Finding therapists that truly understand and affirm our experiences as queer people is a daunting task. Accessing supportive environments where we are safe to be ourselves is not just helpful. It’s critical. Mental health care is a significant concern for many LGBTQ+ people. This article aims to shed light on why LGBTQ+ friendly therapy is essential and the ways it can make a profound difference in our lives.

Understanding the Challenges

Imagine my shock when one of the first therapists I went to told me, at our first appointment, “I don’t think bisexuality is a real thing.” This was the person I was going to for guidance and support. He couldn’t wrap his head around the idea that a person like me could even exist. I feel embarrassed as I write this now that I kept going to his therapy sessions. At the time, I didn't believe that I could find a better option. I didn’t know how to find anyone queer-friendly, or even that there are therapists who specialize in LGBTQ+ issues. I thought he was my option, and so I kept going back. Each time feeling smaller and smaller.

The problem of therapists who don’t understand queer experiences is much bigger than my experience. Our community faces a range of mental health issues at higher rates compared to the general population. PTSD, anxiety, and depression are alarmingly common. That’s according to data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Their 2023 data report showed that lesbian, gay, and bisexual adults are more likely than straight adults to “use substances, experience mental health conditions including major depressive episodes, and experience serious thoughts of suicide.” Those problems are often worsened by experiences of stigma, discrimination, and rejection. Identity exploration and dealing with societal prejudice add layers of stress that can deeply impact mental health.

Prejudice and discrimination worsen these issues. Feelings of isolation and internalized shame can crop up. The constant pressure to conform or to hide your true identity can be mentally exhausting. More than 3 in 4 transgender and nonbinary kids reported symptoms of generalized anxiety disorder in the past two weeks, according to the Trevor Project’s National Survey on LGBTQ Youth Mental Health. It’s crucial to recognize the environment queer people exist in if we’re trying to understand why specialized, affirming mental health care is necessary.

The Importance of Queer-Friendly Therapy

LGBTQ-friendly or “affirming” therapy goes beyond traditional mental health care. It requires therapists who are not only accepting of queer identities but are also knowledgeable about the specific challenges we face. Affirming therapy ensures that our identities are respected and integrated into the therapeutic process. It requires that therapists equip themselves with the understanding and sensitivity required to create a safe space.

What I needed in my own therapy was an environment that allows for deeper exploration of issues without the fear of judgment or misunderstanding. Affirming therapy offers that. As I became a therapist myself, I started working with people who shared stories of how LGBTQ+ friendly therapy has helped them feel seen and validated. Knowing that you are understood provides a strong foundation for healing and growth.

Barriers to Accessing Quality Mental Health Care

Although the benefits are encouraging, it can be challenging to access quality LGBTQ+ friendly therapy. One significant barrier is the lack of trained queer-affirming therapists. Not all mental health professionals get the necessary training or experience to handle the specific needs of our community.

Financial barriers are part of the problem too. Therapy can be expensive. Not everyone has insurance that covers mental health care, and many providers do not accept insurance. People in our queer community often face income inequality, compounding these problems. According to the Human Rights Campaign, LGBTQ+ workers earn 90 cents for every dollar a non-queer worker earns. And it gets worse for non-binary and genderqueer people, who earn 70 cents on the dollar. They found that transgender men earn 70 cents per dollar, and transgender women earn 60 cents. This financial strain can prevent you from seeking the mental health help you need.

Additionally, the fear of discrimination or encountering a therapist who does not understand or care about queer issues can deter many from pursuing therapy. Those fears are justified; mental health providers reported having relatively little training in LGBTQ+ specific issues, according to a 2013 study published in the Journal of Psychotherapy Research.

Benefits of LGBTQ-Friendly Therapy

The benefits of LGBTQ+ friendly therapy are incredible. Affirming therapy can lead to improved mental health outcomes, and makes life easier for queer people in tangible ways. That includes reduced symptoms of anxiety and depression, better coping mechanisms, and a stronger sense of self. This is supported by research starting in the 2010s. For a good summary of the recent research, a book like Transdiagnostic LGBTQ-affirmative Cognitive-behavioral Therapy: Therapist Guide is a good place to start. Research published in the journal Psychotherapy show that LGBTQ+ affirming treatment has been effectively delivered in individual and group formats, as well as in community-based clinics. This shows that when therapists can acknowledge and affirm us, it builds a sense of belonging and acceptance that is crucial for mental well-being.

Building a bond with a therapist you trust allows for more effective treatment. In fact, the relationship you build is the whole foundation of therapy work. Being able to make progress in therapy is based on what kind of relationship you build with your therapist. Feeling understood and validated in therapy can significantly enhance that relationship. The research studies I referenced above have shown that people who receive affirming therapy are more satisfied in their progress and report better overall mental health. These results highlight the transformative power of queer-friendly therapy.

Finding the Right Therapist

Finding the right LGBTQ-friendly therapist is daunting. Let’s start there. It’s not easy, but there are several strategies to help. Start by looking at directories specifically designed for our community, such as Manhattan Alternative here in New York City or the Psychology Today directory with LGBTQ+ filters.

What questions can you ask to find out if your therapist knows how to work with LGBTQ+ people? Asking the right questions can make the difference between finding someone who understands your experience, and someone who doesn’t. Find out about their experience working with queer clients, their approach to therapy, and whether they have specific training in LGBTQ+ issues. Trust and comfort are the foundation of the therapeutic relationship. Take this as permission to go slowly, and take your time finding someone who genuinely understands and respects you.

Self-Advocacy in Therapy

You will need to advocate for your needs and boundaries in therapy, same as with any relationship. If something doesn’t feel right, it is okay to say so. Effective therapy is a collaborative process. Your comfort should always be a priority. It’s true that therapy is a place where strong emotions come out, and painful events are explored. I can’t guarantee that you will feel comfortable and at ease at every moment of therapy. That’s why it’s especially important to feel understood when expressing yourself and sharing your identity. If you feel misunderstood, it’s perfectly acceptable to seek a different therapist. You have power too in this relationship!

Standing up for yourself in therapy means being honest about your experiences in the room or the video call. It’s particularly important to voice how you feel in therapy. If a therapist isn’t meeting your needs, don’t hesitate to start an open conversation about it. Your mental health is too important a topic to just settle. You do not have to put up with anything less than affirming, supportive care.

Quality Therapy for LGBTQ+ People

It is easy enough for us therapists to write that we are “queer-friendly” in our profiles on PsychToday. But how do you determine if your therapist has the qualifications and experience to work with our community? This gets particularly difficult when so many of the different types of therapies are not designed with LGBTQ+ people in mind. One type of therapy that I can speak to is a behavior therapy designed around acceptance, called DBT. I’ve written a lot about how DBT can be adapted to work for queer people, even though that was not who it was originally built for. Here are some good places to start:

• Take a look at how DBT works to treat anxiety.

• You can also read about how one of my favorite skills, radical acceptance, works for LGBTQ+ people.

• More specifically, this article describes how DBT works for bisexual people.

• Lastly, in this article you can check out some of the pros and cons for doing DBT.

Community Support and Resources

In addition to therapy, forming queer community plays a crucial role in maintaining your mental well-being. Creating a supportive network of friends and allies also contributes to mental health resilience. 

• Here is a breakdown of tips and strategies for how to start building LGBTQ+ community.

• Here are some ideas for how to deepen queer friendships for those relationships we already have.

• Connecting with the larger queer community involves even more barriers and challenges for queer people of color. Here is a roundup of ideas for how QTPOC are making it happen and building community in spite of those challenges. 

• For tips that are specific to the local area, here is an article about forming queer community in the NYC area.

These connections offer a sense of community and shared understanding. That can be incredibly comforting. Remember, you’re not alone, and there are many supports available to help you strengthen your mental well-being.

Conclusion

In conclusion, finding a therapist who is LGBTQ+ friendly is not just a luxury. It’s a necessity. Our community faces unique mental health challenges that require specialized care. Queer-affirming therapists who understand can significantly improve mental health outcomes. Ultimately, building a trusting relationship with a therapist who validates you can enhance your overall well-being.

It takes work to find queer-friendly therapy. It requires that we advocate for our needs, find affirming therapists, and connect with supportive communities. By taking these steps, we move toward better mental health. That’s what makes it worth it. You deserve care that respects and celebrates your identity.