People look for words that describe their experience, but sometimes the available language is not adequate to capture our place in the complex web of gender and sexuality. Lesbian, gay, bisexual, transgender, queer: these are all words that people have at times found useful to describe important aspects of their lives.
LGBTQ+ people—with these labeled and unlabeled identities—have not always had affirming therapy experiences. This is unfortunate, as it has stopped many people from obtaining the help they need and deserve. Unfortunately, some therapists have been quick to pathologize and label as “disordered” that which does not fit the dominant social norms.
The negative experiences LGBTQ+ people have had in therapy involve not just a lack of cultural competence from individual therapists, but institutionally sanctioned homophobia and transphobia among our professions. Homosexuality was listed as a mental disorder until 1973; the fifth Diagnostic and Statistical Manual of Mental Disorders, in use today, includes “gender dysphoria” as a diagnosis.
People who identify as LGBTQ+, nonbinary, two-spirit, genderqueer, pansexual, or with other experiences of sexual and gender diversity often seek therapists who understand queer culture and will not pathologize diversity and difference.
Queer people, like heterosexual people, come to therapy for a wide range of reasons. Sometimes LGBTQ+ people come to therapy for reasons anyone would—to work on alleviating depression or anxiety, to have better relationships, or to better understand their goals and values. LGBTQ+ people may also seek therapy for reasons specific to queer experience: navigating a homophobic and transphobic society, living with the threats of discrimination and violence, coming out, dating, and more. Transgender people may seek support for transition, including how to navigate when and where to disclose their trans status, transitioning in the workplace, and accessing trans-competent medical care.
When seeking therapy, it is often important to find a therapist who will be open to understanding your identities and who will not make assumptions. In my work, I often meet people for whom predefined labels don’t apply. For example, the fact you have a partner of the same gender as yourself does not necessarily mean you identify as gay—perhaps you are bisexual, pansexual, or queer, or perhaps none of these words adequately describes your experience. Further, you may not want your therapist to assume you or your partner is cisgender (identifying with the gender assigned at birth). You may want someone to see you as you, rather than trying to fit you into a category.
Sometimes the pressures of heteronormativity or societal homophobia lead people to wish their sexual orientation were different. It is important to know that treatments aimed at changing sexual orientation have been found to be not only ineffective but destructive and have been deemed unethical by all reputable forces in the major mental health professions. On the brighter side, there are more therapists than ever with appropriate knowledge and training to work with people of all sexual orientations and gender identities.
Reading a therapist’s online profile and asking what experience the therapist has in working with queer people is a good start in seeing if a therapist is a good fit for your experience. Hopefully you will know quickly—through signs such as language on intake forms, questions asked, and an open, nonassuming stance—if your therapist has the skills and knowledge to be helpful and inclusive of queer people. Finding a space where you can authentically be yourself can be an important step toward creating the life you want and celebrating who you are.
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