LGBTQ youth’s involvement with the juvenile justice system occurs in the context of family conflict, parental rejection of homosexuality, trauma, and hostility at school and in the community. As they run away from abuse, LGBTQ youth are more likely to commit survival crimes and get arrested for offenses related to homelessness. This chapter focuses on the experiences of lesbian, bisexual, queer, and gender-nonconforming girls in juvenile justice settings and examines how biases about gender and sexual orientation affect court decisions and correctional practices. Lack of awareness and training about LGBTQ issues compounds the harmful effects of homophobia, transphobia, and racism and adversely impacts lesbian, queer, and gender-nonconforming girls’ rights to due process, as well as their access to appropriate health care services. This chapter makes recommendations for LGBTQ-affirming practices in juvenile justice settings.