Inclusive Therapy: Creating Affirming Spaces for LGBT+ Clients
February marks LGBT+ History Month, an opportunity to celebrate the lives, contributions, and resilience of the LGBT+ community while reflecting on the oppression and marginalisation they have faced throughout history. For me, it’s also a time to consider how therapy can play a vital role in supporting LGBT+ clients, offering a space to explore identity, process past and present struggles, and foster healing and self-acceptance.
The Role of Therapy in LGBT+ History and Healing
For many LGBT+ people, the journey toward self-discovery and authenticity is deeply personal but can also be shaped by societal attitudes, discrimination, and stigma. Therapy offers a space to work through the impact of these experiences, from internalised shame to the effects of rejection or marginalisation.
It’s important to acknowledge that counselling and psychotherapy services for LGBTQ+ people have evolved against a historical background of medical and psychological pathologisation of homosexuality over the past 130 years. Until 1973, homosexuality was listed as a mental disorder in the DSM, and practices like conversion therapy were not only common but often endorsed. While significant progress has been made, these historical wounds have left a legacy of mistrust for a lot of individuals, who might worry their identities will be seen as something to ‘fix’ rather than accepted and celebrated.
This historical context highlights the vital importance of creating a safe, non-judgmental, and affirming therapeutic space, where LGBT+ clients can feel seen, understood, and supported on their journey toward healing and self-acceptance. This starts with acknowledging the unique challenges LGBT+ clients may face, such as:
Minority stress: The chronic stress that comes from navigating a society that may not fully accept or affirm one’s identity.
Interpersonal challenges: Navigating relationships with family, friends, and partners who may not understand or support their identity.
Identity development: The process of exploring and affirming one’s gender or sexual orientation, which can be both liberating and complex.
How Therapy Can Support lGBT+ Clients
Therapy tailored to LGBT+ clients can focus on building resilience, fostering self-compassion, and empowering clients to live authentically. It can also provide space to celebrate the joy and strength that comes with embracing who they are. Therapy can be a powerful tool for healing and growth, particularly when it honours the unique experiences of LGBT+ individuals. Whether it’s working through trauma, navigating relationships, or exploring identity, the therapeutic space can be a place of safety, affirmation, and transformation.
The therapeutic relationship offers a safe space where LGBT+ clients can:
Explore their identity: External and internalised homophobia can lead to confusion, self-doubt, or a lack of self-acceptance. Therapy provides a space for LGBT+ clients to process these experiences, affirm their identity, and build self-esteem and self-confidence.
Experience validation: Validating a client’s sexual identity is a powerful act. It can help clients feel accepted for who they are, paving the way for them to accept themselves fully. Affirmation helps to counter the damage caused by LGBT+ erasure and societal messages.
Address homophobia and oppression: Therapy allows clients to work through experiences of discrimination without positioning their sexual orientation as the source of their difficulties. It offers a space to resist the narrative that their sexuality is the ‘problem’.
Address the impact of LGBT+ erasure: Experiences of being misunderstood or feeling invisible can be emotionally taxing. Therapy can help clients articulate these experiences, feel acknowledged and seen.
Deconstruct internalised stereotypes: LGBT+ individuals may have internalised harmful stereotypes that lead to shame or guilt. Therapy can help clients unlearn these damaging beliefs and provide space to create a healthier relationship with different parts of themselves.
Release emotions: Therapy offers a space for clients to process difficult feelings like shame, guilt, and anger, helping them to release these emotions in a healthy way and work toward healing.
Discuss relationship dynamics: LGBT+ individuals may face specific challenges in their relationships, including pressures to conform to heterosexual relationship norms or misconceptions about their sexual orientation. Therapy can provide a space to navigate open communication, set boundaries, and foster mutual respect, allowing for more authentic and fulfilling relationships.
Work through trauma and mental health challenges: Experiences of discrimination, harassment, and invisibility can lead to anxiety, depression, or other mental health concerns. Therapy supports clients navigate these challenges, helping them process trauma and build resilience.
It’s important to recognise that therapy for LGBT+ individuals isn’t solely about addressing trauma or challenges related to their identity. Identifying as LGBT+ is just one facet of their identity and may not be central to their presenting concerns Therapy must be a space to explore the many facets of who they are beyond their gender or sexual orientation. It’s a place to celebrate their successes, navigate their aspirations, and connect with the parts of their lives that bring them joy and meaning. Approaching clients as whole, complex individuals allows for more effective and meaningful therapeutic work, rather than assuming that all their challenges stem from their sexual orientation.
Conclusion
LGBT+ History Month reminds us of the importance of visibility, representation, and allyship. For therapists, this includes continuing to educate ourselves on LGBT+ issues, examining our own biases, and ensuring that our practices are inclusive, welcoming and affirming.
If you or someone you know would like to explore issues related to your sexuality or sexual identity in a supportive and affirming space, please don’t hesitate to reach out. You deserve to be seen and supported on your journey.
Help and Resources
Galop - provides support for LGBT+ adults and young people who have experienced hate crime, sexual violence or domestic abuse.
0207 704 2040 (LGBT+ hate crime helpline)
0800 999 5428 (LGBT+ domestic abuse helpline)
0800 130 3335 (Conversion therapy helpline)
help@galop.org.uk
galop.org.ukSwitchboard - listening services, information and support for lesbian, gay, bisexual and transgender people.
London Friend - services to support LGBTQ+ people’s health and wellbeing, including support groups and counselling.
MindOut - mental health service run by and for LGBTQ+ people.
Rainbow Mind - service run by two local Minds offering LGBTQ+ mental health support. Runs regular online support groups for LGBTQ+ people, including a dedicated group for young people aged 17-24.
Stonewall - information and advice for LGBTQ+ people on a range of issues.
Stonewall Housing - specialist housing advice for anyone identifying as LGBTQ+.
akt - supports for LGBTQ+ people aged 16-25 who are homeless or living in a hostile environment.
Pink Therapy - online directory of qualified therapists who identify as or are understanding of minority sexual and gender identities.
References:
Davies, D., & Neal, C. (Eds.). (1996). Pink therapy: A guide for counsellors and therapists working with lesbian, gay and bisexual clients. Open University Press.
