Protecting the Rights and Providing Appropriate Services to LGBTQIA2S+ Youth in Out-of-Home Care - Tennessee

Date: January 2023

Rights of LGBTQIA2S+ Youth in Foster Care

Citation: DCS Pol. & Proc. § 20.20

In policy: The Department of Children's Services (DCS) is committed to providing all youth and families served a safe, healthy, inclusive, and affirming environment. All DCS employees and persons are prohibited from discrimination based on gender identity, gender expression, or sexual orientation. DCS shall provide services to all youth to ensure safety and well-being; to promote dignity and respect for all youth and families inclusive of their gender identity, gender expression, and sexual orientation; and to protect their civil rights consistent with State and Federal laws, including youth who identify as lesbian, gay, bisexual, transgender, and intersex (LGBTI).

When working with youth, employees, volunteers, and contractors must use respectful language and terminology that does not further stereotypes about LGBTI people.

In the course of their work, employees, volunteers, and contractors must not refer to youth by using derogatory language in a manner that conveys bias towards or hatred of LGBTI people. Employees, volunteers, or contractors must not imply to or tell LGBTI youth that they are abnormal, deviant, or sinful or that they can or should change their sexual orientation or gender identity.

DCS and provider staff are prohibited from disclosing a youth's sexual orientation or gender identity to other individuals or agencies without the child or youth's permission, unless such disclosure is consistent with State or Federal laws or regulations.

Transgender youth must be referred to by their preferred names and the pronoun that reflects the youth's gender identity. The youth does not have to legally change their name. All written documentation should utilize the youth's preferred names as well as their legal name recognized by the court.

Youth must be allowed to dress and present themselves in a manner consistent with their gender identity. Grooming rules and restrictions, including hair, make-up, shaving, etc., must be the same for both male and female units. Dress should be consistent with appropriate placement dress code requirements for congregate care settings.

Supports for LGBTQIA2S+ Youth in Care

Citation: DCS Pol. & Proc. § 20.20; Protocol for Reasonable and Prudent Parenting

All LGBTI youth must be provided with access to medical and mental health providers who are knowledgeable about their health-care needs. These providers should facilitate exploration of any LGBTI issues by being open, nonjudgmental, and empathetic, and they will not participate in corrective or conversion therapy.

If a transgender youth is receiving transgender-related medical care (both formal and informal), such as hormone therapy or supportive counseling, medical staff must consult with the youth's medical providers and must continue to provide treatment.

LGBTI youth must be given the opportunity to participate in extracurricular, cultural, enrichment, and social activities with their identified peer groups and be supported in creating their own safe spaces. These activities can be community-based or self-designed. Activities should be developmentally appropriate and should promote the health, safety, and best interests of the youth, and they must be within the placement rules and guidelines.

From the protocol: Exploring sexual and gender identity is a typical part of growing up. Youth identifying as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) should be provided the same opportunities as any other child or youth. At the same time, they may need additional or special support to manage exploration of their identity in a safe and nurturing environment. This may include participating in LGBTQ support groups or the activities of LGBTQ organizations or experimenting with different styles of dressing and self-presentation. Flexibility is needed for youth participating in activities that would create safe spaces for LGBTQ in foster care. Caregivers should seek assistance and information on resources and opportunities for these youth if not aware of them and seek consultation with the youth's worker, when needed.

Some additional considerations for LGBTQ youth may include the following:

  • Providing and securing clothing that is aligned with the youth's personal gender identity
  • Using pronouns that the youth has requested and proper name usage
  • Providing access to health services that specialize in gender-identity needs
  • Following the treatment plan set out by the health-care provider with special attention to any gender-related medical conditions
  • Supporting and advocating for LGBTQ students in social and educational settings, as requested by the youth
  • Checking in with youth to ensure they feel supported and accepted in their placement

Placement Considerations

Citation: DCS Pol. & Proc. § 20.20

DCS will use all pertinent information gathered during the intake screening and assessment processes, including the youth's stated preference, to make housing, program, education, and work assignments for youth with the goal of keeping all residents safe and free from sexual abuse, physical abuse, psychological harm, and harassment. DCS will determine whether the placement would present management or security problems. With respect to their own safety, an LGBTI youth's own views will be given serious consideration.

Transgender youth shall not automatically be placed according to their birth sex. DCS, providers, and other professionals working with the youth will discuss the placement needs to determine what placement is their best interests based on the needs of the youth and available placement options. The most appropriate placement should be based on the youth's gender identity, taking into consideration any management or security barriers associated with the proposed placement. Each placement shall be made on an individualized basis to best meet the needs of the youth.

Youth must not be prohibited from having a roommate based on a youth's actual or perceived sexual orientation. If a youth is fearful of rooming with another person, they will be provided a single room, if available. This assignment will be made in accordance with classification procedure and facility safety and security needs.

Transgender youth must be given the opportunity to shower separately from other youth, and they must be provided safety and privacy when dressing and undressing and using the bathroom. Placement and programming assignments for transgender or intersex children or youth will be reassessed at least twice each year to review any threats to safety experienced by the youth and the appropriateness of services.

LGBTI youth must not be placed in isolation or segregation as a means of keeping them safe from discrimination, harassment, or abuse.

Caregiver Qualifications

Citation: DCS Pol. & Proc. § 20.20

For employees, volunteers, and contractors to have the awareness and capacity to effectively work with LGBTI youth committed to DCF, all are required to attend training on working with LGBTI youth.


Citation: DCS Pol. & Proc. § 20.20

The terms relevant to this section are defined as follows:

  • 'Bisexual' refers to a person who is emotionally, romantically, and/or sexually attracted to both males and females.
  • 'Discrimination' includes any act, policy, or practice that has the effect of subjecting any youth to differential treatment due to the youth's actual or perceived sexual orientation or gender identity.
  • 'Gay' refers to a person who primarily is emotionally, romantically, and/or sexually attracted to persons of the same sex, typically in reference to boys or men.
  • 'Gender' refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for males and females.
  • 'Gender expression' is the way a person expresses their gender through clothing, appearance, behavior, speech, etc. Gender expression is a separate concept from sexual orientation and gender identity. For example, a female may have a very masculine appearance but may identify as a heterosexual female.
  • 'Gender identity' is a person's internal, deeply felt sense of being masculine, feminine, or other gender, regardless of person's birth sex.
  • 'Gender nonconforming' refers to a person whose appearance or manner does not conform to traditional societal gender expectations.
  • 'Harassment' includes, but is not limited to, name-calling; disrespectful gestures, jokes, or comments; inappropriate touching; threats of physical or emotional acts or negative consequences; physical abuse; sexual abuse, and emotional abuse. Attempting to change a youth's sexual orientation or gender identity is also a form of harassment.
  • 'Intersex' refers to a person whose sexual or reproductive anatomy or chromosomal pattern does not fit typical definitions of boys/men or girls/women. Many medical and some advocacy communities now use the term 'disorder' or 'differences of sex development' (DSD) to distinguish between such medical conditions and a person's self-label or identity. Not all people who are born with a DSD identify as intersex.
  • 'Lesbian' refers to a girl or woman who is primarily emotionally, romantically, and/or sexually attracted to girls or women.
  • 'Sex' refers to the biological and physiological characteristics that define males and females.
  • 'Sexual orientation' refers to a person's emotional, sexual, and/or relational attraction to others. This can include attraction to people of the opposite sex/gender (heterosexual), the same sex or gender (gay/lesbian), multiple sexes or genders (bisexual or pansexual), or even a lack of attraction on a sexual basis (asexual).
  • 'Transgender' refers to a person whose actual or perceived gender identity or gender expression does not match society's expectations of how an individual should dress or behave in relation to their assigned gender.

Transgender is an umbrella term that is used to describe those who transgress socially constructed gender norms. As an umbrella term, transgender can include various communities such as transsexuals, intersex individuals, cross-dressers, or drag queens, etc. Most commonly, however, transgender is the preferred term used to refer to someone who identifies as transsexual or a person whose biological sex does not match the person's gender identity. Not all transgender people take steps to alter their physical presentation. Sexual orientation varies and is not dependent on gender identity.