Supportive Housing for Sexual and Gender Minority Individuals With Criminal Justice Histories: Challenges and Opportunities Identified by Providers and Clients

Figures & data

Table 1. Intervention characteristic themes about supportive housing for sexual and gender minorities with criminal justice histories.

Theme/subtheme	Type	Reported by		Exemplar quote
		Providers	Clients
Provides stability for long-term goals	Facilitator	X	X	“On the street you’re not really worrying about, like, therapy or going to, like, counseling or working with your [Intensive Case Management Services] worker. You’re just worried about survival. But when you have a stable place to live then you can actually…your hierarchy of needs is met and you can worry about other things and other lists and tasks.” (Client)
Comprehensive care models with flexible timelines	Facilitator	X	X	“They have a team for me, so I have my case manager, my substance abuse counselor, my therapist, an occupational therapist…and any time I need help with filling out [Social Security] papers, I can always ask one of the case managers.” (Client)
Priority of behavioral health services	Facilitator	X	X	“It’s an array of different needs, but I think that in order for us to get them stable, we start with providing them mental health [services]. And then, we start working with the rest of the pieces of the puzzle. At the end of the day, we want all of our clients to have a successful exit, right?” (Provider)
Clients may have different priorities than behavioral health services	Barrier	X	X	“They do what they can and, you know, it’s, like, to help you find a place to live, permanently. So that’s the goal. So in the meantime…they want us to go to all the groups and stuff like that. Like, if you have depression…most of the times, I don’t feel like I need that group. Because, I feel like, me personally as myself, I already surpassed that.” (Client)
Focus on population-specific issues	Facilitator	X	X	“I’ve gotten feedback from some of our fellows—they went to apply at an agency that is there to help them, and when they identify themselves as LGBTQ, they felt like they were pushed to the back of the line. So a lot of them don’t want to be living their truth when it comes to try to apply for housing or whatever because they’re afraid they’re going to be discriminated against. Being able to come and sit with someone and be your authentic self and still get help is kind of what we’re here for.” (Provider)
Offering criminal justice outreach and reentry programs	Facilitator	X	X	“Folks write us from prison or a detention center. We connect with them, we have some people that actually write them, and then when they get out they actually just come here, and we help connect them with other services. … Their parole officers—all my clients, I get the same response from them—is that their parole officer tells them ‘I don’t know where to place you’ because they’re Trans.” (Provider)
Different views on appropriate program expectations	Barrier	X	X	“We are not aligned with the [district attorney], or the judges, or the court system. We advocate for our clients. And when someone relapses, they are not discharged. The consequences are much more subtle. We don’t feel that you can discharge a patient for exhibiting the symptoms of the disease. Particularly if you’re in [Recovery Bridge Housing] where we’ve already acknowledged that they’re homeless.” (Provider)

Note. LGBTQ= lesbian, gay, bisexual, transgender, and other queer identities.

Table 2. Individual characteristic themes about supportive housing for sexual and gender minorities with criminal justice histories.

Theme/subtheme	Type	Reported by		Exemplar quote
		Providers	Clients
Staff who can relate to clients	Facilitator	X	X	“We are unapologetically LGBTQ+, and I think that that serves us well…. The [clients] know that ‘we are them.’ At least half of our staff is LGBTQ, so when they walk through the door, they’re seeing people where they may feel more comfortable, that they identify with. So just being who we are, we are a beacon for our LGBTQ+ community.” (Provider)
Staff limitations	Barrier	X	X	“I believe that in order not to have these kind of experiences, it would be help[ful] to know of companies and people who understand and accept [transgender people]. It’s like [case manager] might say ‘I’m going to send you over to this company’…but the company has no familiarity with LGBTQ. (Client)
Varied cultural sensitivity across service providers	Barrier	X	X	“We’ve created a small network of culturally competent LGBT substance use and co-occurring providers. That network is about three providers right now. There are lots of agencies out there that say ‘Oh yeah, we treat ‘em!,’ you know, like that’s something significant, but they have little or no competency…and we had to go through our own personal journey to get there [with our competency].” (Provider)
Limited client self-disclosure to providers	Barrier		X	“I never told [my case manager] about the names that they were calling me. I just figured that people just anywhere wouldn’t get over the fact that I was hanging out with a [transgender woman]…I think if I would have told them they would have done something about it, but I just never brought it up for some reason. I just figured it was part of life.” (Client)
Diversity of people within SGM populations	Facilitator	X	X	“The majority of our applicants are Black. We believe that, because of the disproportionality of our numbers across the board, that this is our opportunity to apply some equity to our issues. Not to say that others are not experiencing [issues with homelessness, mental health, and addiction], but our numbers are so out of whack that at some point it is time for us to have some special attention.” (Provider)

Note. LGBTQ+ = lesbian, gay, bisexual, transgender, and other queer identities (some interviewees used the variations LGBTQ or LGBT).

Table 3. Inner setting characteristic themes about supportive housing for sexual and gender minorities with criminal justice histories.

Theme/subtheme	Type	Reported by		Exemplar quote
		Providers	Clients
Affirming environment	Facilitator	X	X	“I found this [supportive housing] company, which acts like more than just your friends. They act like a community of family members. They have found you a place where you can go in and let your dust settle. And you can, you know, let things kind of clear in your head and give you space to do what you need to do. And they’ll walk with you, if necessary, for as long as you feel it’s necessary.” (Client)
SGM-friendly as a proxy for affirming	Facilitator	X	X	“Where I’m going to be accepted for who I am no matter what that is. That’s what I was looking for. It didn’t matter to me so much that it be LGBTQ, as long as it was an environment where they’re accepting of people of any sexual preference, religion, race, whatever. But that tends to be more inclusive in the LGBTQ community. So I guess that’s why I was hoping for that, and would seek that out again. It’s kind of a crap shoot otherwise.” (Client)
Leadership support	Facilitator	X		“Working at an organization whose upper management supports that community and supports the needs of that community. And the amount of training that the organization does around cultural sensitivity and gay and lesbian and transgender issues. Every year there’s just a ton of mandated trainings that we have to go to, which I think results in having a team that can work better with that population.” (Provider)
Discrimination in supportive housing programs	Barrier	X	X	“When I got out of prison, I was looking for housing—you know, [Recovery Bridge Housing] and stuff like that because I wanted the help. And I didn’t find any LGBT-friendly places because there wasn’t any, or if there was I never found one. … For me being a gay man, it was very hard because I couldn’t be myself first of all, in the place where I was staying. It was like I was leading a double life.” (Client)
Team communication	Facilitator	X		“Just having the ability to have my navigators—they have a relationship with the patient’s doctors. Of course things are confidential, we need consent to release…but just being able to have that contact. We’ve got doctors and [licensed vocational nurses] coming in to our case conferences, when we talk about cases and work on linking clients to different services.” (Provider)
Being visible and accessible within the community	Facilitator	X		“We also are one of the few programs that, on a Friday afternoon, or the day before Thanksgiving, or Christmas Eve, we do take people in. There’s not a time where we shut down and people aren’t in the office and we’re not answering the phone. And we don’t have a machine or a system, it’s live people all the time. So those barriers are eliminated.” (Provider)
Conflict between program rules and client expectations	Barrier		X	“Anything I would change would have nothing to do with it being LGBTQ. It would be more like, maybe a little more diligence about holding people accountable for cleaning the house and stuff like that. Which has nothing to do with sexual preference or identity.” (Client)

Note. LGBTQ= lesbian, gay, bisexual, transgender, and other queer identities (some interviewees used the variation LGBT).

Table 4. Outer setting characteristic themes about supportive housing for sexual and gender minorities with criminal justice histories.

Theme/subtheme	Type	Reported by		Exemplar quote
		Providers	Clients
Discrimination in society	Barrier	X	X	“I’m so protective that when someone applies for housing, for their own apartment, and they don’t get, I go and want to find out. Like, let’s have somebody else submit an application and see what happens. I have this one staff member…she’ll go apply for an apartment after somebody gets turned down. And she’ll get it.” (Provider).
System-of-care issues	Barrier	X	X	“It is really hard when you are told that by law you can only have one case manager that is helping you with housing when that case manager is overwhelmed…there needs to be more social workers or case managers and to be able to have time, because if I just rely on one person and that person has all these other cases, it is really hard to focus on me!” (Client)
Use of informal networks	Facilitator	X		“I know the buildings and the landlords to say to a Trans person, ‘These landlords are really cool. Let’s look and see if they have apartments for rent.’ It’s an inside game.” (Provider)
Alternative systems of care	Facilitator	X	X	“I’m under the mental health umbrella, so [mental health services] go along with me. And, it’s actually a feather in my cap because of my situation. It gives you, I think, some built-in protections.” (Client)
Cycles of marginalization	Barrier	X	X	“Incarceration is kind of just, I guess, a byproduct of their life circumstances. It’s just what they do for survival, being sex workers, or stealing, or drug addiction because of inability to deal with life situations. … Any time you don’t have a source of income to be able to take care of yourself, you gonna survive by any means necessary…. For those that are sex workers, they have to look a certain way, they have to be appealing. So of course they gonna go to a store and they gonna shoplift, they gonna do stuff to keep up their appearance.” (Provider)
Criminal justice system impact on SGM identities	Barrier	X	X	“I would hear people say ‘Is that guy really gay?’ … I guess I don’t act or look a certain way, you know what I mean? It was very hard for me, I didn’t feel like I fit in…. But then as the counselors and the other staff were like ‘Yeah, you’re gay, just be yourself and don’t try to impress nobody else’…. In prison, if you’re gay, it’s a no-no, keep it on the hush-hush, on the downlow ‘cause will get your ass kicked, basically…I had to act and be a certain way to be accepted by the other guys…for 15 years, I was taught to be a certain way.” (Client)
Stigma	Barrier	X	X	“For [my parents] it was acceptable for many years for me to be gay and that is all…my father I don’t believe accepts me as transgender—my mother yes, my father no because he says to me, ‘If you want to be gay, just act like the other men, no one has to know your business.’ So there are members of my family who accept it and other members who don’t accept or don’t have the right information.” (Client)
Formal policy barriers	Barrier	X	X	“If you’ve transitioned, and you’ve gotten your name changed from when you’re in between treatment and sober living, there’s no history for you. If somebody runs a credit check, it’s not that you have bad credit, you don’t have anything. So, if we keep them in sober living for over a year, maybe a year and a half, we can then establish that yes they’ve paid rent here, and they can start to have some credit.” (Provider)
Location of housing embodies stigma	Barrier	X	X	“They seem to have an area, a door, an entrance to where they want to place [supportive housing]. And I noticed that…everybody, for whatever reason, we kind of converged in the space because of, lack of a better term, being displaced. And some displacements could have been much more rockier than others, and much more severe. … That kind of plays out, and you see that a lot.” (Client)