LGBT youth in foster care systems suffer from many problems because of prejudice against their sexual orientation or their non-conformity to gender stereotypes. These problems include a complete lack of recognition of their existence and needs by child welfare systems, insensitive and discriminatory treatment, and outright harassment and violence by peers, foster parents, and child welfare staff. Part I provides a background discussion of the unaddressed problems of LGBT youth in out-of-home care. Part II recommends basic measures for reform that should be adopted by child welfare systems. Some of these measures are adopting and enforcing explicit, system-wide policies prohibiting discrimination on the basis of sexual orientation; and providing high quality training of foster parents and foster care staff to demonstrate sensitivity and support and accurate sexual health education. Beyond foster parent and staff training, foster care systems should provide programs and services designed to address directly the needs of LGBT youth. These include safe and supportive group and foster homes, counseling and community resources, sexual health education, and confidential HIV/AIDS prevention materials and testing. Part III publishes State-by-State findings and recommendations based on a survey of LGBT-related foster care policies and services in 14 States. The results of the survey show that although a few States have taken positive first steps, none has system-wide policies and practices designed to prevent anti-gay abuse and adequately support LGBT adolescents. No foster care agency maintains policies prohibiting discrimination against foster care youth on the basis of sexual orientation. None requires training for foster parents or foster care staff on sensitivity to LGBT youth. Only a handful of locales offer even limited optional training. Only Los Angeles and New York City maintain any group facilities specifically for LGBT youth, while few LGBT youth services can be found elsewhere in the States’ foster care systems.