Building a comprehensive understanding of 2SLGBTQ+ youth homelessness: a scoping review.

Two-spirit, lesbian, gay, bisexual, transgender, queer, questioning, plus additional sexual and gender diverse (2SLGBTQ+) youth are overrepresented among youth experiencing homelessness. 2SLGBTQ+ youth experiencing homelessness are an understudied population, which has resulted in gaps in knowledge about youths’ needs and experiences. The purpose of this scoping review was to synthesize what is currently known about 2SLGBTQ+ youth and young adult homelessness internationally, using a search strategy that included both reviews and grey literature. This review was guided by the five-stage scoping review framework developed by Arksey & O’Malley. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review checklist in the reporting of the methodology of this scoping review. The search strategy utilized a three-concept approach to capture research on 2SLGBTQ+ populations, homelessness, and adolescents/youth. Study selection and data extraction was conducted using Covidence Systematic Review Software. A total of 112 sources—including original research articles and review articles—met eligibility criteria and were included in the review. A majority of the articles focused on youths’ experiences with homelessness, highlighting issues such as family violence, conflict, and rejection; physical and sexual victimization; stigma and discrimination in housing programs; mental health and substance use challenges; engagement in survival sex; difficulties accessing and securing employment and education; and exclusion from community and social supports. Articles also discussed the barriers that youth face in trying to access shelter services, including homophobic, biphobic, and transphobic discrimination, and policies and regulations—such as gender-segregated housing—that make services non-gender-affirming. The reviewed articles highlighted strategies for services and programs to effectively address 2SLGBTQ+ youth homelessness, including training staff to be gender-affirming and inclusive, updating policies and data collection practices to be more transgender-inclusive, facilitating community connections, and adapting services to an intersectional framework. The most effective programs were characterized by five novel components: reliance on clinical evidence; trauma-informed approach; provision of safe, stable, and supportive housing; 2SLGBTQ+ peer providers; and opportunities for mutual learning between 2SLGBTQ+ youth and cisgender and heterosexual youth. As a comprehensive review of the existing literature, this scoping review can be leveraged to inform the development and implementation of targeted interventions for 2SLGBTQ+ youth experiencing homelessness across various care settings. The insights presented offer critical information for policymakers, researchers, and professionals seeking to understand and address the unique needs and challenges faced by 2SLGBTQ+ youth experiencing homelessness.