Finding A Gay-Friendly Therapist: Inclusive Mental Health For The LGBTQ+ Community

Finding a mental health professional who understands your concerns, experiences, and needs can play an important role in ensuring you get quality care. For members of the LGBTQ+ community, finding a gay-friendly or queer-affirming therapist can be a crucial part of having a safe, comfortable, and effective therapy experience.

A therapist who is either queer themselves or is specifically trained and experienced in working with LGBTQ+ individuals can use tailored approaches to address the unique challenges members of this community may face. Below, we’ll talk about the importance of finding a queer-affirming therapist and share tips for how an individual who is queer or questioning might go about finding one.

The unique mental health needs of the LGBTQ+ community

In general, the mental health needs of individuals within the LGBTQ+ community are unique for a few reasons. First, many queer individuals face discrimination, prejudice, systemic barriers, and other challenges on the basis of their sexuality, gender identity, or presentation. As such, queer people are at greater risk of developing mental health conditions. Plus, these barriers mean that it can be harder for many queer people to receive mental health services as well as other components of well-being (e.g., food, housing, education, employment, etc.).

In addition, there's a history of harm by healthcare professionals to people who identify as  LGBTQ+, from forced institutionalization to refusal to provide care to conversion therapy and more. This past—along with forms of harm that continue today—makes it even more important for individuals in this community today to be able to receive informed, sensitive care from specifically trained providers.

Statistics about mental health in the queer community today

Again, the lived experiences of discrimination that many queer people face can deeply affect their mental well-being. Here are a few statistics from the National Institute of Mental Health that paint a picture of mental health in the queer community today:

• As many as 40% of transgender adults have attempted suicide in their lifetime. The same is true for only 5% of the overall population in the US.
• According to a 2019 survey, 86% of LGBTQ+ youth report having been harassed or assaulted at school.
• Lesbian, gay, and bisexual adults are twice as likely to experience a mental health condition as their heterosexual peers, and transgender adults are four times as likely to experience a mental health condition as their cisgender peers.
• Per a 2022 report, less than 37% of queer youth report their homes to be LGBTQ+- affirming spaces.
• LGBTQ+ youth have a 120% higher likelihood of experiencing homelessness than non-LGBTQ+ peers.

The topic of intersecting identities

It can also be important to note that individuals with multiple marginalized identities—or “intersecting identities”—may be at risk for experiencing higher levels of stress as a result of multiple forms of discrimination. For example, a queer person who is also Black, Indigenous, or a Person of Color (BIPOC) may experience discrimination based on their queer identity as well as their racial or cultural identity. The same can be true for a person based on identities like disability status, immigration status, body size, and many others.

This compounding prejudice can have a significant effect on an individual’s mental health. For instance, according to the Human Rights Campaign (HRC), US high school students who identify as both queer and BIPOC are more likely to attempt suicide (27%) compared to queer high school students overall (22%) and non-queer high school students (5%). HRC also notes that 28% of queer BIPOC adults in the US are uninsured compared to 8% of the overall population. Understanding the effects of intersectionality can be important for understanding mental health needs in the queer community in general.

What is queer-affirming mental health care?

According to a 2024 paper on the topic, queer-affirming mental health care is not a standalone treatment, but a perspective that can be incorporated into any healthcare setting. It involves the care provider:

• Acknowledging the history of harm queer people have in the healthcare field
• Understanding the real and systemic challenges queer individuals often face in today’s world and how these can affect their mental health
• Accepting and validating the client or patient’s identity without judgment or efforts to try and change it

Why can finding a gay-affirming therapist be important for those in the LGBTQ+ community?

Research suggests that a strong, trusting client-therapist relationship is typically key for positive therapeutic outcomes. Without it, therapy will typically be less effective—if the person continues their treatment at all.

A therapist who is judgmental or doubting of a client’s identity or lived experiences will typically not make the client feel safe or comfortable opening up. In a world where discrimination against LGBTQ+ people is still common, having a therapist who is compassionate, accepting, and affirming of one's queer identity and experiences can be critical.

Factors to consider when seeking a queer-affirming therapist

If you're interested in seeking a queer-affirming therapist, it can be helpful to think about a few factors ahead of time. Making decisions in each of these areas could help guide your search.

Location

First, do you envision meeting with a therapist in person at an office, or virtually? While some people find it easier to bond with a therapist in person, others might feel more comfortable speaking with someone without being face to face. Also, if you live in a rural area or one that is not as queer-friendly, it may be difficult to find a provider within a commutable distance. In these cases, online therapy might be a preferable option.

Expertise and training

It's important to make sure that the therapist you meet with has the appropriate licensure and credentials to practice in your state. In addition, you might want a therapist with training or expertise in a specific area. For example, someone who specifically practices queer-affirming care might be worth searching for if you are queer or questioning. You could also look for someone with experience treating individuals with the challenges you're currently facing, whether that's depression, obsessive-compulsive disorder, past trauma, low self-esteem, or another concern.

Identity

For some people, the identity of their therapist is also important. For example, some queer people may be okay with any provider as long as they are queer-affirming, while others will specifically look for a therapist who identifies as queer themselves. Or, a person from a particular racial, cultural, or religious background might prefer to meet with a therapist with a similar background. Considering any needs you may have in terms of your therapist’s identity can help you narrow down your search.

Pricing

Finally, you'll generally need to find a therapist who offers services within your budget. If you have insurance that covers therapy sessions, it will likely be important to find a provider who accepts your plan. Otherwise, you might look for a therapist whose pricing options suit your needs. For example, some offer sliding-scale fees or discounts based on income.

Where to begin your search for an LGBTQ+-inclusive provider

Once you have a general idea of the type of provider you're looking for, you can begin your search. If you'd like to meet with a provider in your area, here are a few approaches to consider:

• Ask your doctor for a referral
• Ask your local community health clinic for a referral
• Search for providers who accept your insurance, if applicable
• Inquire at your local LGBTQ+ community center, if applicable, for a referral
• Ask queer friends or community members how they found their therapist
• Consult with an online directory specifically for LGBTQ+-affirming therapists, such as the National Queer & Trans Therapists of Color Network

Exploring the option of online therapy

Online therapy can be a useful alternative if you’re having trouble finding a queer-affirming  therapist near you. With a platform like BetterHelp, you can fill out a questionnaire to share your needs and preferences in a provider, and you’ll be matched with someone accordingly from a pool of tens of thousands of qualified therapists. You can then meet with them virtually from wherever you have an internet connection.

Some people also simply find online therapy to be more convenient or comfortable, since it allows you to meet with a therapist remotely via phone, video call, and/or in-app messaging. If in-person environments are often overstimulating for you or you’re struggling with insecurity or gender dysphoria, online therapy may be a more comfortable format. Plus, online sessions are often more affordable than in-person sessions without insurance, so those who are looking for a cost-effective choice might explore this method.

Research on the effectiveness of online queer-affirming therapy

A growing body of research indicates the effectiveness of online therapy for treating many different mental health challenges. For example, a 2021 research review on the topic reports “almost all reviews and meta-analyses found that these [online] interventions successfully reduce symptoms and are efficacious treatments.”

Studies have also been done on how effective queer-affirming therapy in particular can be when delivered in an online format. A 2021 study on the topic suggests that this approach reduced symptoms of depression and improved stress and coping abilities in participants, and that digital technology can be a “promising intervention” for the delivery of LGBTQ+-affirming therapy.