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Working with lesbian, gay, bisexual, transgender and queer or questioning individuals presents its own set of unique challenges. Individuals who identify as part of this community often come in with experiences very different from those of their heterosexual, cis-gender peers. They face discrimination in a variety of settings, and often have their own internal struggles about coming out or figuring out how to identify.

In addition to these individuals often wanting to work with an LGBTQ (or LGBTQ-affirming) therapist, family members also want to work with someone who can help them better understand the unique challenges their loved ones face, and help them learn to support the individual, regardless of personal or religious beliefs.

Coming Out

The term “coming out” refers to the process someone takes to acknowledge first within him/her self his/her sexuality or gender identity and then the process of sharing that information with others. Coming out is often a very difficult decision for people, and can have devastating consequences such as loss of family, friends, or job. Many people find it helpful to first come out to a therapist, and then navigate the coming-out-to-others process with a professional's help. It is imperative that one think through potential consequences of coming out (such as loss of relationships) as well as potential consequences of not coming out (such as living a double life or lying to loved ones).

Sex and Gender

It is common for people to confuse or not understand the difference between sex and gender. Sex refers to someone’s biological status. People are generally either born with male parts or female parts, although intersex (meaning people born with atypical combinations of both male and female features) individuals exist, as well . Gender refers to a set of (cultural) expectations associated with a person’s biological sex. In other words, the behaviors, attitudes, physical presentations, etc, that is expected of either sex (e.g. girls wear pink, boys wear blue).

Gender Identity and Gender Expression

Gender identity refers to the way in which one experiences his or her own gender. If an individuals assigned sex does not align internally with how the individual feels, the individual may identify as transgender or transsexual. Gender expression, on the other hand, is what a person puts out into the world by how one dresses, acts, talks, or one’s interests. Someone’s gender expression may be very different than his/her gender identity. Often it takes a highly trained professional to help an individual come to terms with his/her gender identity and then to help navigate how his/her gender expression fits into his/her gender identity and what that looks like, as well as how to share this information with loved ones.

LGBTQ Mental Health At A Glance

  1. LGBTQ individuals are 4 times more likely to attempt suicide than their heterosexual peers.
  2. Half of transgender people have seriously thought about taking their own lives.
  3. LGBTQ individuals who come from unaccepting families are 8.4 times more likely to have attempted suicide.
  4. On average, each episode of bullying or victimization increases the risk of self-harm by 2.5 times.