Are you or someone you love considering psychotherapy? Are you unsure about what kind of therapist is most effective? Beginning counseling is a positive step in reducing painful anxiety, depression, addiction, post-traumatic stress disorder, along with a host of other mental health issues that cause us distress.
By James Guay, LMFT
But how do we find the right therapist for us or for a loved one… especially if we’re in search of an LGBTQ Affirmative Psychotherapist? As lesbian, gay, bisexual, transgender and queer people, we have our own unique history, shame-based traumas, needs and culture. While there is no one way to be LGBTQ, as is the case with any minority population, most of us have suffered hateful societal messages about our very being-ness. Living in a heterosexually-dominated world that is mostly cisgender (non-trans), it can be particularly useful to work with a therapist who understands these complexities, regardless of their own sexual orientation or gender identity. Having a therapist that understands the intersection of our gender and sexual orientation as it relates to our age, race, religion, spiritual beliefs and/or differing abilities is also essential.
Many therapists are LGBTQ-friendly. They may have a friend, colleague or family member they know or have an open heart toward a variety of diverse populations. However, being culturally competent to work with an LGBTQ individual, relationship or family requires actual training and knowledge about how to work with us. It’s not enough for a therapist to be “neutral” about harms to our community and how our own oppression impacts our mental health and well-being. Being neutral about real harm that’s been done to us can further perpetuate our oppression. Often we have internalized these societal messages at deeply unconscious levels, impacting our self-esteem and our capacity for closeness, intimacy and full self-acceptance.
LGBTQ-knowledgeable therapists better understand the impact of internalized homophobia, biphobia, and transphobia on our lives. They also understand and appreciate various forms of dating, diverse sexualities, and relationship styles that are more common with LGBTQ people than the heterosexual population. They know better when to focus on LGBTQ-related stuff or when it’s not relevant to what’s being discussed.
Unfortunately, you have to specifically ask if they are knowledgeable about bisexuality and transgender identities as not all therapists are even LGBTQ-friendly. Some even claim to be but then offer "conversion therapy" for those wanting to change their sexual orientation and/or gender identity to straight and cisgender. So, it’s important to interview potential therapists, asking them the following questions:
- What is your training, knowledge and experience in working with the LGBTQ population?
- What is your sexual orientation and gender identity? (Not all therapists will feel comfortable answering this question but most affirmative therapists will respond, as a matter of modeling.)
- Do you provide “conversion therapy” or “reparative therapy” or “sexual orientation change efforts?” If not, what do you believe about this approach?
It’s important to note here that all legitimate mental health associations agree that conversion therapy is ineffective, too frequently dangerous, and is not in alignment with current professional standards of care for working with the LGBTQ population. For example, you can read the California Association of Marriage and Family Therapists’ Statement here:
So, once you’ve asked the above questions to a potential therapist, then what? What else is important to you in a therapist? Do you have a preference for their age, gender, sexual orientation, race, language, or other characteristics? Therapists don’t need to exactly match your own demographics in order to be effective, although knowing they have an understanding and care about who you are is important. A good sense of humor can be useful in the healing process too. It doesn’t have to be all serious, all of the time.
You may also want to consider their location. Is it convenient enough to where you live, work, or frequent? Do you prefer face-to-face or on-line webcam or phone sessions (called telehealth) or all of the above? Do you want someone on your insurance panel to ease the cost of therapy or do you prefer greater privacy and selection with someone (called an out-of-network provider) who may be able to provide a monthly statement for reimbursement purposes, if your insurance covers this too? Finding the right therapist for you should be your top priority here.
When looking for a therapist, ask them the questions that matter to you and use your best judgment. The most important factor in successful therapy is not the therapist’s degree, specialties or approach, but rather your level of comfort with them. It may take two or three sessions to feel more at ease and to start building rapport with a therapist. However, if it’s obvious to you that it’s not the right fit in the first session, there’s no need to schedule another appointment. Find a better match.
Getting a referral for a therapist from someone you trust can be a good way to find a therapist. Also, there are a variety of online resources you can use, including:
It may be helpful to look at the therapist’s website and if they have any professional social media presence, videos, articles and blogs. Sometimes you can get a sense of who they are by looking at their professional presence online.
As a Licensed Marriage and Family Therapist and an LGBTQ Affirmative Psychotherapist, I believe everyone deserves to have a great experience in therapy. Finding the right therapist for you is a huge part in making that happen.
JAMES GUAY is an LGBTQ-affirmative psychotherapist in West Hollywood, working primarily with LGBTQ youth, adults and couples since 1996. Besides co-leading annual workshops for gay men at Esalen in Big Sur, Calif., he also is on a weekly radio show offering sex-positive advice for all audiences. James is currently on the Board of Directors for CAMFT (The California Association of Marriage and Family Therapists) and has served on the Board of Directors for Gaylesta (The Psychotherapist Association for Gender & Sexual Diversity), and AAMFT-CA (The American Association of Marriage and Family Therapy, California Division). James is a Licensed Marriage and Family Therapist (#lmft39252).