "She told me I needed to pray about it, but that's not exactly something I can just pray away."

After coming out, she was rejected by her foster parent, sending her careening into an even more unstable future that included 20 more foster families, five group homes, temporary homelessness, a suicide attempt, sex work, and untold mental and emotional anguish, all before her 18th birthday.

Three to five percent of all youth identify as LGBTQ, according to estimates. That number is far higher -- 19 percent — for youth in child welfare. The disparity exists for many reasons, including biological parents doing exactly what Emerson's respite parents did: rejecting their children once they begin to explore and express their SOGIE (Sexual Orientation, Gender Identity, and Gender Expression).

According to the National Quality Improvement Center on Tailored Services, Placement Stability, and Permanency for Lesbian, Gay, Bisexual, Transgender, Questioning, and Two-Spirit Children and Youth In Foster Care (QIC-LGBTQ2S), 13 percent of youth in child welfare identify as lesbian, gay or bisexual; 5.5 percent identify as transgender; and 11.1 percent identify as gender non-binary or gender non-conforming.

Children and youth with diverse SOGIE are at a greater risk for physical and emotional abuse, drug use, suicide attempts, mental health concerns, homelessness, interpersonal and/or community violence, bullying, harassment, academic challenges, increased school sanctions and various other forms of discrimination and hardship as compared to their heterosexual peers.

Those problems are accentuated for kids in the foster care system, who also face a wide range of additional negative outcomes: They are far less likely to reunify with their biological families once put into the system, have a higher probability of winding up in group homes, and are more likely to age out of the foster care environment without any support system awaiting them on the other side.

It's a nationwide issue whose solution might be formulated locally.

Last June, the Cuyahoga County Department of Child and Family Services (CCDCFS) was chosen for a four-year grant from the National Quality Improvement Center at the University of Maryland School of Social Work to develop programs, standards and practices that will improve the lives of LGBTQ youth in the foster care system, working in tandem with the QIC. Cuyahoga County is one of four sites participating in the grant's research, alongside Prince George's County in Maryland, Allegheny County in Pennsylvania and the state of Michigan.

Research conducted at DCFS will be presented to the QIC in order to identify programs and interventions that address the unique needs of children with diverse SOGIE in foster care.

And Emerson, with all her first-hand experiences, is part of the team.

The research is a multi-pronged effort including agencies and organizations that touch every aspect of kids' lives. Led by Kathleen Sullivan, senior manager at CCDCFS, Cuyahoga County's team has enlisted the LGBT Center of Greater Cleveland, the Waiting Child Fund (now Kinnect), Kinnect (a nonprofit dedicated to helping place children in foster care with permanent families), A Place 4 Me (an initiative of over 30 partners to prevent and end homelessness among young adults age 15 to 24 in Cleveland/Cuyahoga County), and the Mandell School of Applied Social Sciences at Case Western Reserve University.

"Sonia's story is not just her story," said CWRU's Dr. Dana Prince, a health disparities researcher. "It mirrors what we see in our research."

There are currently more than 2,300 children in the Cuyahoga County foster care system, a staggering number that's jumped from 1,600 in 2013 thanks largely to the opioid crisis.

"Some of our kids come into care because of their gender identity or sexual orientation, but many of them come in for other reasons like neglect, abuse, or mental health issues just like any of our other kids. But then sometimes, we'll find out that the subcontext was their SOGIE," Sullivan says. "Just coming into care can be traumatic for a child. But for LGBTQ kids, having the added stigma poses an even greater risk. We can't be sure on the numbers, but national research indicates there are likely more than 400 kids in our care who fall somewhere on the LGBTQ2S spectrum. That's a lot of kids."

Research done by Caitlin Ryan and the Family Acceptance Project has shown that children develop a sense of gender identity (a sense of being male, female, or neither) and begin expressing it around the age of 2 or 3; that children discover their attraction to the same or opposite gender between the ages of 7 and 9; and that they determine their sexual orientation, on average, at the age of 13 and a half.

"What we know about LGBTQ youth in foster care is that they experience more placement instability when they're in care," said Dr. Prince. "But it all begins with that seed of discovering sexuality and gender identity, but not having any space to express that within a caring relationship."

Because the children in foster care are minors, it's difficult to determine the best and safest way to inquire about a child's SOGIE during what is already a difficult and traumatic experience.

In fact, Prince adds, "Right now in Cuyahoga, there's no policy for when, where, and how you ask a young person about their sexual orientation or gender. It doesn't exist."

The unfortunate reality is that not all parents are going to be accepting or affirming of a child with a diverse SOGIE, and there is a policy for collecting that information.

When applying to be a foster parent, prospective candidates answer a range of questions like, "What was your childhood like?" "What education do you have?" "What's your parenting style?" "How do you and your partner support one another?" "What activities does your family do together?" and "How do you deal with family issues?"

Whether or not they're comfortable with an LGBTQ child is another one of the questions, and a sizable portion of the respondents answer "no." It restricts an already limited pool of possible homes for LGBTQ kids, especially given the low placement rates for older children. Or, if they haven't yet come out, the limited number of options put them in the position of shielding their identity from foster parents who might be explicitly or implicitly intolerant of LGBTQ people.

"When they're in our custody, it becomes even more difficult for them to come out," Sullivan said. "We've got a percentage of kids who walk in saying, 'I'm here, I'm queer, deal with it,' but the majority don't, because they're in a foster home with people they don't know, and some foster parents can be intolerant."

They also face the prospect of being outed by the system before they're ready.

"A lot of the problem was that my social worker would out me before I was comfortable being outed," Sonia Emerson says about her experience. "They didn't realize the impact it would have on me, or the home, or how it would isolate me just because of my sexual orientation."

As part of the grant's efforts, Kori Sewell with DCFS is leading the charge on discovering the safest and most confidential methods to identify the SOGIE of a child in foster care. The agency is creating a disclosure form so social workers can talk to the youth and inform them of the services available to them if they are willing to disclose their SOGIE to resources other than their social worker.

The disclosure form will contain a flowchart identifying where any shared information will go, and with whom it will be shared, in order to provide the child an affirming home or to educate their current home on how to become affirming.

Cuyahoga County is trying to address the latter in a couple of ways. One is the PRIDE Caregiver Network.

"It will be a network of foster parents and caregivers who receive extra training, training from the national level that we are given access to, to teach them how to be affirming in their home with LGBTQ youth," Sullivan says.

The PRIDE Caregiver Network will also provide support groups for parents with LGBTQ youth to develop a system of care for affirming families to connect and serve as resources for each other.

"Parents are often rejecting behaviors that come from misinformation, crisis, ignorance, fear," said Shannon Deinhart, co-founder and associate director of Kinnect, an independent nonprofit that works with DCFS, but does not receive federal funding. "But sitting down with people and informing families of the dangers of rejecting — like homelessness, trafficking, higher rates of suicide — and offering the educational process can often move them from rejecting to accepting."

While it's important for children to have an accepting household, it's more important for LGBTQ children to live in an affirming household.

An affirming household is one that provides equality and positive welcome, while acceptance can be closely related to tolerance. And there is a difference.

The Chosen-Affirming Family program does its best to try and assist with these misconceptions surrounding LGBTQ youth. "If we have a kid in care who still has a chance at being reunified, we'll work with the family of origin through the Youth Acceptance Program and educate them to try to help them understand what their youth is all about." Sullivan says. "If they do not have a permanent plan, we will work with the youth to find affirming adults in their lives and help them with legal or emotional permanency and a support network."

In either case, the end goal is stability, the lack of which, research has shown, is the direct cause of the litany of poor outcomes.

"The need for improved permanency services for LGBTQ youth in foster care has never been greater," says Mike Kenney, the executive director of Kinnect.

Nearly one-third of LGBTQ youth never finish high school, according to a study by the Jacksonville Area Sexual Minority Youth Network. The National Foster Youth Institute reveals that children in the foster care system are three times more likely to leave the program without a high-school diploma.

Forty-six percent of homeless LGBT youth report running away from home due to family rejection of their sexual orientation and 17 percent ended up on the streets after they aged out of the foster care system, according to the Human Trafficking Search.

LGBTQ youth are 120 percent more likely to experience homelessness than their heterosexual peers, according to the True Colors Fund.

Approximately 1,000 children age out of the foster care system statewide every year, and are left with no support or connections once they're forced to live on their own, according to Ohio Fostering Connections.

Nearly forty percent of former foster youth will experience homelessness or housing instability before they're 24. While the numbers specifying LGBTQ foster youth are unavailable, experts believe they're likely higher.

Sonia Emerson is intimately acquainted with those stats, because she's lived through every single one.

When she was 16 years old, living with a family that locked her in a closet to try and "'pray away the gay," she tried to commit suicide. Fearing that she'd be placed back in the system, she made every attempt to make everything appear okay. But not because she wanted to stay where she was.

"The police were called but I acted 'normal,''' Emerson says. "After they left, I packed my things and ran away and ended up living on the streets for a few months. I refused to turn myself in, which lead to some risky behaviors."

Living on the streets, at that moment, was a better option than her foster home, and it all came back to the lack of an accepting or affirming household.

"Being in that environment was a risk I was willing to take because I was so tired of not being given the space to be myself and identify as who I am," she said.

A threatening experience with a pimp at the age of 18 finally drove Emerson to make a change. One overworked social worker, one temporary shelter, and some luck later, she finalized paperwork for subsidized placement housing. She began searching for volunteer opportunities, eventually discovering Fill This House, an organization that assists children who have aged out of the system in finding their first apartment. While working there, she attended a women's conference where she was introduced to A Place 4 Me, one of the partner's working on Cuyahoga County's grant project.

Run by the YWCA of Greater Cleveland, it coordinates the planning and implementation of local efforts to improve outcomes for transition age youth in the areas of housing, employment, education, permanency, physical and mental health, financial capability and social capital.

"I really learned what self advocacy really was and I was finally surrounded by people who really mentored and nourished the broken parts of me, while at the same time teaching me I can develop my own leadership skills and life skills that have sustained me into the leader I've become today," Emerson says. "I still don't think they know they saved my life."

They helped her finish her high school education online and helped her get her life back on track, so when an opportunity arose to join their newly formed youth leadership board, Emerson quickly applied for a co-chair position.

"After not hearing anything for a month, I was super anxious, so I just called to see if I had gotten the position or not gotten it. They said, 'We were actually just going to call you, you got it!', and I just put the phone down and cried," she says. "I cried so much, because for the first time, something felt like it was mine and I finally accomplished something."

The youth advisory board has adopted a mantra: "Nothing about me, without me," emphasizing the importance of the LGBTQ youth's participation with the research and programs that will come from this grant, as they will be the ones most affected by its implementation and are the ones who bring firsthand experience to the table.

"The fact we as the youth get to advise ..." Emerson says, "that's partnership."

The Cuyahoga County team has also brought her on as a project coordinator, specifically working on sensitivity training for social workers, case workers, and foster parents, in addition to her work with the youth board.

"Healing is a process, but I never thought I would end up here," she says.

Here is a position that can hopefully help ensure that the LGBTQ youth who follow Emerson into the system don't follow her exact path.

"Everything we do will be rigorously evaluated to make sure what we're doing works," says the Cuyahoga County Department of Child and Family Services' Sullivan. "At the end of this grant in three more years, we will have a manual that other parts of the country can use if they choose to replicate our programming."


Resources for the LGBTQ community and their families are available throughout Northeast Ohio

The LGBT Community Center of Greater Cleveland offers advocacy, support, education, and celebration in addition to a slew of support groups and interest organizations for LGBTQ community members. The Center is at 6600 Detroit Avenue.

The Division of Children and Family Services offers a web-based service program called Just In Time Training, designed to connect foster parents, kinship or other caregivers with training, peer experts and other resources, through

Medina-based “Out Support is a support group that promotes the health and well being of lesbian, gay, bisexual, transgender, questioning, non-conforming, fluid, and non-binary individuals, as well as their family and friends, through support, education and advocacy. Meetings are held monthly at Unity of Medina, 787 Lafayette Rd., Building D.

If you or someone you know may be interested in becoming an affirming foster parent to LGBTQ youth, you are highly encouraged to join the Pride Caregiver Network. For more information about this new program, please contact Kathleen Sullivan at [email protected].

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