Same Sexual Orientation of Therapist and Client May Affect Therapy Outcome

Lesbian, gay and bisexual (LGB) clients may form better alliances with therapists who have similar sexual orientations, according to a new study. This new study done by researchers at the Graduate School of Education at Fordham University examined gay and bisexual men in therapy who had therapists of the same sexual orientation. Trends found in the research may be applicable to the LGB community at large. Thomas I. Stracuzzi, lead author of the study, said that when LGB clients share the same sexual orientation with their therapists, they may achieve better treatment outcomes because the alliance developed between the client and therapist begins with identification and trust. Stracuzzi said, “From this perspective, LGB counselors may be more likely than their heterosexual colleagues to have the knowledge and attitudes associated with successful clinical work with LGB clients and the possibility that LGB clients may fare best with counselors who are LGB or are perceived to be LGB.” Additionally, some experts believe that cultural diversity, including universal-diverse orientation (UDO), self-reported or perceived, provides a common platform from which a LGB client and their therapist can develop a strong alliance. “For some LGB clients, it can be especially meaningful to work with a counselor who also is LGB,” said Stracuzzi. He added, “However, counselor disclosure may inhibit client exploration of issues related to sexual identity due to clients’ assumptions about how their counselor’s sexual orientation might influence the counselor’s understanding of and reactions to the client. For example, a gay male client may mistakenly assume that his gay male counselor understands aspects of his experience due to their shared sexual identity.”

Stracuzzi and his colleagues interviewed 83 male LGB clients. Of the therapists who worked with the men, some told their clients their sexual orientation, while others did not. The researchers discovered that the clients whose therapists revealed their orientation experienced a smooth, strong, working alliance. But the clients who assumed the sexual orientation of their therapists did not form strong alliances. The team added, “However, findings do suggest that LGB-affirming counselors should be aware that clients do not always accurately perceive their counselor’s orientation and that perceived similarity—whether accurate or not—may negatively affect the therapeutic process.”

Stracuzzi, Thomas I., Jonathan J. Mohr, and Jairo N. Fuertes. “Gay and Bisexual Male Clients’ Perceptions of Counseling: The Role of Perceived Sexual Orientation Similarity and Counselor Universal-diverse Orientation.” Journal of Counseling Psychology 58.3 (2011): 299-309. Print.

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Yvonne Grayson

    Yvonne Grayson

    October 9th, 2011 at 8:00 PM

    Well, it makes sense that if a gay man talks to another gay man about issues relating to being gay, that therapist might have his own firsthand experiences on the topic at hand to draw upon. Experience is far more potent a tool than the massive pile of books they have read, surely. The practical always outweighs the theory.

  • bernadette shaw

    bernadette shaw

    October 9th, 2011 at 8:14 PM

    I don’t think it’s that much different from a first-time mother seeking advice from a more experienced mother. You will get better advice and help from someone who’s more likely to have “been there, done that” than one who hasn’t. It’s a question of who you’d feel more confident about listening to and taking advice from as well.

  • monty


    October 25th, 2011 at 4:08 PM

    Question about concerns of a male having sexual orientation issues and talking with a therapist is a a lesbian but does not disclose it to the client. the male thought he was gay but the therapist said he was not but the client really felt he was.

  • Jonathan Mohr

    Jonathan Mohr

    November 1st, 2011 at 1:53 PM

    As one of the coauthors of this study, I feel it is important to let readers know that the summary of our findings presented here is not accurate. In fact, therapist’s sexual orientation (actual or client-perceived) was generally unrelated to the quality of the therapeutic relationship or perceived progress in therapy. A much better predictor of positive therapy was the extent to which the therapist reported high levels of interest in and comfort with diversity. The “take home message” is that the therapists’ diversity-related attitudes were far more related to positive therapy than was the therapists’ sexual orientation.

  • helenwillow


    January 26th, 2012 at 3:34 PM

    just curious, but would this also apply to transgendered therapists (are there any?) and transgenders? I am an MTF who identifies as lesbian

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