Individuals who identify themselves as lesbian, gay, bisexual, transgender, or questioning sometimes face challenges unique to the LGBTQ community. Although there is a much wider cultural acceptance of this community than 20 years ago, discrimination is still frequent in many areas. Rejection by friends and family is a very real fear facing people coming out for the first time. Additionally, often LGBTQ youth and adults face violence, bullying, or hate crimes. All of these factors can lead to extreme stress, addiction, depression, anxiety, PTSD, identity issues, poor self-esteem, self-harm, suicide, and eating disorders.
One of the most important things that a therapist can do to make LGBTQ clients comfortable in a therapy session, is to put aside his/her judgments, opinions and moral beliefs about gender and sexuality. Secondly, the therapist needs to refrain from assumptions about accurate terminology that clients chose to use. A valuable approach to building rapport and offering affirmative support, is to ask each client, for example, what “gay” means to them specifically. Similarly, a therapist’s acknowledgement that there is nothing wrong with the LGBTQ person, that s/he was born this way, is crucial to doing effective work with this population. The therapist’s advocacy continues with the committed belief that what is wrong is the physical violence, legal sanctions, discriminatory practice, and social disapproval that is done to LGBTQ individuals and couples by our society institutions and norms.