How to Create a Support Group for LGBTQ Youth

Young people sitting in a student lounge area.

When lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth walk through the ANCHOR Project’s front door for its Thursday-afternoon trauma- and substance-abuse-recovery support group, they sink into comfy chairs and gather around the coffee table. BUOY, or Building Understanding of Yourself – happens in the living room of ANCHOR’s cozy rented house in Tucson, Arizona, where the project prepares 18- to 26-year-old LGBTQ homeless youth for independence by offering education, coaching, and casework.

The home-like environment puts LGBTQ youth at ease during BUOY sessions, says Courtney Waters, health educator for the project, a partnership of the University of Arizona, the Southern Arizona AIDS Foundation, and CODAC Behavioral Health Services. Establishing safety is the first step to creating a space where youth can open up, Waters says. BUOY addresses youths’ post-traumatic stress and addiction issues by recognizing the adversity they have overcome.

“It’s really important to acknowledge that LGBTQ identity isn’t the reason that people are at risk for trauma or homelessness or substance abuse, she says. “Rather it’s family rejection, it’s discrimination, it’s hostility, it’s exclusion, it’s feeling unsafe.”

Waters says creating a good support group that makes LGBTQ youth want to keep coming back boils down to building on the safe, welcoming environment ANCHOR created by pulling out those comfy chairs. Here are her tips for starting your own group that enables LGBTQ youth in your programs to heal over time.

Create structure and ensure safety by choosing a trauma-informed curriculum. Choose a curriculum that takes participants’ traumatic pasts into account. The ANCHOR Project uses Seeking Safety, an evidence-based group treatment program for adults with trauma and substance abuse issues, in the BUOY support group. Waters says the flexibility of Seeking Safety is ideal. The 25 freestanding modules can be covered in any order, so you can respond to participants' changing needs as you go. Anyone can lead a Seeking Safety group after attending one training.

[Discover a video series designed for organizations that serve LGBTQ homeless youth.]

Use gender-neutral words to make sessions welcoming. In order to be truly inclusive, Waters says you need to stay away from the gender binary (he/she), which could alienate sexual minority youth. Ask youth to state their preferred pronouns at the start of every session.

"Identities are fluid,” Waters says. “A person may be experimenting a little bit or exploring their identity and so they may have different pronouns today than they did last week.”

Every time the facilitator’s manual or a handout has “he/she” in the text, Waters says aloud, “he/she/they,” or just “they.” (Your organization’s intake forms should ask for preferred pronouns, too.)

Encourage youth to communicate if they step out of a session. Sometimes youth may leave a support group mid-session, and without some communication, it is difficult for a facilitator to know why. Waters encourages youth to use hand signals to let her know. BUOY participants know that if they step out of the room before the session ends, they need to make eye contact with Waters and give a ‘thumbs up’ or ‘thumbs down,’ so she knows whether they feel okay or need support. If a youth signals, ‘thumbs down,’ the Peer Recovery Support Specialist, who sits in on every session, will follow the youth outside to offer help.

[Learn more about serving transgender and gender non-conforming youth.]

Draft group agreements to maintain healthy boundaries. Waters invites participants to suggest ground rules to be followed during sessions, so everyone feels comfortable. She says the list of group agreements is a living document that grows and changes as needed. For example, one BUOY participant suggested the group agree to “Refrain from war stories,” because youth were sharing details that made them feel uncomfortable. BUOY adopted another agreement, “Limit distractions,” when a participant said they felt anxious when people got up, moved around, and played with their phones. Weekly reminders of the agreements and everyone agreeing to them is an essential routine, Waters says.

In addition to reminders, Waters says it is important to occasionally dedicate group time to talking about why group agreements are important. This is especially helpful if the group has not consistently been following them. Knowing that the others in the group value their opinions and care about their sensitivities can help participants to open up. After one such discussion in BUOY, Waters says, a usually reluctant participant shared details about their addiction. The disclosure spurred an enthusiastic and supportive response from the rest of the group.

[Watch the video, "Safe Spaces. Safe Places: Creating Welcoming and Inclusive Environments for Traumatized LGBTQ Youth"]

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