Supportive And Affirmative Mental Health Care: How To Find An LGBTQ Therapist

In today’s world, many members of the LGBTQ+ community face discrimination, harassment, and even violence based on their identity. Mental health challenges are more likely to arise among populations with these lived experiences, but finding safe, affirming mental health care can be difficult. Without the proper training and experience, a therapist has the potential to perpetuate unfair biases about the queer community during sessions and may do more harm than good. Here, we’ll take a closer look at why LGBTQ+-affirming mental health care from a qualified provider can be so important for queer individuals. Then, we’ll provide tips to help LGBTQ+ people find this type of therapist online or in their area.

What is LGBTQIA+ affirmative therapy?

LGBTQ-affirmative therapy, also known as LGBTQ+-affirmative psychotherapy or affirmative counseling, is a form of therapy specifically tailored to the unique mental health needs of lesbian, gay, bisexual, transgender/two spirit, and queer or questioning (LGBTQ+) individuals. Affirmative counseling aims to create a safe and supportive environment for clients to explore their experiences and address personal challenges related to how society treats people with
their sexual orientation, gender identity, or gender expression

Affirmative therapy is based on research findings indicating that queer individuals face unique challenges related to societal prejudice, discrimination, and stigma, which can significantly impact their mental health and well-being. This type of counseling aims to provide clients who identify as part of the LGBTQ+ community with support, validation, and understanding. It can be a method of mental health treatment for various conditions in a setting that affirms the client’s identity rather than aiming to change it or perpetuating harmful stereotypes and prejudices.

An emphasis on respect and awareness

Affirmative counseling emphasizes the importance of respecting and affirming an individual's sexual orientation, gender identity, and gender expression. Therapists who provide affirmative counseling typically have specialized training in the reality of the systemic issues that LGBTQ+ individuals face today and understand how these can impact a person's mental health.

How does affirming mental health therapy for LBGTQ+
individuals work?

LGBTQ+-affirming therapy can take many different forms depending on the person’s needs. As with traditional therapy, a queer-affirming therapist can provide treatment for symptoms of mental health challenges (like depression, anxiety, bipolar disorder, etc.) as well as for emotional challenges (like low self-esteem or relationship conflict). A queer-affirming therapist will simply provide this care in a way that is cognizant of their queer client’s lived experiences and inclusive of their identity.

Finally, a qualified LGBTQ+-affirming therapist may also provide gender-affirming talk therapyfor transgender, non-binary, and other gender non-conforming individuals. This may involve routine therapy but with warm acceptance of the person’s identity (e.g., using their preferred name and pronouns, which is still not yet commonplace in healthcare settings), or it may involve more specific types of support related to their experiences.

For example, an inclusive therapist could help a gender non-confirming individual cope with the psychological discomfort that often accompanies gender dysphoria. A therapist may also support trans and gender non-conforming clients who want to explore medical transition. For example, they may write a letter of support for insurers and surgeons on behalf of a client who wants to transition medically via hormone therapy or gender-affirming surgery.

Potential benefits of LGBTQ+-affirming therapy

Queer-affirming therapy from a qualified provider can be a positive force in the life of an LGBTQ+ client. In some cases, it can even be life-saving. Below are just a few potential benefits of this type of care for individuals in the queer community.

Validation of queer individuals’ feelings and identity

An LGBTQ+-affirming professional can provide a supportive space for individuals to explore their identity, express their feelings, and feel validated and accepted for who they are—without experiencing any judgment or pressure to change. Successful, productive therapy in general depends on a trusting client-therapist relationship, and this is only possible for LGBTQ+ individuals when their therapists are accepting and supportive of who they are.

Support in coping with identity-based discrimination

A report from 2023 shares that seven in 10 LGBTQ+ individuals report having experienced discrimination based on their identity in the previous year, and that the majority of transgender and non-binary people don’t feel safe walking in their own neighborhoods. An affirming counseling provider understands the current climate for queer people and can provide constructive support and coping mechanisms rather than dismissing valid fears or even re-traumatizing their client.

Treatment for mental health conditions

Research consistently demonstrates that queer individuals are at higher risk of developing mental health conditions. This is not because being a member of the LGBTQ+ community inherently puts a person at risk of a mental illness, but because lived experiences of identity-based discrimination do.

Lesbian, bisexual, and gay adults are more than twice as likely to develop a mental illness as heterosexual adults, and transgender adults are more than four times as likely to develop a mental illness as cisgender adults (whose gender identity aligns with the one they were assigned at birth). LGBTQ+-inclusive therapists can provide affirming mental health treatment for these individuals that is effective and does not place blame on the client’s identity.

Promotion of positive self-image and acceptance

According to a 2020 study, “Lower self-acceptance is considered a risk factor for adverse mental health outcomes.” Counseling with a licensed therapist can help queer individuals develop a positive self-image and sense of self-worth, even in a world where those with diverse identities are often judged, put down, and attacked.

Support for families

Therapycan also be a form of support for individuals and their families as they navigate any challenges related to the individual questioning their identity, coming out, and/or transitioning. A therapist who is trained in queer-affirming care can offer a safe space for all parties to have their voices heard and work toward mutual acceptance and support.

Starting your search for an LGBTQ+-affirming counselor

Whether you’re looking for affirming support in healing from past trauma, navigating experiences of discrimination, building self-worth, addressing mental health symptoms, or coping with another challenge, help is available. The first step is typically to decide whether you'd like to meet with a provider in person or online. Both can be effective, so it typically comes down to availability and personal preferences. See below for advice on how to start your search
either way.

Finding an in-person, queer-affirming therapist

Particularly in major metropolitan areas, it may be possible to find an LGBTQ+-affirming therapist nearby by doing an online search or looking in an online directory through your insurance provider, if applicable. A queer organization or professional network may also be able to help you find support in your area. Or, you could consider asking for recommendations from trusted individuals in your community who have attended queer-affirming counseling.

Finding an online, queer-affirming therapist

Online therapy allows you to meet with a licensed therapist remotely, from home or anywhere you have an internet connection. With a platform like BetterHelp, you can even get matched with a provider according to your needs and preferences as outlined in a questionnaire. BetterHelp also allows you to switch providers at any time, for any reason and at no additional cost, which can take the stress out of your search for a good match

Online therapy vs in-person therapy

A growing body of research suggests that online therapy with a licensed therapist can often be as effective as in-person therapy for treating various mental health conditions and challenges. That means deciding between these two formats for care often depends on individual needs and preferences. If you’re having trouble finding a queer-affirming therapist in your area, online therapy can connect you to a much larger pool of providers. It can also be more comfortable for people who would prefer to not meet with a provider face-to-face, since online therapy allows
connection via phone call, video call, and/or in-app messaging. Regardless of the format you might choose, compassionate and inclusive care is available.

Additional potential benefits of online therapy

Online therapy platforms like BetterHelp also offer additional tools and services that may be useful for clients seeking care. One example is the ability to message your therapist through the platform at any time, with them responding as soon as they’re able to. Another is the availability of worksheets, journaling prompts, and other tools that an individual may find helpful. 

Vetting a prospective LGBTQ+-affirming therapist

During your initial consultation or first session with a new therapist, you might ask them any questions you may have about their experience or approach. Their answers can help you decide whether they might be the right fit for you. Examples of some questions you might consider asking include:

• Have you undergone specific training for LGBTQ+-related care?
• Can you tell me more about your experience working with LGBTQ+ clients?
• What evidence-based treatments and therapy do you offer? What types of therapy do you specialize in?

Remember that it’s okay to switch providers at any time until you find someone you feel comfortable with.

Reporting providers who are causing harm

If you meet with a therapist who just doesn’t feel like the right fit for your personality or your unique needs, all you need to do is find a new provider. However, if you meet with a therapist who causes active harm, canceling future appointments with them and reporting them to the appropriate authority may be necessary.

For example, some counselors may claim to offer LGBTQ+ counseling when their goal actually is to coerce queer individuals into trying to change their identity. These pseudoscientific practices, often called "conversion therapy," often target young people facing rejection from their families and communities. They tend to be faith-based and may not be offered by licensed professionals.

Because of the significant trauma and harm this practice can cause and has caused, conversion therapy is banned in many places. If you come across a therapist who is practicing “conversion therapy”—now referred to more clearly as “sexual orientation change efforts (SOCE) or gender identity change efforts (GICE)”—report them to their state board (or have a trusted loved one do so if you don't feel comfortable). Reporting a therapist who engages in any other types of discriminatory or otherwise prejudiced treatment is also recommended.

Takeaway

LGBTQ+-affirming therapy is mental health care that’s inclusive and welcoming of queer people of all identities. Therapists who provide this type of care are typically trained in and sensitive to the history of discrimination faced by LGBTQ+ people so they can provide informed care. Today, it’s possible to meet with this type of provider in person or online.