Social Services

Social service agencies work best when they employ informed, evidence-based policies rather than practices based on personal biases or lack of understanding.

Among professionals, social service providers are particularly positioned to help people across the various systems and environments in which they find themselves. Operating from a holistic perspective that takes into account the complexity of individual experiences and conditions, social service professionals work to help people in virtually every aspect of their lives. Providers frequently find themselves working with clients, including children and youth, as they face some of life’s most difficult challenges, and it is not at all uncommon for issues related to a child’s gender to be an important factor. Thus, it is imperative that the professionals working to alleviate the problems being encountered have a solid understanding of the various ways gender impacts a young person.

Many of the social service providers working with children or youth will find themselves doing so within the context of the child welfare system. These youth are particularly vulnerable. Whatever the context – juvenile detention settings, group homes, foster care – these young clients will often find themselves in such circumstances at least in part due to their gender, or more accurately, the perceptions of others about their gender.

It is not uncommon for Gender-expansive youth to face rejection at home and/or within their communities. In some cases, they have, or will be pushed out of their homes or schools. In others, they will make this decision on their own as they seek a safer, more supportive environment. Unsettled by rejection from those around them, these vulnerable youth may well find themselves in unstable living situations. From here, it can be a perilously short step into the child welfare system.

The child welfare provider’s understanding and response to the child’s Gender identity and expression has particularly high stakes. Support and affirmation may provide a life-saving safety net; rejection, belittlement or aspersion a critical blow to an already fragile existence.

Common Concerns: What You Need to Know & How You Might Respond

Beyond this foundational level of knowledge about gender, there are a number of important issues and best practices that are specific to gender-expansive youth who find themselves in child welfare settings.

Building Gender Literacy

Having knowledge about gender specifically, as well as recognition of the various ways in which gender intersects with other aspects of a child or teen’s life, can be one of the best ways in which to provide inclusive advocacy and support for gender-expansive youth in your care. This includes understanding basic concepts and terminology about gender, as well as some of the best practices for supporting the mental health of these vulnerable youth. A general level of gender literacy must also take into account the context in which that young person lives. This includes recognizing the impact of various forms of identity—ethnicity and race, geography, language, religion, socioeconomic (class) and many others—and the ways that each of these might influence how others might perceive and respond to a young person’s gender, including the importance of acknowledging the challenges a child’s gender may present.

Respecting Youths’ Gender Identity and Expression

First and foremost, demonstrating a basic level of respect for a young person’s authentic sense of gender is imperative. What does this look like? It includes using the name and pronouns requested by the young person, and whenever possible the gender marker consistent with their gender identity. Allowing gender-expansive youth to dress, style their hair or wear make-up or other accessories consistent with their gender identity is also important. In addition gender-expansive youth need to see the adult staff around them modeling acceptance of gender diversity and interrupting behaviors of others that are disrespectful. Another demonstration of this respect for gender identity and expression is to institutionally acknowledge gender diversity through intake processes, language used by staff, visual images, written resources and other practices that reinforce the institution’s commitment to being fully gender inclusive.

Balancing Personal Views with Professional Responsibilities

As social service professionals expand their baseline knowledge about gender and gender-diversity, they must simultaneously examine their own values, experiences and beliefs about gender. Having most likely already been subjected to a high degree of rejection and social isolation, gender-expansive clients need providers who can affirm them and reassure them that they will be safe in their care. Social service agencies should work to provide spaces in which staff can reflect on and achieve clarity about personal, religious and cultural beliefs and values regarding Sexual orientation, gender identity and expression. They then must be supported to identify strategies for how they will meet their professional obligations when these personal views conflict with expectations to support these vulnerable youth.

Establishing a Sense of Safety

Unfortunately, many gender-expansive youth do not feel safe in the very systems that are charged with protecting them. Studies have revealed some startling youth-perceptions about institutional care. High percentages report running away from alternative care placements because they experience hostility towards their identity. Others perceive that it is safer on the street than in a group home, or other institutional setting. Agencies must therefore actively work to counteract these perceptions by consistently articulating and reinforcing gender-expansive youth’s sense of safety through policies and practices.

Respecting Confidentiality

Another important consideration is to ensure that there exist clear guidelines and processes for maintaining the privacy of a gender-expansive youth’s identity. This includes reporting information about the young person’s identity to their biological, adoptive or foster care parents, to other staff members with whom the youth might interact, and to peers. Agencies must ensure that there are well-defined and regularly reinforced policies for managing the privacy needs of youth, including clear expectations about written documentation.

Issues Specific to Out-of-Home-Care Facilities

Gender-expansive young people who find themselves in out-of-home-care settings have a number of unique needs that are also important to account for. Having already lost the stability of a caring and supportive home environment, these youth present a variety of issues to which social service providers and agencies must be cognizant of and responsive to. Many of the ideas below come from A Place of Respect: A Guide for Group Care Facilities Serving Transgender and Gender Non-Conforming Youth written by staff from the National Center for Lesbian Rights (NCLR) and the Sylvia Rivera Law Project. The following information summarizes some of the major findings and recommendations from this invaluable resource.


Group care facilities are often in a difficult position when it comes to meeting the housing needs of their gender-expansive youth. Often feeling constrained by various licensing guidelines, they feel unable to individualize the placement needs of an atypically gendered client. However, in perhaps no other area of need are the risks higher. In thinking about appropriate placement, agencies must account for the physical, as well as the emotional and psychological safety of the youth.

According to A Place of Respect:

“When facilities encounter transgender youth, most often they place these youth according to their assigned birth sex rather than their gender identity, without considering other more appropriate options. Placing transgender youth with youth of the same assigned birth sex without doing an individualized analysis of the transgender youth’s gender identity and related needs in this regard, can cause serious harm to the youth’s well-being, create unnecessary safety risks, and may violate non-discrimination laws. In addition, once improperly placed, youth are frequently required to conform to gender norms that are inappropriate for them, which increase their levels of stress and discomfort.”

The guide makes the following recommendations:

  • Provide individualized placement and classification assessments for Transgender youth that recognize the youth’s gender identity and ensure emotional and physical safety. In most cases, it will be appropriate to place the client based on gender identity, and not the assigned sex at birth.
  • Look for mixed-gender programs or housing units. Such placements offer a number of advantages, including eliminating may of the challenges that arise from sex-segregated facilities.
  • If placement based on assigned birth-sex is required or deemed most appropriate, it is incumbent that the facility understands and regularly monitors the youth’s safety risks and their legal responsibility to keep the youth emotionally and physically safe while respecting the youth’s gender identity.

Mistreatment and Harassment

  • Another persistent problem youth face in out-of-home care settings is being subjected to various forms of abuse from those around them. Regardless of placement, facilities must accept responsibility for the safety and well-being of the gender-expansive resident. Some ways of doing so includes:
  • Adopting, articulating and enforcing clear policies prohibiting any form of harassment
  • Establishing clear guidelines for reporting harassment and establishing expectations among staff for responding consistently and appropriately to all reports of abuse
  • Provide diversity trainings for youth in the facility, including information about the effects of various forms of identity-based harassment

Sexualizing Gender-expansive Youth

Too frequently, staff members as well as other residents make assumptions about atypically gendered youth that sexualize their gender identity. This includes conflating the young person’s gender with sexual orientation, and/or operating as if the gender-expansive resident is a predator- consequently limiting or prohibiting the youth’s authentic Gender expression because it is considered “inappropriate sexual behavior.” Treatment plans designed to prevent gender expression may have significantly negative consequences for the youth’s emotional well-being, reinforce notions of their gender as problematic, and may well violate the youth’s legal rights. Therapeutic approaches must be monitored to ensure they are not seeking to change the young person’s gender identity or limit expression, or punish them for asserting their gender. This includes any providers working with youth from outside of the agency. Similarly, referring gender-expansive youth to sex-offender or other programs based on these misperceptions is equally misguided.

Privacy and Access to Facilities

Gender-expansive residents frequently face great danger in using restrooms, changing clothes, or utilizing shower facilities. This risk is heightened in group-care facilities that provide little or no privacy for changing clothes and showering, such as when facilities require all youth housed in a particular unit to shower in each other’s presence. In addition to physical risks, for some youth this is so emotionally traumatic that the youth avoids using the bathroom or shower altogether, which can cause severe discomfort and medical and hygiene problems. Another potentially traumatic situation is when these youth are subjected to strip searches. Once again, it is incumbent upon facilities to ensure a high degree of respect and dignity as the gender-expansive youth navigates these circumstances.

Health Care Access

Transgender and other gender-expansive young people often find their basic medical needs unmet in institutional care settings. This can even be the case when the youth is under the direct care of a physician for gender-related care. Denial of such care occurs for numerous reasons, including insurance of a resident’s compliance to facility rules. Not only is this inappropriate method to try and ensure compliance, preventing full access to needed care can have negative health and social consequences, including depression, suicide attempts, and self-treatment (using street hormones and engaging in other medically unsupervised activities for gender Transition). In addition, when a facility fails to meet a transgender youth’s medical needs by abruptly stopping a transgender youth’s hormone treatment, or refusing to provide the youth with other medically necessary care, the facility is at risk of liability for violating the youth’s right to adequate medical care.


Gender-expansive youth face a variety of challenges in schools. Lack of access to facilities, harassment by peers and staff, disengagement from learning and social isolation are just some of the difficulties frequently encountered. Providers supporting youth in group-care settings need to be keenly aware of the local policies and requirements around meeting the needs of transgender and other gender-expansive youth in schools. This includes knowledge about how to effectively advocate on behalf of a gender-expansive client, as well as available resources that schools can access in order to meet their responsibilities accordingly. Please refer to the Explore Topics – Education section of the site for more ways to advocate for gender-expansive students.

Learning More

A Place of Respect: A Guide for Group Care Facilities Serving Transgender and Gender Non-Conforming Youth, authored by the National Center for Lesbian Rights and the Sylvia Rivera Law Project, urges group care facilities to reassess their treatment of transgender and gender-expansive youth and to adopt policies and practices that provide these youth with appropriate, fair and equal care. The report is the first to provide comprehensive guidance about the treatment of transgender and gender-expansive youth in-group care facilities, —including detention centers, correctional facilities, and group homes. The report also provides model policies and a framework for staff to ensure that all youth are given a safe and healthy living environment.

Opening Doors for LGBTQ Youth in Foster Care: A Guide for Lawyers and Judges – American Bar Association, Laver & Khoury, 2008. This guide aims to increase the legal community’s awareness of LGBTQ youth in foster care and the issues they face. It provides tools for lawyers and judges to aid their advocacy and decision-making on behalf of LGBTQ youth. Special attention is given to helping lawyers and judges understand the unique needs and risk factors of LGBTQ youth, forming positive attitudes and beliefs about LGBTQ youth, developing strong attorney-client relationships, and using effective advocacy strategies.

Getting Down to Basics: Tools to Support LGBTQ Youth in Care – Child Welfare League of America and Lambda Legal Defense & Education Fund, 2006. This tool kit offers practical information on helping to ensure that LGBTQ youth in care receive the support and services they deserve. Consisting of 18 colorful pullouts, it serves as an ideal starting point for administrators and practitioners unfamiliar with LGBTQ youth in out-of-home care issues. Specific target audiences include: caseworkers; attorneys, guardians ad litem, and advocates; congregate care providers; juvenile justice professionals; faith-based providers; LGBTQ youth; and families supporting LGBTQ youth. Sub-topics include (but are not limited to): working with transgender youth; working with homeless LGBTQ youth; LGBTQ youth risk data; recommendations for training and education; combating misguided efforts to ban lesbian and gay adults as foster and adoptive parents; and basic facts about being LGBTQ.