What Does LGBTQ+ Affirming Therapy Actually Look Like?

What does it mean to be an LGBTQIAP+ affirming therapist? While many therapists claim to be affirming, the meaning of this claim can get lost. Research, such as the 2024 study by Burger and Pachankis, offers some guidance on how to practice from an affirming lens, but truly practicing from an affirming perspective blends both the science and the personal.

Being an LGBTQIAP+ affirming therapist is more of a practice for me than a declaration. It’s something I strive toward rather than something I can definitively claim. It reflects how I work more than what I do. It isn’t a specific type of therapy or a singular intervention. It’s not something you do once and complete. It’s an ongoing process, something I return to as a way of staying grounded in my work.

Here are four main principles that guide my LGBTQIAP+ affirming approach:

1. Creating a space that fosters courage and authenticity

While we as therapists can’t determine whether a space feels safe for our clients, we can create conditions that support clients in showing up with bravery and authenticity. For LGBTQIAP+ clients, this can include inviting exploration of identity in ways that allow for both fluidity and stability, trusting clients to lead that process. It also involves investing in understanding aspects of the LGBTQIAP+ experience while remaining humble and curious about each person as an individual. Reducing shame is central to this work, helping clients feel less alone through curiosity, validation, and genuine understanding.

2. Understanding the impact of trauma and oppression, both inside and outside the therapy room

An important part of being affirming is recognizing what our clients experience beyond the therapy space. Systems of oppression and trauma have a profound impact on the nervous system. Many clients have developed protective strategies to survive these experiences and to continue navigating ongoing threats. A strengths-based, non-pathologizing perspective helps us understand that what may be labeled as “problems,” such as anxiety or mood concerns, are often protective responses shaped by minority stress over time. Honoring intersectionality is also essential, recognizing that being LGBTQIAP+ is one part of a person’s identity, interacting with many others that shape their experience. This understanding can also guide advocacy, both within the therapy room and beyond it.

3. Ongoing professional development guided by the needs of the community

While lived experience can be meaningful, no single experience can represent the full range of LGBTQIAP+ identities. Centering LGBTQIAP+ care in professional development is essential to maintaining an affirming practice. This can include ongoing training, staying informed about current research, participating in consultation with other affirming clinicians, and learning from the work of others in the field. At its core, this principle is about remaining open to growth and continuing to deepen understanding over time.

4. Fostering connection to affirming community resources and supporting visibility

Healing and wellness for LGBTQIAP+ individuals are often rooted in connection, both within oneself and with others. While therapy may focus on building compassionate internal relationships, affirming care also involves supporting connection outside the therapy room. This includes having knowledge of affirming referrals, community resources, and opportunities for social connection. These connections can support broader wellbeing and help clients feel less isolated.

Research shows that outcomes improve for LGBTQIAP+ individuals receiving affirming therapy, particularly in areas such as anxiety, depression, substance use, and suicide risk, all of which disproportionately impact this community (Burger and Pachankis, 2024). But affirmation is more than lived experience, positive regard, or visible symbols like a rainbow. It is an ongoing practice of cultivating awareness, knowledge, and humility in order to more fully honor the humanity of people of all genders and sexual orientations, both in the therapy room and beyond.

Take the Next Step

Learn learn more about our approach to LGBTQ+ Affirming Therapy in Cincinnati and what working together might look like.

You’re also welcome to reach out for a consultation to see if it feels like a fit. Contact us today.

Frequently Asked Questions

• What is LGBTQIAP+ affirming therapy?
  LGBTQIAP+ affirming therapy is therapy that actively supports and respects your identity. It creates a space where your experiences are understood within the context of culture, relationships, and systems, rather than minimized or pathologized.

• Do I have to educate my therapist about LGBTQIAP+ issues?
  Not generally. LGBTQIAP+ affirming therapists are already familiar with many of the common experiences folks in our community face, so you don’t have to spend your time teaching your therapist about cultural aspects of an LGBTQ+ identity. A solid affirming therapist will usually balance a solid base of knowledge about the community and culture with humility in understanding each person’s experience is unique.

• Is LGBTQIAP+ affirming therapy only about identity?
  No. You can bring anything into therapy. Identity may be part of the conversation, but so are relationships, anxiety, trauma, personal growth, and everyday life.

• What if I’ve had a negative experience in therapy before?
  Many people seek affirming therapy after feeling misunderstood or unseen in previous therapy. A different kind of therapeutic relationship can feel more collaborative, respectful, and supportive.

• How do I get started with LGBTQIAP+ affirming therapy in Cincinnati?
  The first step is usually a brief consultation with a therapist to see if it feels like a good fit. From there, you can decide together how to move forward.  Learn more about services at Lumenso Wellness or contact us at Lumenso Wellness to see if we might be the match for you.

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Resources

Burger J, Pachankis JE. State of the Science: LGBTQ-Affirmative Psychotherapy. Behav Ther. 2024 Nov;55(6):1318-1334. doi: 10.1016/j.beth.2024.02.011. Epub 2024 Mar 6. PMID: 39443068.