The Importance of Affirmative Therapy for LGBTQ+ Individuals
- Lisa S. Larsen, PsyD
- Apr 27
- 4 min read
The everyday stressors that affect cisgender, heterosexual people also impact LGBTQ+ individuals—this might seem obvious at first glance. Yet, the current social and political climate often portrays LGBTQ+ folx as different, exotic, or difficult to understand. The truth is, most people have a friend, coworker, or family member who is LGBTQ+.
The added layer of stress for LGBTQ+ individuals stems from what's known as minority stress—the chronic strain of existing within a marginalized and stigmatized group. That’s why it’s especially important for LGBTQ+ people navigating life’s challenges to have access to safe, affirming psychotherapy. But what exactly is affirmative therapy? This post explores the foundations and significance of LGBTQ-affirmative psychotherapy.
The Evolution of LGBTQ+ Identity in Psychology
Not long ago, homosexuality was classified as a mental disorder by the field of psychology—a harmful legacy that has shaped how LGBTQ+ people have been treated within the mental health profession. Psychologist Evelyn Hooker’s groundbreaking research on homosexual men was instrumental in challenging these outdated views and contributed to the removal of homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973.
Unfortunately, damaging practices like Sexual Orientation Change Efforts (SOCE), including so-called Conversion Therapy or Reparative Therapy, persisted for years. These approaches sought to “convert” individuals with same-sex attraction to heterosexuality, or push transgender and nonbinary people to conform to a cisgender identity. These practices have not only proven ineffective but have also been linked to a doubling in the likelihood of suicide attempts among youth subjected to them.¹ Most major professional organizations, including the American Psychological Association, have since denounced these methods.
Despite that progress, the mental health field has not always been a safe place for LGBTQ+ people—even among professionals meant to provide care and support.
What Is Affirmative Therapy for LGBTQ+ Individuals?
Affirmative therapy has evolved significantly, but there is still room for growth. Rather than internalizing and reinforcing societal stigma, affirmative therapy intentionally counters it by adopting the following principles:
· Acknowledging and validating the lived experiences of LGBTQ+ clients, including both challenges like discrimination and moments of joy and pride;
· Showing respect for each individual’s inherent dignity (a core value of all ethical psychotherapy);
· Practicing cultural competence and maintaining awareness of LGBTQ+ issues and communities;
· Embracing inclusivity across all gender identities, sexual orientations, and cultural backgrounds;
· Fostering resilience, strength, self-compassion, and personal empowerment;
· Creating a physically and emotionally safe therapeutic space—this includes removing reminders of transphobia or homophobia, updating policies and forms to reflect inclusive language, and consistently using correct pronouns and preferred names;
· Avoiding assumptions about clients’ gender identities, sexual orientations, or sexual practices;
· Providing space for safe exploration of sexuality, gender, and identity;
· Engaging in ongoing self-reflection to uncover and confront implicit biases or internalized homophobia and transphobia;
· Recognizing the societal and institutionalized forms of discrimination that negatively affect LGBTQ+ mental health.²
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Cognitive Behavioral Therapy (CBT) has often led the way in affirmative approaches, but many other modalities—such as Eye Movement Desensitization and Reprocessing (EMDR) therapy—can also be effective for LGBTQ+ adults and teens coping with trauma or anxiety.³
Affirmative Therapists Examine Their Own Biases
Just as cultural competence is essential when working with Black, Indigenous, and People of Color (BIPOC), affirmative therapy requires therapists to intentionally examine and confront their own biases. Without awareness of how racism, sexism, transphobia, biphobia, or homophobia can be internalized, therapists risk perpetuating these harms within the therapeutic space. This kind of unconscious bias can deepen the very stigmas that clients are seeking to heal from.
That’s why ongoing self-awareness and personal reflection must be a consistent part of a therapist’s practice. Training that enhances knowledge, attitude, and skills around LGBTQ+ issues can make a significant difference in therapeutic effectiveness. Ideally, this kind of professional development occurs in a supportive environment where therapists can explore and challenge their own assumptions and beliefs.
Are You Looking for Affirmative Therapy?
Maybe you’re curious about exploring your gender identity or sexual orientation but haven’t felt safe doing so. Perhaps you’re carrying grief or trauma from discrimination—whether personal or directed at someone you love. Or maybe you’re feeling anxious or depressed due to the additional stressors that often come with being LGBTQ+. If so, LGBTQ-affirmative therapy could be a powerful resource for your healing and growth.
I invite you to reach out by calling 661-233-6771, or click the button below to learn how I can support you in creating a safe, affirming space for your inner work.
References:
[1] Burger, J. and Pachankis, J. (2024). The state of the science: LGBTQ-affirmative psychotherapy. Behavior Therapy, 55: 1318-1334.
[1] Pepping, C. A., Lyons, A. and Morris, E. M. (2018). Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol. Psychotherapy, 55(1), 52-62
