Tuesday, December 9, 2014

Top 10 Ways for Therapists to be LGBTQ Friendly

This post, geared for therapists and other helping professionals, was written as part of the Private Practice from the Inside Out blog carnival.  For the blog carnival, 8 therapist-bloggers have posted articles on the theme of "Top 10s" in private practice.  At the end of my post you will find links to the other therapists participating in this event.

While some therapists make a deliberate decision to focus our practices on therapy with lesbian, gay, bisexual, transgender, and queer (LGBTQ) people, all therapists can and will encounter LGBTQ clients over the course of their careers.  This is why it is important for all therapists to be prepared to work with LGBTQ people.  

Below you will find my Top 10 Ways for Therapists to be LGBTQ Friendy.

Top 10 Ways for Therapists to be LGBTQ Friendly

  1. Get the forms right.

The questions you ask on your intake forms, and how you ask them, will communicate a lot to potential clients about your knowledge and understanding of the LGBTQ community.  There are many individuals and organizations out there that tell people being LGBTQ is the source of their problems.  It’s important to let clients know that this is not you.  In general, fill-in-the-blank lines work better than checkboxes (see #4).

  1. Use inclusive language.

Do not assume the gender identity or sexual orientation of your clients, their partners, or their friends and family members.  

  1. Pay attention to pronouns.

Use the pronouns that clients ask you to use.  People may want to be referred to as “he,” “she,” or with another gendered or non-gendered pronoun.  If you don’t know, ask.

  1. Get over the categories.

Being queer means not fitting into the box.  Don’t expect that all of your clients will identify as “heterosexual,” “gay,” “lesbian,” “bisexual,” “male,” “female,” etc.  Embrace fluidity and encourage clients to identify in whatever way feels right for them.

  1. Know the community.

Getting to know a community is like learning a language.  Learn and know community resources available to LGBTQ people.  Have information about these resources visible in your office and be ready to connect clients to these resources.  Get to know other therapists working with LGBTQ people and consult with them when you need to.

  1. Be imperfect.

As a Dialectical Behavior Therapy (DBT) therapist I follow one of DBT’s core assumptions, the fallibility agreement.  Whatever we have been accused of doing wrong, we have probably done. If you are wrong, be wrong.  When you mess up with an assumption, judgment, or imprecise language, apologize and make an effort to get it right next time.

  1. Don’t divide the bathrooms.

Transgender, genderqueer, and gender-non-conforming people are often subject to violence and discrimination just for needing to use the bathroom.  Avoid labelling the restrooms in your office according to binary gender categories.

  1. Know your biases.

Living in a homophobic, biphobic, and transphobic society we all internalize norms and judgments about how people should be.  Often we are not aware of these beliefs, yet they still seep out in our assumptions about and reactions to other people.  Examine how you feel about gender and sexuality, and challenge your beliefs.

  1. Don’t expect the therapy to be all about sexual orientation and gender identity.

LGBTQ people seek therapy for many different reasons, as with people of any identity group.  They may not be coming to you for help with gender and sexuality.  As always, start where the client is.

  1. Recognize our strengths.

LGBTQ people have unique strengths that can be channeled into personal growth and into contributing to the larger society.  Our ability to challenge social norms, our creativity in establishing families, and our resilience from overcoming stigma and bias are strengths that can tapped into for even greater personal and social change.

Looking for LGBTQ affirming psychotherapy? Contact me and see if we can work together.

This post is a part of the Private Practice From the Inside Out blog carnival on the theme of "Top 10s" in private practice.  Please visit the other therapist-bloggers participating in this event:

Rosellen Reif, MS, LPCA, CRC, QDD/MHP: Top 10 Tips to Make Your Private Practice Accessible to Clients with Disabilities -

Elizabeth Peixoto, MS, LMHC, LMFTA: Top 10 Reasons I Love My Private Practice


  1. Oh, where did my comment go? Haha. I will try to capture my thoughts again. Although my practice does not specialize in LGBTQ, I have found that my clients were some of the best teachers in sharing terms, struggles, and LGBTQ culture. #3 definitely reminded me of an experience where I had to use your suggestion. When in doubt, ASK! #9 is so very true in my experience.

  2. Hi Camille! Thanks so much for stopping by and commenting on my post. I'm so glad you found some points that resonated!

  3. Jeremy, thank you for looking out for the LGBTQ community.

    These are such simple things for any therapist to do.

    It speaks volumes to me about the therapists who chooses to tweak their forms and their language to include everyone.

    And, it also speaks volumes to me when they do not.

    A therapist's willingness to admit what she doesn't know and just ask the question presents so much more confidence than the therapist who just fakes it or disregards the comment at all.

    Thanks, Jeremy, for looking out for our clients, our colleagues, and my family.

    I look forward to meeting you one day!

  4. Hi Jeremy, I really enjoyed reading your post. I agree with Tamara - these are such simple things for any therapist to do, and they can make a huge difference in so many ways. I love your point in #6 - be imperfect. For me, being imperfect is being genuine. It's learning from our mistakes and asking questions when we don't know it all.

  5. After reading this post, I definitely need to look over and revise the intake forms I use for my private practice! There are so many ways we can be assuming and unwelcoming to clients who are reaching out for help. Sharing information like this allows us as therapist to stop the cycle of discrimination some of our potential clients keep experiencing from society in general. Thank you for writing this!

  6. I love the comment about accepting when you're wrong. It's easy to feel a pressure to be "in the know" and get everything right.

    As for bathrooms: I wish we had that level of control over the space. I would make all the bathrooms ungendered. For a while our office's bathroom keys were even like this: the women's room key attached to a pink rubber band and the men's room key attached to a piece of PVC pipe. I don't think that was on purpose (really -- I don't!) but it was certainly striking.

  7. Thanks so much for all of your comments! And thank you to those of who who participated in the blog carnival with me for stopping by.

    Tamara, you are so right that the actions we take, even seemingly small ones such as how we design our forms and what questions we ask, say so much about us and our values. I look forward to meeting you at some point as well!

    Elizabeth, yes -- we never need to act as though we have all the answers! Our willingness to be open, curious, and willing to learn can do so much for our clients. Sometimes there seems to be this pressure to be the "expert" -- but it is our clients who are the experts of their lives and experiences.

    Vanessa, I'm so glad this post was useful and may have inspired you to make a change! There are always ways we can be more inclusive and welcoming. Please reach out to me if I can be of any help as you look over your forms.

    Roy, what a striking example indeed! Unfortunately we don't always have control over the spaces in which we work. When the moment is right to advocate for change, though, I hope you will!

  8. Great article, Jeremy! Wonder if it is helpful too to clearly indicate on your website that you are LGBTQ friendly. Thanks for your thoughts!

  9. Hi Allison, thanks for stopping by and commenting! Your point is well taken -- I want my focus on work with the LGBTQ community to be very clear!


submit to reddit