Coming Out To My Therapist: The Importance Of Authenticity

People in your life may make assumptions about your gender and sexuality, possibly automatically assuming you are heterosexual or cisgender. This tendency to assume everyone is heterosexual and cisgender is known as “heteronormativity.” It’s a societal attitude in which heterosexual and cisgender identities are considered the standard from which all other sexual orientations and gender identities deviate.

Because of heteronormativity, people who do not identify as heterosexual or cisgender may feel the urge to come out to correct assumptions others might be making about them. If you are a member of the LGBTQIA+ community consulting a therapist for mental health services, you may wonder whether you should come out to them.

Mental health and the LGBTQIA+ community 

The LGBTQIA+ community has made historic strides toward equality, fair representation, and respect in recent decades. However, people who come out may still face shame, stigma, and, in some cases, outright hate. Coming out can lead to negative reactions from loved ones. 

Conversely, continuing to conceal crucial components of your identity from meaningful people in your life can also have negative consequences. For example, members of the trans community who do not feel they can fully express their gender identity in their daily lives may be more prone to developing gender dysphoria, the sense that their gender identity conflicts with their biological sex. While gender dysphoria is not considered a mental health condition, it may lead to mental health challenges such as anxiety and depression. 

Overall, members of the LGBTQIA+ community might be more predisposed to developing mental health conditions. This phenomenon may be explained by the minority stress theory. 

According to the American Psychological Association, minority stress theory posits that the higher levels of stress experienced by marginalized groups are partly due to the discrimination they face from society. 

This prejudice may include outright harassment and victimization, decreased social support, and fewer economic and educational opportunities, potentially resulting in financial strife. The heightened possibility of experiencing these adverse events may lead to negative experiences and mental health complications in an LGBTQIA+ person’s life.

Therapy can be a beneficial support system and a safe space for members of the LGBTQIA+ community to work through mental health concerns. However, the advice and strategies a therapist can provide you with may be limited if you do not share your authentic identity with them. 

Ways therapists can support you

If you are open about your sexuality and gender identity with your therapist, you may be able to start working with them to identify ways in which your experiences as a member of the LGBTQIA+ community, both positive and negative, have shaped the person you have become. 

It can be helpful to receive professional support in addressing some common concerns associated with navigating a significantly heteronormative world as a member of the LGBTQIA+ community. A therapist may support an LGBTQIA+ person in the following ways.

Questions about identity and labels

Vivienne Cass, a clinical psychologist specializing in sex therapy and the study of sexuality, developed a six-stage model for discovering one’s identity. Several of the earlier stages of the model — namely, identity confusion, identity comparison, and identity tolerance — may involve exploring what it means to be a member of the LGBTQIA+ community and potentially the words you feel comfortable using to describe your identity.

Society can have a bit of a hyperfocus on labeling people’s sexuality and gender identities. If you are beginning to come to a new understanding of your own identities, it can feel daunting to navigate the language around sexuality and gender. You may feel pressure to identify with one of the following labels:

• Straight
• Gay
• Bisexual
• Lesbian
• Queer
• Cisgender
• Transgender
• Nonbinary

However, the above list is just the tip of the iceberg! Not to mention, many labels for gender sexuality may overlap, i.e., some transgender people may also identify as nonbinary, a gay person may also refer to themselves as “queer,” etc.

A therapist trained in gender and sexuality concerns may help you discover where your identity falls among these labels. Alternatively, they may support you in learning that no label can fully capture your complexity and individuality. There is no “right” or “wrong” way to identify, and the support of a therapist may help you to understand your own unique identity. 

Addressing expectations 

Many members of the LGBTQIA+ community who have not come out (and some who have) may feel as though they are not meeting the expectations that other people have of them. These expectations may include the following:

• Dressing and acting a certain way
• Being romantically or sexually interested in a certain kind of person
• Using a certain type of name or pronouns
• Proceeding along a certain life track (i.e., marrying someone of a different gender, having biological children with that person, etc.)

These expectations could come from a family member, a church, a friend group, or a larger community. If you are feeling the pressure of such expectations, you may fear (or have already experienced) anger or betrayal if you do not live up to them. 

While it is understandable that you may not want to disappoint the people close to you, it can benefit your sense of self and mental well-being to live your authentic truth, regardless of what other people think. A therapist can help you identify what you want from your life and how to pursue your dreams and desires, independent of what others want or expect.  

Moving away from shame

If you do not have supportive people in your life who love you for who you are, or if you have been taught unhealthy and untrue concepts about your sexual orientation or gender identity (for example, that it is something you have chosen or something that can be changed), then you may feel a deep sense of shame around these pieces of yourself. Even if you have not directly experienced rejection from loved ones, societal attitudes towards LGBTQIA+ people can cause what is known as internalized shame.

You and your therapist can work together to understand the root of any shameful feelings you are experiencing, which may then enable you to work through your internalized shame and move past it. 

Connecting With An LGBTQIA-Affirming Therapist

For LGBTQIA+ people that may need therapy, it can be essential to connect with a therapist trained in gender and sexuality therapy. Some LGBTQIA+ people may prefer working with a therapist who identifies as a community member. It may be difficult for you to find such a provider in your area. If you are experiencing challenges with finding a therapist to meet with in person, you may want to consider online therapy.

Online therapy can help LGBTQIA+ people receive therapy from the comfort of their homes, creating a safe environment where they can openly express their thoughts and emotions without fear of judgment or discrimination. Additionally, online therapy can provide those living in remote areas or areas with limited LGBTQIA-affirming resources ability to see specialized therapists. This can ensure that LGBTQIA+ individuals receive the support they need, irrespective of their geographical location, while maintaining personal comfort if desired.

Scientific research has demonstrated that online therapy may be as effective as traditional in-person therapy. One study found that online therapy helped address the mental health related-symptoms of minority stress associated with identifying as gay, lesbian, bisexual, or transgender.