Can Online LGBTQIA+-Friendly Therapy Help Improve Mental Health?

Therapy can be a valuable source of support and guidance for members of the lesbian, gay, bisexual, transgender/two spirit, queer/questioning, intersex, asexual (LGBTQIA+) community. Unique challenges can sometimes accompany matters related to gender identity and sexual orientation, and LGBTQIA+-based discrimination can also cause mental health concerns. Here, we’ll discuss the unique mental health needs of the
queer community, how inclusive therapy can improve mental health, and how individuals may be able to find effective, affirming care through online therapy.

What is LGBTQIA+ affirmative therapy?

LGBTQIA+ affirmative therapy, or LGBTQIA+-affirming therapy, is an approach to psychotherapy that validates and supports the experiences of LGBTQIA+ clients. It involves therapists not simply being tolerant of their client’s identity and experiences, but actively accepting them as well as being thoroughly knowledgeable about and sensitive to LGBTQIA+ topics and history.

While LGBTQIA+-friendly therapy may involve a provider who is simply personally accepting of queer people, LGBTQIA-affirming therapy often takes it a step further. It typically requires specialized training and a specific perspective that allows the provider to engage on LGBTQIA+ matters from an informed place. While both can be helpful, queer-affirming therapy may be more effective since it involves the provider being specifically trained and informed.

What mental health support can affirmative therapists offer?

As one paper on the topic indicates, queer-affirming therapy is “not a stand-alone treatment, but it can be incorporated into any medical and mental health practice setting.” That means that queer-affirming therapists can typically help address any mental health concerns or conditions that a therapist who is not trained in this approach could, but they are also informed and able to support clients in addressing challenges specifically related to queer experiences.

In addition to treating concerns like anxiety, depression, eating disorders, low self-esteem, relationship conflict, and other common challenges, LGBTQIA+-inclusive therapists may also offer informed guidance regarding topics like:

• Questioning gender or sexuality.
• Coming out.
• Transitioning.
• Healing from trauma.
• Combating discrimination and/or stigma.
• Coping with familial or social rejection.
• Navigating sex and relationships.

What is gender-affirming talk therapy?

Gender-affirming talk therapy is one type of LGBTQIA+-affirming mental health care, or one form that it can take. In general, gender-affirming care is a broad term that includes any type of healthcare designed to support and affirm an individual’s gender identity, which can include affirming therapy. This term is typically used in the context of providing care to individuals who are transgender, genderqueer, non-binary, gender non-conforming, or questioning their gender identity. In the form of talk therapy, it normally affirms and validates the individual’s self-identified gender and provides compassionate, informed support as they navigate their journey of self-discovery.

Gender-affirming therapy: transitioning with the support of a therapist

Gender-affirmative therapists are specially trained to help clients on the road to deciding whether they want to pursue any type of gender-affirming transition, including medical transition. They will typically work with the client throughout their transition process, should they choose to take that path.

Gender-affirming therapists tend to be knowledgeable about the unique challenges that can arise in relation to gender identity, and they are usually experienced in providing support for the types of difficulties that commonly affect gender non-conforming individuals in an often unaccepting world. They may also be familiar with the process of writing letters of support that an individual may need in order to pursue gender-affirming hormone therapy or surgery.

Gender-affirming therapy does not aim to change the gender identity of a client. In fact, aiming to change a queer person’s gender identity or sexuality is the opposite of gender-affirming care and may fall under the umbrella of conversion “therapy”—which is now illegal in many places. Instead, gender-affirming therapy aims to help individuals navigate challenges while warmly affirming the way in which they identify.

Understanding the mental health benefits of LGBTQIA+-friendly therapy

Evidence-based therapeutic techniques have the potential to help individuals of all ages, backgrounds, sexual orientations, and gender identities. Again, queer-affirming therapy uses the same evidence-based approaches, but through a perspective that’s understanding and informed on queer-related topics.

Context and understanding for queer experiences

Individuals in the queer community are at greater risk of experiencing mental health challengesthan the population in general. This risk stems from the lived experiences of queer individuals, which often involves both systemic and interpersonal discrimination and the trauma that can result. This can be particularly true for individuals with intersecting marginalized identities, such as queer people of color or queer and disabled individuals.

An LGBTQIA+-affirming therapist will typically be knowledgeable and mindful of the reality of the lived experiences for queer people of all different types today and throughout history. This Informed perspective can allow them to be sensitive to such topics so they can provide useful guidance and avoid causing further harm.

Family therapy from an LGBTQIA+-affirming therapist

In addition to individual therapy, many LGBTQIA+-inclusive therapists can also offer relationship and family support. This often involves using their informed perspective to help relatives understand each other and improve their relationships.

LGBTQIA+-affirming therapy for families with queer members

Some families with LGBTQIA+ members may decide to seek therapy for support in addressing prejudice and biases that may exist among non-queer members. Queer-informed therapists may help promote understanding among family members and advocate for open, respectful communication and acceptance.

Finding LGBTQIA+-affirming therapy near you

When seeking therapy, it can be crucial to find a therapist who is well-versed and empathetic to LGBTQIA+ issues to ensure you get the necessary support for your therapeutic objectives. You can opt for either in-person or online sessions, both of which can offer distinct advantages and drawbacks. Reflecting on your goals for therapy can guide you in choosing the most suitable mode for your needs.

Seeing a therapist for LGBTQIA+ mental health: in-person vs. online therapy

Whether you decide to see an inclusive therapist online or in person depends on many factors. One of the key considerations is availability. If you live in a rural area or a place that has more anti-LGBTQIA+ legislation and sentiment, it may be difficult to find an inclusive provider within a commutable distance.

Comfort can also play a role in your decision. Some people find it more comfortable to meet with a therapist face-to-face, while others feel more at ease speaking to someone remotely via video call or phone call.

Finally, cost is a consideration for many people as well. Online therapy is typically more affordable than in-person therapy without insurance, though some in-person therapists may offer sliding-scale fees based on income. Considering your preferences and exploring all your options may help you move toward a decision.

Finding an in-person, queer-inclusive therapist

If you decide you’d prefer to meet with a therapist in your local area, here are a few different approaches to finding one who meets your needs:

• Use LGBTQIA+-specific directories: Online directories can help you find therapists in your area who specialize in LGBTQIA+ issues.Online directories can help you find therapists in your area who specialize in LGBTQIA+-affirming care, like the National Queer and Trans Therapists of Color Network.
• Contact local LGBTQIA+ groups: Many towns and cities have LGBTQIA+ groups that can provide recommendations for LGBTQIA+-friendly therapists in the area.
• Ask for referrals: If you have queer friends who see a therapist in your area, you might ask them how they found their provider.
• Look for signs and fliers: Local businesses, including mental health professionals, sometimes advertise in community spaces like coffee shops, libraries, and fitness studios. Be sure to read reviews and verify the licensure of any therapist you may find before booking an appointment.

Finding an online queer-inclusive therapist

One of the easiest ways to connect with a therapist virtually is to sign up for an online therapy platform. With a service like BetterHelp, you can share your needs and preferences in a brief onboarding questionnaire and get matched with a provider accordingly. You can then meet with them virtually, via phone call, video call, and/or in-app messaging from anywhere you have an internet connection. You also have the option to change therapists at any time, for any reason, and for no additional cost until you find the right fit.

Is online, inclusive therapy effective for LGBTQIA+ clients?

In general, research suggests that therapy delivered online can often be as effective as therapy delivered in person. Similar findings have emerged for queer-affirming therapy specifically.

For example, consider a 2021 study that suggests that online LGBTQIA+-affirming therapy helped reduce symptoms of depression and improve coping mechanisms in participants, and that “digital technologies are a promising platform for the delivery of affirmative therapies for LGBTQA+ populations.”