Government-funded systems for youth in out-of-home care have laudable and important public policy goals. The juvenile justice system is designed to rehabilitate youth; child welfare is designed to ensure a safe, permanent home; and runaway and homeless youth systems are designed to provide secure, temporary shelter and helpful services. Some youth in care, however, have always been unofficial exceptions, left by the wayside with their needs unmet and system promises to serve all youth, regardless of who they are, unfulfilled. Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) youth have long been one of these exceptions. Thankfully, over the past 20 years, change has come for many of these youth in the broader world and in out-of-home care, but full inclusion in the promise of care and assistance still eludes far too many.