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What is LGBTQIA+ Affirming Therapy? | A Guide for LGBTQIA+ Clients

What does “LGBTQIA+ affirming” actually mean?

For members of the 2SLGBTQIA+ (Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual, and other associated identities) community, finding a therapist who feels safe and accepting can be difficult. LGBTQIA+ clients are looking for more than a therapist who simply states “I accept LGBTQ people.”

At its core, LGBTQIA+ Affirming Therapy:

  • Recognizes and respects 2SLGBTQIA+ identities

  • Does not treat someone's sexual orientation, gender identity, or gender expression as a problem to be fixed

  • Understands how stigma, discrimination, family rejection, and minority stress can impact mental health

  • Is intersectional--meaning that affirming therapists understand and acknowledge how clients’ (and their own!) social and political identities create different experiences of privilege and discrimination.

I would like to emphasize that clients do not need to be struggling specifically because they are LGBTQIA+ to benefit from affirming therapies. Being 2SLGBTQIA+ is NOT the problem. The stress of navigating a world that isn’t always accepting can be.

What does an LGBTQIA+ affirming therapist do?

An affirming therapist will:

  • Use your chosen name and pronouns.

  • Avoid making assumptions about your gender, sexuality, relationships, or family.

  • Ask open-ended questions rather than assuming heterosexuality or cisgender identity.

  • Respect different ways of expressing gender and sexuality.

  • Understand that identities can be fluid or change over time.

  • Support you in exploring your identity without pushing you toward a particular label.

  • Recognize the impact of discrimination, microaggressions, conversion practices, family rejection, and other forms of stigma.

  • Help you navigate coming out, relationships, family dynamics, or gender transition if those are things you want to explore.

Why does LGBTQIA+ affirming therapy matter?

Minority stress--the stress that impacts people of marginalized identities--affects many members of the LGBTQIA+ community. According to The Trevor Project’s 2025 US Survey, 90% of LGBTQ+ youth respondents reported stress or anxiety in response to “recent anti-LGBTQ+ laws, policies, and debates” (2025).

LGBTQIA+ identities are NOT mental illnesses. However, LGBTQIA+ are more likely to experience:

  • Discrimination and harassment

  • Anticipated discrimination

  • Family rejection

  • Religious or cultural stigma

  • Internalized stigma

Again, these stressors are not a result of being LGBTQIA+. Instead, societal prejudices contribute to the above experiences, which increases mental health disparities.  

How can you tell whether a therapist is actually LGBTQIA+ affirming?

What you can look for on their website or in their paperwork:

  • Specific language on the therapist's website rather than just a rainbow symbol.

  • Do they mention particular LGBTQIA+ populations (trans, nonbinary, bisexual, etc.)

  • Does their intake paperwork uses inclusive language?

  • Do they have relevant training or experience?

Questions you can ask during a consultation:

  • “What does LGBTQIA+ affirming therapy mean to you?”

  • “What experience do you have working with LGBTQIA+ clients?”

  • “How do you work with clients who are questioning their gender or sexuality?”

  • “How do you approach pronouns and chosen names?”

  • “How do you incorporate intersectionality into your work?”

You deserve a therapist who sees your identity as a part of you--not a problem to solve. Therapy is a place where you can explore what it looks like to be your authentic self.

Looking for LGBTQIA+ Affirming Therapy in Washington?

I offer telehealth counseling and art therapy for LGBTQIA+ adults throughout Washington State. My approach makes space for the ways identity, relationships, neurodivergence, and broader social experiences can intersect—without assuming that your identity is the problem or something that needs to be explained.

Learn more about LGBTQIA+ Affirming Therapy, explore Art Therapy, or contact me to schedule a free consultation.

About Beryl Olson
Beryl Olson, MS, LMHCA, ATR-P, is an art therapist and mental health counselor based in Olympia, Washington. She provides LGBTQIA+ and neurodivergent-affirming therapy via telehealth throughout Washington State.

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