Hollywood Homeless Youth Point-in-Time Estimate Project: An Innovative Method for Enumerating Unaccompanied Homeless Youth

Homeless youth are greatly undercounted in the United States.  Census methods for homeless adults are inappropriate for homeless youth; thus, nationally, organizations are determining new methods for counting homeless youth.  In collaboration with the Hollywood Homeless Youth Partnership, we utilized an agency-based approach to count and survey all homeless youth entering their facilities and encountered on their outreach activities. Between October 19 and October 25, 2012, 460 unique homeless youth were counted and surveyed in Hollywood. Of these, 222 experienced literal homelessness on the night of Thursday, October 18, 2012, and 381 experienced literal homelessness within the previous year.  Literal homelessness refers to youth who are either living in emergency or transitional housing or living on the streets or in parks, abandoned buildings, cars, subway tunnels, or other places not meant for human habitation. Of the surveyed youth who experienced literal homelessness in the last year, 65% were male, their average age was 21 years, their average age of first literal homelessness experience was17 years, and 43% were from Los Angeles. Our week-long, agency-based approached was successful in enumerating homeless youth in Hollywood.

Development and validation of the Transgender Adolescent Stress Survey-Dysphoria

ObjectiveTransgender and nonbinary adolescents (TNBA) may experience gender dysphoria arising from incongruities between their body and their gender. Prior dysphoria measures have largely focused on clinical diagnosis with little regard to comparability of forms for people assigned male or female at birth, overall psychometric performance, or applicability to nonbinary populations. This study develops and validates the Transgender Adolescent Stress Survey-Dysphoria (TASS-D), intended to address these gaps.MethodsThe current study recruited a U.S. national sample of TNBA (N = 444, aged 12–17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% nonbinary, 9.5% agender). The item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Scale development included factor analysis, item response theory modeling, measurement invariance testing, and reliability analyses. Associations were examined between the TASS-D and existing measures of gender dysphoria (convergent validity), gender minority stress (divergent validity), and behavioral health outcomes (criterion validity).ResultsTASS-D and its subscales (body distress and gender expression burden) were significantly and strongly associated with gender dysphoria; significantly but weakly associated with gender minority stress; and significantly associated with most indicators of psychological distress including depressive, anxiety, and posttraumatic stress symptoms, suicidal behaviors and nonsuicidal self-injury.ConclusionsThe TASS-D is a reliable and valid measure of gender dysphoria for TNBA, offering notable benefits over existing measures: It is psychometrically sound, inclusive of all gender identities, and does not assume that respondents identify binarily or desire medical transition as a terminal goal

Violence in the Social Networks of Homeless Youths

This study examined social network processes related to interpersonal violence using a sample of 360 homeless youths from Los Angeles. Results indicated that violence is pervasive among homeless youths. Consistent with previous findings, hard drug use and childhood maltreatment experiences were closely related to violence experiences. Social network analyses revealed that having a higher proportion of violence-engaged peers in a youth’s network is associated with increased risk of personal violent behavior as well as having a high k-core number within the larger overall homeless youth network. The findings have important implications for the development of violence prevention programs for homeless youths, particularly the potential for network-based programs. </jats:p

Changes in Self-Rated Physical Health After Moving Into Permanent Supportive Housing

Purpose: Homelessness is associated with poor health outcomes and heightened risk of premature mortality. Permanent supportive housing (PSH) is a key solution for ending homelessness, but there is insufficient evidence of a relationship between PSH and improvements in physical health. Self-rated health—a consistent predictor of mortality—is a meaningful approach to understanding health improvements in PSH. Design: Longitudinal, observational design with interviews at baseline, 3-months, 6-months, and 12-months (with 91% retention at 12-months). Setting: Permanent supportive housing in Los Angeles, CA. Subjects: Four hundred twenty-one adults moving into PSH (baseline interview prior to/within 5 days of housing). Measures: Three self-rated health assessments: general health status, and limitations to physical and social activity because of health problems. Results: Generalized Estimating Equations (controlling for demographics and important health covariates; n = 420) found self-rated general health status improved between baseline and 3-months (coef: 0.13; 95% confidence interval [CI]: 0.02-0.24) and persisted at 12-months (coef: 0.16; 95% CI: 0.05-0.27). Improvements in limitations to physical or social activity because of health problems started at 6-months posthousing (physical: coef: 0.25; 95% CI: 0.12-0.39; social: coef: 0.18; 95% CI: 0.05-0.32) and persisted through 12-months (physical: coef: 0.14; 95% CI: 0.01-0.27; social: coef: 0.16; 95% CI: 0.02-0.29). Conclusions: Despite limitations associated with observational study design, these findings provide further evidence that PSH may improve health among those with homelessness histories. </jats:sec