Why LGBTQIA+ Therapy Matters (And How To Find an LGBTQ Therapist)

The LGBTQIA+ community is in the midst of a mental health crisis, and the statistics are troubling, to say the least. LGBTQIA+ individuals are more than twice as likely to experience symptoms of a mental health condition as heterosexual, cisgender people are. Even more sobering, the Trevor Project found that a whopping 39% of LGBTQIA+  young people seriously considered suicide, and 12% attempted suicide in the last year. 

Despite growing acceptance, increased visibility, and (often performative) Pride collections sold by major corporations, many LGBTQIA+ individuals and families face discrimination, bullying, and barriers to care. Anti-LGBTQIA+ bills are still being proposed in the U.S. (533 in 2024 alone), and somehow, conversion “therapy” is still around, with over 1,300 practitioners in the U.S.

This is why it’s crucial for members of the LGBTQIA+ community to have access to safe, affirming therapists who get it — and hanging up a rainbow flag in the office isn’t enough.

Read on to learn about the importance of LGBTQIA+-affirming therapy, the benefits of working with an affirming therapist, how to find an LGBTQIA+ therapist, and more. 

Why LGBTQIA+ therapy matters

For a long time now, the community has been in need of better care. 

“The history of mental health treatment for LGBTQIA+ individuals contains important context for today's challenges,” explains licensed clinical social worker Kit Morgan. “Homosexuality was classified as a mental disorder until 1973, which means many practicing therapists were trained by professionals educated by a deeply homophobic framework.” Unfortunately, even today's licensing exams may contain questions reflecting homophobic and transphobic rhetoric, he adds. 

Sadly, many members of the LGBTQIA+ community have experienced less-than-ideal scenarios in therapy. “Many therapists are not trained to work with LGBTQIA+ clients and don’t understand the nuances of how our identities impact and interact with our mental health,” says licensed therapist Alo Johnston (aka @thetranstherapist). “Even well-meaning therapists without the proper training can slow down or impede the work of their LGBTQIA+ clients — and worst case scenario, a non-affirming therapist can create more trauma in the process.”

Finding an LGBTQIA+-affirming therapist can make all the difference. “Therapy should be a space where you don't have to shrink or explain your identity to be understood,” says licensed psychotherapist Rachel Wright. “An LGBTQIA+-affirming therapist doesn't just tolerate or ‘accept' you; they actively create space for you to feel safe, celebrated, and supported.”

The benefits of an LGBTQIA+ therapist 

Affirming care isn’t just a nice-to-have — it can be the difference between a healing experience and a harmful one. Here are some of the potentially life-changing benefits of LGBTQIA+ affirming therapy.

Permission to be 100% yourself

“Therapy tends to work better when clients feel safe enough to speak openly and authentically,” says licensed psychologist Dr. Luke Allen. “For LGBTQIA+ clients, this often involves being able to discuss topics like identity, relationships, sexual experiences, and trauma without monitoring for signs of discomfort or disapproval from their therapist.”

Less emotional labor

No need to explain LGBTQIA+ culture, terminology, or context. “In an affirming space, clients don’t have to filter or 'code-switch' their language to feel understood,” Dr. Allen says. “This reduces their emotional labor and frees up energy for the actual work of therapy.”

More space to do the work

Time is limited in therapy sessions. Without wasting time trying to explain yourself to someone who just doesn’t get it, affirming care frees up space for you to get to work on what you came to therapy for. “Affirming care allows us to actually do the work of therapy — exploring identity, relationships, trauma, and healing — without carrying the extra weight of defending who we are,” Wright says.

Shared lived experience

If you choose a therapist who shares the same gender identity and sexual orientation as you, you can benefit from an unspoken sense of solidarity. For example, if you’re a gay man, you might seek a gay therapist who’s lived through many of the same struggles as you. “When a client works with a therapist who shares their identities, they often experience immediate understanding and relief from the burden of educating their provider about basic aspects of their experience,” Morgan says.

Working with a trans or non-binary affirming therapist

Going a step beyond LGBTQIA+ affirming therapy, you might consider seeking further specialty if you are transgender or non-binary. “A non-binary/trans affirming therapist is a therapist who is trained in the issues specific to the trans community and understands the ongoing trauma of living in a transphobic world and how it affects mental health,” Johnston says. 

Non-binary or trans affirmative therapy isn’t just about support—it’s about being truly seen. A trans-affirming therapist can help you explore and embrace your gender identity, work through any challenges like gender dysphoria, and talk openly about what it’s like to move through the world as a trans or non-binary person. They’ll create a safe, validating space where you don’t have to explain or defend who you are.

You might prefer to work with a therapist who shares your gender identity or lived experience — and that’s totally valid, but it’s not a must for effective therapy. What matters most is that your therapist is informed, respectful, and committed to affirming care.

How to find an LGBTQIA+ therapist

So, now that you know you want to work with an LGBTQIA+ therapist, where do you begin? 

Start by browsing reputable therapist networks. Many of these services offer filters so you can easily find a therapist who meets your needs. Typically, there will be a filter for “LGBTQ,” “LGBTQIA,” “LGBTQ issues,” or something similar. Some allow you to filter by provider identity, so you can look for someone who is transgender, non-binary, gay, bisexual, or whatever else you’re looking for. 

Some examples include:

• Inclusive Therapists. Filter by LGBQ+ or transgender communities under “specialties” 

• National Queer and Trans Therapists of Color Network. Provides a location-based directory of therapists.

• Psychology Today. Filter by transgender under “specialty” or lesbian, bisexual, or LGBTQ+ under “sexuality”

• Alma. Filter by LGBTQIA+ under “specialty.” Filter by non-binary, transgender, asexual, bisexual, gay or lesbian, or queer under “provider identity”

• Octave. Filter by LGBTQ+ or Trans+ under “specialty”

• Grow Therapy. Filter by LGBTQ under “specialties” 

• Rula. Filter by gender identity, LGBTQIA+, sexual orientation, or transgender issues under “specialty” and non-binary, agender, bigender, gender fluid, or trans under “gender”

Through these services, you can find options for both in-person and online therapy. You can also browse services through Project Healthy Minds. 

If you’re facing financial difficulties, you can ask therapists about sliding scale options (cost based on your income) or check out local LGBTQ+ centers and organizations. Trans folks can also contact the Trans Lifeline. 

What to do in a mental health crisis

If you’re experiencing a mental health crisis, such as feeling the urge to self-harm or considering suicide, reach out for help immediately – you can find curated crisis services here. The Trevor Project has crisis counselors who are specifically trained to understand LGBTQ challenges, and offers free crisis support 24/7 through online chat, text, or phone call.  

Choosing the right LGBTQIA+-affirming therapist for you 

Even if a therapist comes up through these filters, it’s important to do your homework and look into their stance on LGBTQIA+-affirming therapy. You can get an idea first by looking through their page, but your best bet is to have a consultation.

“While many therapists include phrases like ‘LGBTQIA+ allied’ or ‘provides therapy for LGBTQ+ issues’ in their professional materials, these descriptors alone don't guarantee affirming care,” Morgan says. “I encourage potential clients to look beyond these labels and engage in a brief consultation to assess compatibility.”

You might also be curious about the therapist’s lived experience or other training related to the LGBTQIA+ community. “There are many ways people can gain this knowledge and experience: lived experience, LGBTQIA+ specific training in school or training site, or training through professional organizations like World Professional Association for Transgender Health,” Johnston says. “But there is no single credential or qualification that will guarantee someone is a good therapist to the LGBTQIA+ community, and it's always important to assess them yourself and trust your gut.”

Questions to ask an LGBTQIA+ therapist

Most therapists offer a free consultation (via phone or video) before an initial appointment. Use this as a chance to suss them out and make sure they're the right fit. Wright says you shouldn’t be afraid to “interview” them during this consultation. You’re making a big decision!  

To get a solid idea of whether your potential therapist is the real deal, Dr. Allen suggests asking the following questions:

• "What is your experience working with LGBTQIA+ clients?"

• “How do you approach working with gender-diverse clients?”

• “What does being ‘affirming’ mean to you?”

• “How do you handle situations where you’re unfamiliar with aspects of a client’s identity or culture?”

If they are truly LGBTQIA+-affirming, they will have solid answers to these questions. If not, consider interviewing another choice. “A good therapist will welcome these questions and answer them with transparency and respect,” Dr. Allen says.

Red flags to look out for

In the same vein, you’ll want to keep an eye out for red flags. You might notice these during a consultation or even during initial sessions. Dr. Allen says the following are signs you should be wary of:

• You frequently have to educate your therapist on fundamental aspects of LGBTQIA+ life

• They dismiss or downplay your identity

• They use outdated or pathologizing language 

• They’re overly confident without demonstrating cultural humility

• They ask personal questions that seem driven by curiosity rather than genuine care

• They suggest “it’s just a phase”

• They make any attempt to change or “correct” your identity

In these scenarios, it’s time to move on to other LGBTQ counseling options. 

Other things to consider in a therapist

Yes, being LGBTQIA+ affirming — or even being part of the LGBTQIA+ community themselves is a huge factor — but it shouldn't be the ONLY one. When seeking mental health services, think about what you want in a therapist, what your therapy goals are, and what type of treatment you’d like. 

For example, Wright suggests asking yourself if you want someone who’s sex-positive, trauma-informed, or experienced with polyamory, for example. “The best therapy happens when you feel safe and aligned with your therapist's approach, tools, and energy,” she says. 

You may also consider:

• Their cultural background

• Their age

• Their specialties (i.e., anxiety, depression, or OCD)

• The therapy modalities they practice (i.e., cognitive behavioral therapy, dialectical behavior therapy, or acceptance and commitment therapy)

Need help finding an LGBTQIA+ therapist?

If you’re an LGBTQIA+ individual looking for support, Project Healthy Minds can help you discover many therapists — and peer support —to choose from. Click here to browse mental health services for the LGBTQIA+ community.

The LGBTQ+ community is a strong and resilient group. On top of seeking therapy for mental health conditions, you can also go to therapy to experience general personal growth and get help navigating everyday life. Affirmative therapy can be life-changing. You deserve a space where your identity is celebrated and you can work towards better mental health with someone who gets it.