Centering LGBTQ+ youth of color “explicitly, unequivocally, and without apology” to deliver culturally and structurally responsive, evidence-based mental health services

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Introduction LGBTQ+ youth of color face profound mental health inequities driven by intersecting systems of oppression, including racism, homophobia, and transphobia. Community-based organizations (CBOs) can mitigate this, but their impact is hindered by contextual constraints and a culturally unresponsive evidence base that tends to privilege individual-level interventions and restrictive definitions of effectiveness. Methods We conducted a three-year, participatory, single-case qualitative study of Boston GLASS, a CBO serving LGBTQ+ youth of color, to elucidate how high-quality mental health care is conceptualized and enacted. Co-led by community- and university-based researchers, the study gathered data via interviews, focus groups, document review, and observations between October 2022 and December 2025. Results GLASS staff treat care not as a set of discrete clinical encounters but as a structurally and culturally responsive, relationship-centered ecosystem. Three forces animate this model: (1) connecting to broader social movements; (2) centering collective joy, community, and shared humanity; and (3) elevating lived, practice-based, and local expertise. However, the model is vulnerable to restrictive and fragmented funding and administrative burden, staff burnout, and a hostile sociopolitical environment targeting LGBTQ+ people of color. Conclusion The GLASS model problematizes dominant conceptions of the active ingredients in "effective" care by foregrounding community, infrastructure, and relational practices as central to impact. Sustaining such models will require broadening definitions of evidence to support community-led frameworks, with correspondingly broad metrics to capture diverse impacts, and political will of f funders, policy-makers, and researchers to cultivate conditions in which community-led models thrive.

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