LGBT2SQ Children and Youth and the Child Welfare System: Risks and Challenges

LGBT2SQ children and youth can experience unique risks and challenges in the child welfare system. This section discusses some of these risks and challenges, as well as some that LGBT2SQ children and youth may face more generally.

By becoming aware, child protection workers, agencies, residential service providers, and caregivers can take steps to address and minimize these risks and challenges. The fact that an LGBT2SQ child or youth may be at risk of these challenges should be considered in decision-making about placements, permanency planning, and other services.

Family Rejection

Supportive relationships with family members promote healthy development in all children and youth. Unfortunately, the over-representation of LGBT2SQ children and youth in the child welfare system is in part due to children and youth being forced out of their homes, or leaving voluntarily due to rejection or physical or emotional abuse by their family.23 When children and youth are forced to leave home for reasons beyond their control, they may experience homelessness, poverty, violence, and other risks.

“It comes down to not receiving respect. Period.”
- Youth

According to a study conducted by the Family Acceptance Project, LGBT2SQ youth who reported high levels of family rejection were 8.4 times more likely to have attempted suicide, 5.9 times more likely to be depressed, and 3.4 times more likely to use drugs than LGBT2SQ peers from families that reported no or low levels of family rejection.24 Further, a recent Ontario study conducted by TransPulse found that transgender youth who had supportive families experienced a 93% reduction in suicide attempts over one year, compared to transgender youth who did not have supportive families.25

Research has also shown that, if given the chance to learn about LGBT2SQ identities and experiences, and to understand the negative impacts that their rejection has on children and youth, parents, caregivers, and other family members may become more supportive.26

Healthcare Concerns and Needs

While LGBT2SQ children and youth often struggle with the same health concerns as non-LGBT2SQ children and youth, they are also much more likely to experience mental health and addictions issues.

In general, LGBT2SQ individuals receive poorer quality health care than the general population as a result of stigma, discrimination, exclusion, and lack of access to quality care.32 Many health care providers have little to no training on LGBT2SQ health issues, or on providing specialized clinical care for members of LGBT2SQ communities. As a result, health care providers may not be sensitive to the particular health needs of, or be knowledgeable about, how to best support LGBT2SQ children and youth.33 Access to appropriate health and mental health services for transgender and gender diverse children and youth is even more limited and challenging. Accessing affirming health care services may be even more challenging for LGBT2SQ children and youth outside of large urban centres, where specialized health care can be limited and training for health care professionals on appropriate LGBT2SQ care is less accessible.

Because of negative past experiences with the health care system, LGBT2SQ people may delay or avoid seeking health and mental health supports, or may choose to withhold personal information from health care providers.34

LGBT2SQ children and youth involved in the child welfare system may have particular challenges getting appropriate health care. Frequent placement moves, for example, may make it even more difficult to find health care providers with whom they can build trust and feel confident about how they will be treated in talking openly about health issues.

RESOURCES: LGBT2SQ-friendly health services and information on sexual and gender diversity

What does it mean to transition?

Some transgender and gender fluid children and youth may choose to socially, medically, and/or legally transition as a way to affirm their gender identity.

Social transition is the process a person takes to affirm their gender identity in public spaces and in social interactions. This includes deciding how to navigate gendered spaces like washrooms or change rooms, as well as considering gender expression, name, and pronoun use in different social environments (e.g., dressing in a style that aligns with their gender identity, adopting a different haircut).

Legal transition is the process a person takes to change their name and/or sex designation on provincial, territorial and federal documents, including their birth certificate, driver's licence, and passport (for further information on changing government issued identification, see pg. 53).

Medical transition involves the therapeutic, pharmaceutical, surgical, or other healthcare-based interventions a person may wish to undertake to affirm their gender identity. Some examples include speech therapy, hormone therapy (including puberty blockers for children and youth), counselling, hair removal, and/or gender affirming surgical procedures. Gender-affirming health care must be individualized according to a client's needs. Healthcare providers have an important role to play in supporting trans and gender diverse children and youth throughout their gender journey. This may include conversations about non-medical and non-surgical aspects of gender affirmation (e.g., safe chest-binding, voice therapy).

Choosing whether to (or not to) transition, in what way(s), and at what time, is a very personal process. Decisions around transitioning are based on a number of factors, including individual comfort levels, safety (particularly within less inclusive spaces where children or youth may face bullying and/or violence), access to financial resources, and connection to appropriate healthcare supports.

For more information about transitioning and the needs of transgender and gender diverse children and youth, refer to the Families in TRANSition guide developed by Central Toronto Youth Services:

Violence and Harassment

Gender-based Violence and Harassment

Gender-based violence can include any form of violence (e.g., sexual harassment, assault, exploitation, physical threats, and emotional and psychological violence) that is based on an individual’s gender, gender expression or gender identity, and is intended to control, humiliate or harm the individual.35 Violence based on gender is an issue that affects diverse populations including women-identified persons, Indigenous persons, LGBT2SQ persons, racialized women, persons with disabilities, and seniors. Lesbian and bisexual girls and women, transgender girls and women, gender fluid people, LGBT2SQ communities of colour, Two-Spirit and LGBTQ Indigenous communities, LGBTQ newcomers and refugees, LGBT2SQ persons with disabilities, and LGBT2SQ persons with HIV/AIDS are disproportionately impacted by this violence.36, 37 The absence of LGBT2SQ inclusive policies and programs may result in further harm to LGBT2SQ survivors of gender-based violence, and could contribute to the perpetuation of gender-based violence.

Harassment and Violence in School

School can be a challenging place for children and youth in the child welfare system. Those who identify as LGBT2SQ may face experiences that compound these challenges. For example, research indicates that many LGBT2SQ students routinely face discrimination, harassment, bullying, and violence by other students—and even some teachers—on the basis of their sexual orientation, gender identity, and/or gender expression.38

A 2011 Canadian study, conducted by Egale Canada Human Rights Trust that surveyed over 3,700 students from across Canada, found that:39

The study found that LGBT2SQ children and youth are more likely to miss class due to feeling unsafe, which impacted their academic performance40 and demonstrates that experiences of bias, harassment, and violence can have a profoundly negative effect on a student’s success in school, and their general wellbeing.

For LGBT2SQ children and youth involved in the child welfare system, the experience of moving from placement to placement and changing schools in the process can further compromise education. Consistently supportive allies, caregivers, workers, and teachers are essential to helping LGBT2SQ children and youth cope with these realities.

Supporting LGBT2SQ Students

There are provincial, school board, and school-based policies and programs in place to help support LGBT2SQ children, youth, and their families navigate school environments.

Take a look at Egale's resource for supporting children and youth in Ontario schools to learn more:


Unfortunately, many children and youth will experience bullying—as someone who has been bullied, as someone who witnesses bullying, or someone who has bullied, or a combination of all three. Bullying is a particularly significant issue for LGBT2SQ children and youth.

LGBT2SQ children and youth experience high rates of cyberbullying and online harassment in comparison with their non-LGBT2SQ peers. U.S. based research has found that LGBT2SQ youth are harassed or bullied online three times more often, and sexually harassed four times more often, than their non-LGBT2SQ peers.41

The consequences of bullying are significant:

In addition, LGBT2SQ children and youth may have fewer supports available to help them address bullying and its impacts.44 Those who are in care may also experience bullying in their foster or group home; as a result, they may lack a safe home environment, which is so important to helping children and youth cope with bullying.45


In 2015, the first national study of children and youth who experience homelessness concluded that involvement in the child welfare system is a key risk factor for homelessness. Of the 1,103 respondents surveyed from 47 different communities across 10 provinces and territories, a high percentage of homeless youth had previous involvement with protection services (57.8%), and experienced one or more forms of abuse (63.1%) and/or neglect (37%).46

Additionally, a disproportionate number of LGBT2SQ children and youth experience homelessness. In Canada, 29.5% of homeless youth report being LGBT2SQ.47 In addition to the reasons that other youth become homeless, LGBT2SQ children and youth involved with the child welfare system may have left placements because they did not feel supported.48

With no fixed address, regular meals, clean clothes or showers, homeless youth may drop out of school and/or find it difficult to find or keep a job. For these reasons, many homeless youth lack the education, job experience or life skills to transition to independence.49

On the street, LGBT2SQ children and youth may face barriers to accessing homeless shelters and other programs aimed at supporting street-involved children and youth. LGBT2SQ children and youth have reported being afraid to access mainstream shelters for fear of psychological, physical, or sexual violence. Transgender and gender fluid youth in particular may face barriers because homeless shelters and other support programs are often segregated by gender, and may not have an understanding of transgender and gender diverse children and youth and their needs.50 Lack of access to LGBT2SQ-inclusive shelters and programs is even greater outside of large urban centres.

Two-Spirit and LGBTQ Indigenous children and youth are particularly at risk of homelessness. They face unique barriers to accessing safe, affirming and culturally appropriate housing. Some Two-Spirit and Indigenous LGBTQ children and youth are forced to relocate to urban centres to find housing which can result in limited access to community, language, culture, and ceremony.51

The risk of homelessness speaks to the need for appropriate placements for LGBT2SQ children and youth in the child welfare system and the importance of working to support family acceptance and reunification.

SKETCH: Working Arts for Street Involved and Homeless Youth

Located in Toronto, SKETCH is a community-arts development initiative for youth, ages 15–29, who are homeless or living on the margins. SKETCH offers young people the opportunity to explore and develop artistic and musical skills, connect with other youth, and work with artists to receive mentorship and feedback on their work. As an LGBT2SQ-friendly initiative, SKETCH implements strategic programs to increase equity and inclusion as part of their mandate. For more information, visit or email