Affirmative Therapy: Caring for the LGBTQIA+ Community

Published on: 16 Jun 2022
Clinically Reviewed by Meaghan Rice PsyD., LPC
two women sitting on an couch discussing

One-size-fits-all doesn’t apply to therapy. No two sessions are the same, no two people’s needs are the same, and no treatment plans will work in the same way. Add into the mix the barriers and prejudices faced by members of the LGBTQIA+ community, and things become even more challenging.

The fact that there’s been blatant bias against people who identify LGBTQIA+ is undeniable. We see it every day in the real world, and it’s glaringly obvious in the world of mental health. Much research has been done on the topic of LGBTQIA+ mental health, and studies offer some striking, disturbing findings. Some of the most notable stats include:

  • Compared to heterosexual counterparts, LGBTQIA+ people are at least 1.5 times more likely to receive a mental health diagnosis for anxiety, depression, or substance abuse.
  • Those who identify as LGBT have a higher rate of suicidal ideations and are about 2 times more likely to attempt suicide. 
  • The transgender population (who identify, behave, or express differently than the sex they were assigned at birth) has some of the highest risk for mental health challenges throughout life, including:
    • More than 33% will be diagnosed with an anxiety disorder
    • Over 41% will be diagnosed with depression
  • Another study found that within the last 3 years, 57.4% of females and 55.3% of males who identify as transgender were either diagnosed with or treated for a mental health condition.
  • Finally, people who identify as transgender overwhelmingly have higher rates of suicide attempts. 

The need for a new approach is clear, and affirmative therapy — therapy that seeks to inclusively meet the needs of any minority group, including and perhaps especially, those who identify as part of the LGBTQIA+ community — might be part of the solution. 

Exactly what is gender-affirming therapy? How does it work? Who can it help? We’re answering all of that and more here. 

What Is Affirmative Therapy?

Affirmative therapy, or gender-affirming therapy, is one of many types of therapy (also known as talk therapy). It’s used in LGBQTIA+ therapy to effectively validate the needs of minority populations, like those who identify as lesbian, gay, bisexual, transgender, queer, intersex, or asexual (LGBTQIA+). 

Therapists who are trained in affirmative therapy learn to use both nonverbal and verbal tactics to establish a positive, affirming position toward clients who identify other than cisgender (people who identify with the gender they were assigned at birth). 

Though the reasons for attending therapy don’t vary much (if at all) from any other population, the life experiences of someone who identifies LGBTQIA+ are often largely shaped by their gender identities.  

At a high level, gender affirmative therapy can work to:

  • Help therapists address their own internalized transphobia or homophobia (even if they’re unaware they have these)
  • Acknowledge the many challenges members of the LGBTQIA+ community face
  • Offer resources and support
  • Help people resist judging nontraditional identities
  • Allow people to resolve beliefs or needs contradictory to how they identify

How Does Affirmative Therapy Work?

LGBTQIA+ affirmative therapy works by training therapists to effectively treat minority populations, like LGBTQIA+, who’ve historically had to deal with higher rates of mental health conditions than the cisgender population has. 

Research shows that most therapists who’ve been trained in affirmative therapy believe they’re well-prepared to treat and work with people who identify LGBTQIA+. They also feel less likely to exhibit trans-negativity and/or homo-negativity attitudes. Overwhelmingly, most therapists feel that they benefit from the training and are better equipped to help their LGBTQIA+ clients and patients.  

“Affirmative therapy is a type of therapy that focuses on the needs of individuals from sexual and gender minority groups. This kind of therapy intends to meet the clients where they are. The idea is to create a safe space for the client to share their thoughts and feelings around sexuality and gender free from judgment and bias.”

Talkspace therapist Reshawna Chapple, PhD, LCSW

Members of the LGBTQIA+ community face many obstacles and challenges throughout life. For example, they might regularly need to navigate things like: 

Not only does affirmative therapy help them learn to deal with injustices, but it can also work to raise awareness. It can ensure people avoid loneliness, thoughts of self-harm or suicide, depression, anxiety, and a general sense of hopelessness that might develop as a result of not feeling accepted and supported. 

Who Benefits from Affirmative Therapy?

By focusing on enhancing awareness and inclusion, LGBTQIA+ affirmative therapy can benefit more than just the person in treatment. It’s a proven modality that can be exceptionally beneficial for both the LGBTQIA+ community and those around them.  

The minority stress theory recognizes that an overwhelmingly homophobic culture has resulted in sometimes life-long discrimination and harassment for members of the LGBTQIA+ community. The mental health discrepancies we see throughout the population can largely be explained through this theory. 

In addition to helping minority groups themselves, affirmative therapy can also be an effective approach that benefits families and couples, too. 

LGBTQIA+ community

Gender affirming therapy offers us a way to rethink how as a society, we approach an entire community. It reinforces the idea that we should all strive to want to better understand sexuality and gender. We can begin to normalize that these concepts don’t necessarily fit into a box. In the broadest sense, affirmative therapy can help us begin to accept one another.  


Particularly in the early stages after someone comes out, affirmative therapy can help all family members. Coming to terms with new roles and letting go of pre-existing ideas for someone’s future can be tough. Learning to accept and honor a loved one’s identity can be easier with the use of affirmative therapy.   


It makes sense that therapy can be most effective when it’s structured to directly deal with issues and concerns specific to a couple’s relationship. Affirmative therapy can help by providing a therapist who understands the dynamics of what LGBTQIA+ couples might face. 

Additionally, couples might find they’re able to relax, trust the process, and open up a bit more when they’re working with someone who’s trained in this specialized modality. Because it’s specifically designed to treat couples who identify LGBTQIA+ without bias, the entire process might feel more comfortable. 

“Affirming therapy is not only beneficial for the LGBTQIA+ client, it can also help friends and family members understand how to relate to the individual. In couples therapy it can be used to target interpersonal issues that can come up related to gender and sexuality.”

Talkspace therapist Reshawna Chapple, PhD, LCSW

Seeking Help with Affirmative Therapy

If you’re struggling with your identity, or you know someone else who might need help, reach out. You can find the support and care you deserve. Working with a therapist who’s skilled and trained in LGBTQIA+ affirmative therapy can change your life. You’ll get gentle, understanding care and guidance from someone who knows what you’re experiencing. They can help you learn to accept your identity, or show you how to work towards more positive, healthy relationships with friends and family members.

The most important thing for you to understand is that you’re not alone. So many people in the world accept you and love you, exactly as you are. Affirmative therapy might just help you realize that. Learn how to find an LGBTQIA+ therapist with Talkspace today.  


1. King M, Semlyen J, Tai S et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8(1). doi:10.1186/1471-244x-8-70. Accessed June 2, 2022.

2. Bockting W, Miner M, Swinburne Romine R, Hamilton A, Coleman E. Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population. Am J Public Health. 2013;103(5):943-951. doi:10.2105/ajph.2013.301241. Accessed June 2, 2022.

3. Leonard W, Lyons A, Bariola E. A closer look at private lives 2. Published 2015. Accessed June 2, 2022.

4. Grossman A, D’Augelli A. Transgender Youth and Life-Threatening Behaviors. Suicide and Life-Threatening Behavior. 2007;37(5):527-537. doi:10.1521/suli.2007.37.5.527. Accessed June 2, 2022.

5. Pepping C, Lyons A, Morris E. Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol. Psychotherapy. 2018;55(1):52-62. doi:10.1037/pst0000149. Accessed June 2, 2022.

6. King M, Semlyen J, Tai S et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8(1). doi:10.1186/1471-244x-8-70. Accessed June 2, 2022.

7. Dentato, PhD, MSW M. The minority stress perspective. Published 2012. Accessed June 2, 2022.

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

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