Homeless sexual minority youth are overrepresented among homeless youth and experience more negative health outcomes than their heterosexual peers. Barriers to access and ethical challenges contribute to make this population one of the most underserved in the United States. The aim of this article is to provide an overview of the evidence related to the health of homeless sexual minority youth and to identify a theoretical model of care for the nurse practitioner.

A systematic literature review was used to determine the state of the evidence related to the health and health needs of homeless youth who identify as lesbian, gay, bisexual, or transgender and to search for a theory-based model of care. Findings confirm significant disparities in health and access to care. Among homeless youth, those who do not identify as heterosexual are at greater risk for suicide, substance use, mental health problems, and victimization. They are more likely to experience discrimination and to be affected by stigma than similar heterosexual youth.

The nurse practitioner is well-suited to provide care to this population. Ecological systems theory provides one theoretical base for the development or adaptation of practice models. A new model based on existing ecological models is proposed.