Risk factors for homelessness among lesbian, gay, and bisexual youths: A developmental milestone approach

Abstract

Lesbian, gay, and bisexual (LGB) youths are over-represented in the homeless population. To examine why some LGB youths become homeless, this report compares homeless and non-homeless LGB youths. Of the 156 LGB youths, 48% reported ever being homeless (i.e., running away or being evicted from home). Results indicate that sexual orientation awareness and the initiation of sexual behavior occurred earlier in homeless than in non-homeless LGB youths and predated the first homeless episode. Substance use was more frequent and first occurred at an earlier age in homeless as compared to non-homeless LGB youths; however, substance use occurred subsequent to first homelessness. Childhood sexual abuse was associated with homelessness; and, early sexual orientation development was related to homelessness among youths without a history of sexual abuse. Findings suggest that interventions should help youths cope with their unfolding sexual orientation and work to prevent or address the consequences of sexual abuse.

Introduction

Homelessness among young people, including both runaways and youths evicted from their homes by parents (i.e., “throwaways”), is a significant public health crisis. At particular risk for homelessness are lesbian, gay, and bisexual (LGB) youths (Coker et al., 2010, Dunne et al., 2002, Gattis, 2009, Institute of Medicine, 2011, Zerger et al., 2008). Although LGB youths compose only 1.4%–5.0% of the general youth population (Kann et al., 2011, June 6, Narring et al., 2003, Savin-Williams and Ream, 2007), LGB youths compose 15%–36% of homeless youths (Bailey et al., 1998, Fournier et al., 2009, Freeman and Hamilton, 2008, Gangamma et al., 2008, Leslie et al., 2002, Moon et al., 2000, Noell and Ochs, 2001, Rew et al., 2005, Van Leeuwen et al., 2006, Whitbeck et al., 2004). Nevertheless, these prevalences also demonstrate that not all LGB youths experience homelessness, suggesting the need to identify the reasons why some LGB youths experience homelessness, especially given the potential long-term consequences of homelessness for the health and well-being of LGB youths (Clatts et al., 2005, Cochran et al., 2002, Noell and Ochs, 2001, Rosario et al., in press, Whitbeck et al., 2004; see Gattis, 2009 for review).

The current study examines potential risk factors for homelessness among LGB youths with and without a history of homelessness. We hypothesize that sexual abuse and earlier LGB sexual identity development are risk factors for homelessness among LGB youths. Sexual abuse may lead to running away as a way of avoiding further sexual abuse occurring in the home. Negative reactions to a developing LGB sexual orientation may result in running away or eviction, if the home becomes too stressful for either the child or the parents. We also will examine the role of substance use, which may serve as either a risk factor or consequence of homelessness. Substance use may lead parents to evict a child (i.e., a risk factor), or it may be a way of coping with the stressors associated with being homeless (i.e., a consequence).

Below, we review what is known in the literature about the risk factors for homelessness among LGB youths and provide the basis for the above hypotheses. Given the limited research comparing LGB homeless and non-homeless youths, we begin by reviewing the more robust literature that compares LGB and heterosexual homeless youths.

Research comparing LGB and heterosexual youths with a history of homelessness has suggested potential differences in reasons for homelessness in these two groups. More homeless LGB youths than heterosexual homeless youths experience sexual abuse (Cochran et al., 2002, Leslie et al., 2002, Rew et al., 2005, Tyler and Beal, 2010, Tyler and Cauce, 2002, Whitbeck et al., 2004), physical abuse (Cochran et al., 2002, Whitbeck et al., 2004), and substance use (Bailey et al., 1998, Cochran et al., 2002, Moon et al., 2000, Noell and Ochs, 2001, Van Leeuwen et al., 2006). Indeed, when LGB youths are asked why they ran away, they were more likely than heterosexual youths to report running away due to sexual abuse (Rew et al., 2005). Issues of LGB sexual identity development (e.g., disclosure of sexual orientation as LGB, engaging in same-sex behavior) also are reported by homeless LGB youths as reasons for running away or being evicted by parents (Cochran et al., 2002, Kipke et al., 2007, Rew et al., 2005, Whitbeck et al., 2004). Although some LGB youths run away or are thrown out due to parental disapproval and discord regarding adolescent substance use (Gangamma et al., 2008), this may be more common among homeless heterosexual youths (Rew et al., 2005).

Nevertheless, comparisons between homeless LGB and heterosexual youths cannot identify the factors that contribute to homelessness because they lack a non-homeless comparison group. Differences between homeless LGB and homeless heterosexual youths may be a function of disparities in abuse, substance use, and psychological symptoms between LGB and heterosexual youths found in the general adolescent population (for recent reviews and meta-analyses, see Coker et al., 2010, Friedman et al., 2011, Marshal et al., 2008, Marshal et al., 2011, Rothman et al., 2011, Saewyc, 2011), rather than homelessness. To understand why some LGB youths have experienced homelessness while other LGB youths have not, comparisons must be made between LGB youths with and without a history of homelessness. Because both groups are LGB, any differences between them are likely a function of homelessness. This research design has recently been recommended as a robust method for understanding the risk factors for homelessness (Gattis, 2009).

Although comparisons between homeless and non-homeless youths have been made in the general adolescent population (Johnson et al., 1997, Shelton et al., 2009, Tucker et al., 2011, Tyler and Bersani, 2008, Windle, 1989, Wolf et al., 1999), only a few studies have compared the experiences of homeless and non-homeless LGB youths. Homeless LGB youths were more likely than non-homeless LGB peers to experience verbal and physical abuse, substance use, and psychological symptoms (Walls, Hancock, & Wisneski, 2007). Among young men who have sex with men (YMSM), those who were currently or had ever been homeless or run away were significantly more likely to engage in substance use than those without such history (Clatts et al., 2005, Kipke et al., 2007, Thiede et al., 2003).

However, much of the research comparing LGB youths with and without a history of homelessness is limited because it cannot determine whether differences are potential risk factors or consequences of homelessness. Specifically, the majority of research has not identified whether sexual abuse (Leslie et al., 2002, Rew et al., 2005, Whitbeck et al., 2004), the initiation of sexual activity (Bailey et al., 1998, Cochran et al., 2002), and the initiation of substance use (Bailey et al., 1998, Thiede et al., 2003, Van Leeuwen et al., 2006) occurred prior to or subsequent to homelessness (see Clatts et al., 2005, Zerger et al., 2008 for critique of the current literature), given temporal order is unclear. Risk factors and related issues, such as reactions to either pubertal maturation or a developing LGB sexual orientation, (Corliss et al., 2009, Haynie and Piquero, 2006), can only have contributed to homelessness if they occurred prior to homelessness.

Although common in examining predictors of homelessness in the general adolescent population (Johnson et al., 1997, Shelton et al., 2009, Tucker et al., 2011, Tyler and Bersani, 2008, Windle, 1989), to date only a single study has addressed the issue of temporal order in potential contributors to homelessness among LGB youths. Clatts et al. (2005) examined the ages at which youths first experienced homelessness and substance use. They found that the initiation of illicit substance use occurred significantly after first running away from home at age 14, suggesting that substance use might be a consequence of homelessness rather than an antecedent. To date, a similar treatment has not been conducted with other potential predictors or consequences of homelessness (see Zerger et al., 2008 for review). Thus, the current report extends the work of Clatts et al. (2005) by examining the ages at which various milestones (e.g., sexual abuse, sexual initiation, disclosure of LGB sexual orientation, puberty, substance use) first occurred to identify those factors that occurred prior to and, therefore, may have contributed to first homelessness.

In summary, LGB youths are disproportionately represented among homeless youths. However, not all LGB youths have a history of homelessness. Therefore, it is essential to understand the factors that may explain why some LGB youths becoming homeless while others do not. The current report compares LGB youths with and without a history of running away or being evicted by their parents to identify potential contributors or consequences of homelessness. As mentioned earlier, we hypothesize that LGB youths with a history of homelessness will be more likely than non-homeless LGB peers to experience sexual abuse and earlier LGB sexual identity development. However, it is unclear whether substance use is a potential precursor or consequence of homelessness.