Being An LGBT+ Affirmative Therapist

As a therapist, I’m fully LGBT+ affirmative. 

But what does that actually mean? Does it mean that you are with seeing LGBT+ people, or does it mean something completely different?

Being LGBT+ affirmative is about much more than simply saying you are happy to see clients from that community. It’s about having an understanding of the issues specific to LGBT+ people. It’s about having knowledge of the barriers that LGBT+ face when trying to access therapeutic support. And it’s about accepting LGBT+ people’s identities in a truly congruent way, without any kind of judgment.

Before discussing being LGBT+ affirmative in more detail, lets first go through what LGBT+ means. It’s an acronym that stands for Lesbian, Gay, Bisexual and Transgender. 

The + encompasses a range of other identities relating to sexual orientation and gender identity. This could include, but is not limited to, Asexual, Pansexual, Genderfluid, Genderqueer, Non-binary, Trans, Questioning, Queer and Intersex. The LGBT+ acronym includes a spectrum of identities that fall within it, with many variations on the acronym also existing. You may have seen LGBT, LGBTQ, LGBTI, LGBTIQ or even LGBTTQQIAP. Different people use different acronyms but the most commonly used and accepted one is LGBT+.

So, what makes LGBT+ people different to everyone else in terms of accessing therapy? Isn’t it enough to simply say you’re ok to see an LGBT+ client?

While it’s fantastic that as a therapist you may be ok with seeing LGBT+ clients, being LGBT+ affirmative goes further than that. There are issues and barriers that are specific to LGBT+ people and it’s important for any therapist wishing to be LGBT+ affirmative to understand those.

Let’s take some of the issues that are specific to LGBT+ people. This could include:

• Coming out
• Not being accepted by their family
• Homophobic, biphobic or transphobic bullying
• Discrimination
• Hate crimes
• Gender dysphoria
• Difficulty accepting their identity
• Struggles with having an intersectional identity – e.g. being LGBT+ and a person of faith, or being LGBT+ and a person of colour

There are many issues that arise as a result of being LGBT+ because unfortunately many LGBT+ people are still not accepted by families, friends and often society too. Hate crime levels continue to rise year on year. 

That’s not a rise in reporting of hate crimes, but a rise in the crimes themselves according to research conducted by organisations such as Stonewall and Warwickshire Pride, where a recent study showed that hate crime against LGBT+ people in one town are happening at a rate of more than twice the national average. Despite strides forward in terms of legal equality, society is yet to catch up.

Of course, LGBT+ people experience the same problems as many other people. They experience anxiety, depression, low confidence and self-esteem, as lots of other people do. However, with LGBT+ people it’s often due to one of the problems stated above. It relates to their sexual orientation or gender identity in some way.

Barriers for the LGBT+ community exist too. They may worry about whether their therapist will accept them for who they are. They may wonder if they’ll be able to express their sexual orientation or gender identity in the therapy room. 

There will be thoughts about whether their therapist has prejudices and if that will impact on the therapy. Therapists are taught about being non-judgemental and congruent during their training, but the reality is that every single person will have a prejudice about something. We all do, whether we realise it or not. That’s just a fact of life. Nobody is perfect.

So, how can you become LGBT+ affirmative? By being willing to see LGBT+ clients you’ve already made a start. To progress with being truly LGBT+ affirmative it’s important to take the following steps:

1. Gain more knowledge and understanding about the LGBT+ community. This could be learning more about the different LGBT+ identities, including correct use of pronouns for trans or non-binary people (she/her, he/him, they/them). It could be learning more about the lived experiences of LGBT+ people and the issues specific to that community. Educating yourself is key, even if you think you have an awareness already, which leads me to the next point.
2. Enrol on some LGBT+ awareness training. This will help you to gain the knowledge and understanding required to be truly LGBT+ affirmative. It will provide you with an opportunity to engage with LGBT+ people and others who are seeking to become more LGBT+ aware. Taking part in such training is often an eye opener and can really make a difference to your awareness.
3. Once you have done all of that, look at the way you work and your surroundings to ensure it’s as LGBT+ friendly as possible. You could actively promote that you are LGBT+ affirmative on your website, social media pages and in literature. This sends a powerful message to the LGBT+ community that it’s safe to choose you as their therapist. At your place of work you could make toilets gender neutral by putting a sign up saying it’s an accessible toilet that all are welcome to use. There are many ways of showing that you are LGBT+ affirmative and often the small things make the biggest difference.

Being LGBT+ affirmative is something that all therapists should be and by following the advice above it’s something that you can achieve.