Finding a secure place to live has not been easy for Nez Marquez, 23, who has experienced homelessness for the past five years. Born in Mexico and raised in New York, he left home at 18 because his family did not accept his gender identity and sexual orientation, he said.

Marquez is staying at Sylvia's Place, an emergency shelter for LGBTQ young adults on the bottom floor of a Manhattan church. He said shelters that specifically cater to lesbian, gay, bisexual, transgender and queer people are safer for him because he has been subjected to homophobic attacks at general-population shelters. But now, in addition to anti-gay violence and the inherent dangers of life on the streets, Marquez has another fear: the coronavirus and its ripple effects.

Nez Marquez, 23, is staying at Sylvia's Place, an emergency shelter in New York City for LGBTQ teens and young adults. Courtesy of Nez Marquez

"I've been worried about not having housing," Marquez said in an interview. "If where I'm staying shuts down, I'll be out of options."

Not only does he worry about being "forced to live in a homophobic environment," but he also has a congenital lung issue, putting him at higher risk for adverse outcomes if he were to get COVID-19, the illness caused by the coronavirus.

LGBTQ youth and young adults, like Marquez, make up a disproportionate number of homeless young people, and this vulnerable demographic is facing unique hardships amid the global health crisis. With countrywide shutdowns of schools and youth programs, diminished office hours at LGBTQ community centers and, for many of them, unsupportive family members, these young Americans and the organizations that serve them are forced to find new ways to get and provide support.

Increase in needs, decrease in services

LGBTQ adults make up an estimated 4.5 percent of the U.S. population, but recent studies have found that 20 percent to 45 percent of homeless youth identify as LGBTQ, and among young adults ages 18 to 25, LGBTQ people have a 2.2 times greater risk of homelessness than their non-LGBTQ peers, according to a new research brief by the Williams Institute at UCLA Law.

Many homeless LGBTQ young adults rely on the approximately 260 LGBTQ community centers across the U.S. for their vital needs and general well-being. During the pandemic, however, many of the centers are reducing their hours and services or closing their doors completely to protect staff and visitors.

“Our clients rely on nonprofits to provide health care, and a lot of those places have closed or shut down hours.” Kate Barnhart, New Alternatives Executive Director

New York City's LGBT Community Center, at the center of the pandemic in the U.S., closed its Manhattan location and suspended its in-person operations indefinitely on March 13. It is providing some services remotely, such as individual counseling sessions, 12-step support groups and youth social programs. Similarly, the Los Angeles LGBT Center has canceled all nonessential meetings and limited its youth programs to lunch services and critical needs while keeping its housing center open.

Detroit's Ruth Ellis Center, which includes drop-in services, a health clinic and an overnight shelter, has also reduced some of its services. Before the coronavirus crisis, the drop-in center offered hot meals and showers daily and professional skills training three days a week. Now, the center is open only to distribute groceries from its front doors on Mondays and Wednesdays from 3 p.m. to 5 p.m. Staff members are still doing videoconference appointments for behavioral health and primary care.

"The need for services is increasing, and the availability of services is decreasing," said Kate Barnhart, executive director of New Alternatives, a New York City-based nonprofit for LGBTQ homeless youth.

Barnhart said the pandemic has further complicated her clients' already inconsistent access to care, particularly when it comes to their health needs.

"Our clients rely on nonprofits to provide health care, and a lot of those places have closed or shut down hours," she said, saying a client of hers recently ran out of psychiatric medication when all her go-to medical providers were closed because of the crisis.

Barnhart said a third of her clients are living with HIV, and she fears what will happen if they are unable to get their daily medication.

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For LGBTQ youth and young adults who are able to find beds at one of the few overnight shelters across the country that cater to them, there is a different set of challenges and risks.

Brad Schlaikowsky, co-founder of Courage MKE, a Milwaukee organization that operates a group home for LGBTQ youth, said soap, hand sanitizer and other hygiene products — many of which are crucial to help prevent contraction of the coronavirus — have been hard to come by for people who are housing insecure. Due to the contagious nature of the virus, his organization is not accepting food and clothing donations.

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"This is a huge expense on the budget, and it's hitting everyone hard right now," Schlaikowsky said. "The best way people can help any organization is through financial support."

The Centers for Disease Control and Prevention recommends that everyone physically distance themselves from others by about 6 feet to reduce the chance of contracting the virus. The CDC has issued interim guidelines for the country's thousands of homeless shelters if someone does get sick, including confining symptomatic clients to individual rooms or moving them to alternative facilities if possible. However, at many shelters, the guidance is impractical.

"We don't have a private room," said Wendy Kaplan, director of Trinity Place Shelter, an LGBTQ youth shelter in New York City. "It's unrealistic, out of touch and makes us feel like the government isn't able or prepared to protect some of our most vulnerable members of society."

'Serious implications' for mental health

In addition to the physical well-being of LGBTQ homeless youth and young adults, there are also concerns about the unique mental health challenges they may face.

The Trevor Project, a national nonprofit that focuses on LGBTQ youth in crisis, released a white paper Friday outlining the "serious implications" the COVID-19 crisis could have on the mental health of lesbian, gay, bisexual, transgender and queer young people. The organization cited the physical distancing, economic strain and increased anxiety related to the pandemic as being among the most worrisome problems.

“For a lot of LGBTQ young people, the main sources of support that they get are at their schools, at clubs, at community centers, at physical spaces that they no longer have access to." Amit Paley, Trevor Project CEO

"LGBTQ young people ... are already at risk of discrimination and isolation, which can impact their mental health," Amit Paley, the organization's CEO, said Tuesday in an interview with MSNBC. "For a lot of LGBTQ young people, the main sources of support that they get are at their schools, at clubs, at community centers, at physical spaces that they no longer have access to. ... Not being able to connect with some of those really important, positive influences in your life can be extremely challenging for LGBTQ youth right now."

Paley said the Trevor Project, which operates a 24/7 crisis hotline, has had a steep increase in the number of LGBTQ youth who have been reaching out.

"We saw nearly twice the level of young people reaching out, and we know that this pandemic is having an impact, that young people are not sure where they can turn to for support," he said.

'It's most important they know they're not alone'

Local and national organizations that serve LGBTQ homeless youth are working to acclimate to the new normal, developing innovative pathways to accommodate the changing and expanding needs of this vulnerable population.

Lilianna Angel Reyes, director of the Ruth Ellis Center's drop-in service, said staff members at the Detroit facility "aren't waiting for people to create a solution."

"They're creating them, and we're helping [our clients] be the healthiest they can," she said.

With schools closed, staff members at the center's group home, Ruth's House, have developed an educational curriculum for their residents, who are ages 12 to 17. And at the drop-in center, which typically caters to teens and young adults ages 13 to 30, staffers have turned the large open space into a makeshift classroom for their group home residents.

Reyes said the Ruth Ellis Center is a safe space that "can be built anywhere" — including online, where the center has ramped up its presence. Staffers are now offering some services through digital video platforms, like its tobacco cessation program for transgender women, and clients can connect with staffers on social media, including Facebook Messenger and Snapchat.

Reyes said that overcoming obstacles and a lack of resources "isn't new" for the youth and young adults whom the Ruth Ellis Center serves and that this may ultimately help them get through the pandemic and its ripple effects.

"Most of our youth have had long histories of trauma, and they're extremely resilient," she said.

Trinity Place Shelter, which caters to LGBTQ New Yorkers ages 18 to 24, is typically open only in the evening and overnight, but during the pandemic, it is operating 24 hours a day. The extended hours give the center's 10 residents a place to socially distance, three meals a day and somewhere to wash their hands.

"The less time they're on the subway and out interacting with the public, the safer they are," the Rev. Heidi Neumark, the shelter's executive director, said in an interview.

Neumark, who is a pastor at Trinity Lutheran Church, which houses Trinity Place Shelter, said that now it is "particularly important that we offer a lot of extra reassurance."

"Most of the young people are here because they have been rejected by their families and do not have the support system and comfort that some people can count on," she said.

While Milwaukee schools and most of the city's youth programs are closed, Courage MKE has tripled the number of onsite staff members working at its group home, Courage House, the only LGBTQ youth shelter in Wisconsin. The increase is intended to help ensure that the organization's clients get the extra support they need during the pandemic while also keeping burnout low and morale high among the staff.

"We're 24/7 for the next 30 days, and it's not always sunshine and daisies, so we want to protect them, too," Schlaikowsky said of his staff.

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Schlaikowsky said Courage MKE's staffers are also trying to keep a brave face on for the youth and young adults they serve.

"If we show fear, it will rub off on the kids and make their anxiety even higher," he said.

In addition to getting help, Courage MKE's clients are helping others by preparing sandwiches for people in the community in need of food. Schlaikowsky said that making 300 peanut butter and jelly sandwiches has been an effective distraction for the organization's clients and that feeding others has been an affecting way to thank the broader community for all the support it has given the nonprofit since it launched in 2015.

In his interview on MSNBC, Paley of the Trevor Project spoke directly to LGBTQ young people, telling them they "are deserving of love and respect" and are not alone. He also stressed that "social distancing is not the same as social isolation."

"There are places you can reach out to for support," he said. "There are always organizations like the Trevor Project that are here 24/7."

The Trevor Project provides multiple round-the-clock services for LGBTQ youth in need, including TrevorSpace, a social networking site specifically for LGBTQ youth, and a network of trained crisis service counselors who can be reached through TrevorChat, TrevorText and TrevorLifeline (1-866-488-7386).

In its new report, the Trevor Project also encourages LGBTQ young people who are in distress because of the negative social impacts of physical distancing to participate in shared activities online, like gaming, watch parties and physical activity classes.

As for Nez Marquez, he has been staying indoors most of the day at his shelter, which is offering extended hours. He said that while his circumstances were not ideal before the coronavirus emerged, he longs to return to his pre-pandemic life.

"I was applying for housing, I was applying for jobs and had interviews, and I can't do that anymore," Marquez said. "I just can't wait for this to be over and I can go back to my life to do what I need to do."

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