Lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) people struggle with mental health issues at higher rates than their heterosexual peers.1 They face multiple stressors such as homophobia and discrimination, issues around coming out, communicating with family, and finding a peer group. Finding a therapist that is openly LGBTQ, LGBTQ friendly, or specializes in LGBTQ issues can help validate a clients experience and make them feel heard.
Why Finding a LGBTIA+ Therapist Is So Important
Mental health disorders are much more prevalent for LGBTQ+ individuals due to multiple factors including discrimination in society, social stigma, lack of support, and internalized homophobia. In a 2017 Harvard School of Public Health survey of 489 LGBTQ+ members across the US it was found that 57% of all LGBTQ+ people have experienced slurs, 57% of those surveyed had they themselves or had family members that were threatened or non-sexually harassed, and 51% have experienced violence because of their sexuality or gender identity.3 Alarming as these statistics may be, they show that LGBTQ+ people are more likely to face experiences and traumas that lead to a greater likelihood of developing a mental health disorder.
In terms of the prevalence of mental health issues research has shown that LGBTQ+ individuals are more likely to suffer from a mental health disorder compared to their heterosexual counterparts.3 LGBTQ+ individuals are at higher risk of suicide, especially for those members who identify as transgender. According to a 2015 UCLA Transgender survey, which is the largest survey of transgender people in the U.S, 81% of transgender adults reported thoughts of suicide and 48.3 % had tried to kill themselves in the past year. Also alarming was 40.3 % reported attempting suicide at some point in their lifetimes.3
A 2003 Cochran study looked at prevalence rates of specific mental health disorders in 2,917 heterosexual and gay and lesbian adults in the US, and found that the rates of depression and anxiety were at least two times greater or more for LGBTQ+ individuals.4
The study found that of 37 gay and bisexual men, compared to 1,239 heterosexual men, one-year prevalence rates were reported for the following disorders:
| Gay/Bisexual Men | Heterosexual Men | |
| Major Depression | 31% | 10.2% |
| Generalized Anxiety Disorder | 2.9% | 1.8% |
| Panic Disorder | 17.9% | 3.8% |
| Alcohol Dependency | 8.9% | 5.6% |
| Drug Dependency | 9.7% | 2.7% |
| Two or more disorders | 19.6% | 5.0% |
The 2003 Cochran study also looked at 37 lesbian and bisexual women compared to 1,604 heterosexual women for the same disorders:
| Lesbian/Bisexual Women | Heterosexual Women | |
| Major Depression | 33.5% | 16.8% |
| Generalized Anxiety Disorder | 14.7% | 3.8% |
| Panic Disorder | 17.1% | 8.6% |
| Alcohol Dependency | 11.8% | 3.4% |
| Drug Dependency | 6.5% | 1.5% |
| Two or more disorders | 23.5% | 7.7% |
Additionally, research has shown that people with minority identities may prefer a therapist who understands the LGBTQ+ experience, like what it’s like to come out as gay, lesbian or bisexual to family and loved ones.2 According to the American Psychological Association (APA) Practice Guidelines for Working with LGBTQ+ Clients, therapists must understand the social stigma, discrimination, and antigay victimization that can plague LGBTQ+ clients. Some guidelines state that psychologists must understand how stigma can affect LGBTQ+ clients, recognize one’s own biases as they relate to the therapeutic work, and recognize there may be difficulties outside of being a member of the LGBTQ+ community.2
Where to Find a List of LGBTQIA+ Therapists
LGBTQ+-friendly therapists can be found using online directories and specific apps as well as through traditional referral sources, like trusted family members, friends, or primary care physicians. Additionally, many national, state- and city-wide non-profit agencies that serve the LGBTQ+ community have therapist referral networks. A college or university’s student health center or LGBTQ+ student association can also be a great place for students to find a list of therapists. In most cases, accessing these directories is free.
National Queer and Trans Therapists of Color Network
The National Queer and Trans Therapists of Color Network is s network of Queer and Transgender identified therapists of color transforming mental health for Queer and Transgender People of Color (QTPoC). They have a directory where you can search on a Google Map, or search by featured therapists in a certain area. Most therapists are primarily in larger gay friendly cities on the East and West Coast, and splattered through the Midwest and South. When you click on a potential therapist you will be able to view their contact information, fees, practice website, specialties, etc.
PrideCounseling
PrideCounseling is an online therapy platform that’s operated by BetterHelp. It connects you with licensed therapists (Licensed Professional Counselors, Marriage and Family Therapists, Social Workers, and Psychologists) in your state and can connect international clients with US licensed therapists. Therapists on PrideCounseling specialize in working with the LGBTQ+ community. Therapy sessions are done online and are completely confidential and HIPPA compliant.
You provide your information regarding what kind of therapist you are looking for and they connect you with someone that meets your needs. Sessions are provided via video chat, phone, or live chat (like a chatroom). You can also message your therapist during the week when needing support. Pride Counseling costs $50 – $80 per week and is billed monthly. No insurance is accepted.
Get 20% Off Your First Month With Pride Counseling
Your City’s LGBTQ+ Center
LGBTcenters.org is a comprehensive list of LGBTQ+ centers in the US. This helps you easily locate the nearest center near you. Many LGBTQ+ centers have licensed therapists that you can see or know of resources in your area.
Lighthouse
Lighthouse connects you with LGBTQ+ friendly healthcare and wellness providers in your area. These can be therapists, psychologists, psychiatrists, doctors, dentists, etc. When clicking on a potential therapist profile, the therapist will provide their identifier (Gay Cis Man), address and contact info, specialties, experiences, fees, if they accept insurance, and a short bio about them.
Other Places to Find a List of LGBTQ+ Therapists
While online therapist directories and non-profit organizations are a great place to find LGBTQ+ therapists, they aren’t the only options. Those employed by medium to large size companies should look into the options provided in their Employee Assistance Program (EAP). Students currently enrolled in college or university should check in with their campus health department or their student center. Another good option is to request a referral from your primary care physician or another trusted medical provider. And it’s worth considering tapping into your network of friends, colleagues, and family members if you have reason to believe they’ve dealt with a similar search before.
Weighing Your Options for LGBTQ+-Friendly Therapists
Now that you have decided to take that leap to find a LGBTQ+-friendly therapist, it’s time to consider logistics. If you have insurance it may be cost effective to find a therapist that accepts that insurance, if possible. It’s also important to look at the license and education of the therapist to make sure you believe they have the qualifications to meet your needs as a client. In addition, you need to see if the therapist can accommodate your schedule.
Lastly, reading their website can give you an idea of what kind of personality they have and if you think you would vibe well with them. Research has shown that the most important indicator that a client will improve is the therapeutic relationship. Regardless of the therapeutic style, when there is a strong alliance between a client and therapist the client will be much more likely to see a reduction in mental health symptoms. This makes the importance of finding a therapist that you relate to the best factor for treatment.9 Reading their biography, specialties, and education with a critical eye will be beneficial when making the decision to move forward.
Licensing, Certification, and Education
Finding an LGBTQ+ friendly therapist is the first step in making sure you have a great match. The next thing to look at is the therapist’s license and education. Depending on the severity of your needs you may want someone with more education, training, or specialization in addition to being LGBTQ+-friendly.
- Licensed Professional Counselors (LPC), also known as licensed clinical professional counselors (LCPC) or licensed mental health counselors (LMHC). These therapists work with family, individuals, couples, and group therapy. They complete around two years of education to obtain a Masters in Mental Health Counseling and complete 3,000 hours of supervised clinical experience under a licensed counselor. Lastly, they must pass the National Counselor Examination (NCE).5
- Social Workers receive a Master of Social Work (MSW) after completing around two years of coursework. Similar to LPCs they do an internship in different clinical settings while taking classes. After receiving an MSW they must have two years of full-time clinical social work experience (a minimum of 1,920 supervised hours of face-to-face client contact). Lastly, candidates must pass the Association of Social Work Boards (ASWB).6
- Psychologists primarily receive a Ph.D. (Doctorate of Philosophy) or Psy.D. (Doctorate of Psychology) in Clinical or Counseling Psychology. The doctorate degrees take an average of 4-7 years to complete. A PsyD is focused more on working in the clinical field with clients, while a PhD devotes more time to research. Most states require one year of supervised experience (under a licensed psychologist) before graduation and an additional year of postdoctoral experience (under a licensed psychologist). Lastly, psychologists must pass the Examination for Professional Practice in Psychology (EPPP).7
There is much debate about which mental health professional is “better.” Every professional goes through rigorous hours of training to hone their craft. Social Workers have been known to be more social justice and advocacy focused and the degree opens possibilities for administrative and nonprofit work, in addition to being a therapist. On the other hand, Psychologists many times have more research experience and may have greater specializations. Licensed Professional Counselors are primarily specialized in therapy (compared to the other two specialties discussed).
Costs and Insurance
The cost per therapy session will vary depending on the education, experience level, and specialty area of the therapist. Certain geographic areas can also impact the cost of therapy. For example, in New York City therapists may charge anywhere between $65-$350 per session and the average in most cities is between $100-$200.8
If a therapist you are interested in accepts your insurance then your out-of-pocket costs will be significantly lower. Your insurance will cover most of the session and you will; be responsible for just the copay, usually between $10-$40 a session depending on your insurance benefits. If your insurance has “out of network” benefits, then you would pay the full fee of the therapy session and your insurance would reimburse a percentage of that fee after. It is important to call your insurance ahead of time to see how much they cover for in network and out of network therapy.13
If you don’t have insurance or your preferred therapist isn’t in network, you may be able to find more affordable rates by looking for therapists that offer a sliding scale fee where your session fee amount is based on your income. If you see an intern or trainee (a future therapist completing their coursework and working under supervision of a licensed therapist) the costs will be much lower. Another option is to seek therapy through a community mental health center which often offers reduced costs.
If you have a particular issue you would like to work on that may require a more experienced and trained therapist, then you will most likely need to pay more. As you can see, finding a therapist who is LGBTQ+ friendly is just one part of the puzzle. Finding someone who takes your insurance, has training in your particular difficulty, and who is available and affordable is just as vital.
Scheduling
It’s important to find a therapist that has open availability during your preferred time. Oftentimes the clinician’s general hours of operation are listed on their website, but you will typically not know their current availability. To get that information, you’ll need to give them a call or inquire via email.
When making your first phone call or email inquiry to the potential therapist to discuss briefly what you are struggling with, your goal of finding an LGBTQ+ friendly therapist and your time and date availability.
Example Email Enquiry to a Therapist
“Hi my name is _________ , I am looking for a therapist to help with issues of sadness and who has experience with LGBTQ+ populations. I am available for therapy _____________(Days of Week) between _____________ (Time of Day). The best phone number to reach me at is _____________ and the best email address to reach me at is _____________.”
This gives the therapist a good idea of what you are looking for and your availability from the start so they can see if their schedule can accommodate you.
The importance of choosing a session during a time that you have the least commitments is key. When choosing a therapist to work with you never want to bend your schedule to the therapist’s availability. This will create problems in the future if you have to continue juggling commitments and can’t give proper time to your treatment. A good rule of thumb when scheduling a session is make sure you have plenty of time to get to your appointment and make sure you have some time to reflect afterwards. The less likely you are to miss a session the better your treatment will be. If you continually need to cancel then this will affect your outcomes. Your time is valuable and you must treat it as such.
Finding the RIGHT Therapist
Finding a good therapist can be like finding a good partner. You might go on a lot of first “dates” to see which one you vibe with the most, and which person you connect with. This is your opportunity to see if the therapist has the right skills, personality, and therapeutic style that you will find helpful. Everyone is unique and not all therapists will be your cup of tea, and that’s ok!
When you are able to schedule an in person or phone consultation you can use a more critical lens to see if you think this therapist is a good fit. You may prefer an active therapist who challenges you or a therapist who listens and reflects.
A good rule of thumb is to arrange meetings with multiple therapists. Usually the first phone call and consultation are free. When meeting for the first time don’t be afraid to ask more about their experiences working with the LGBTQ+ population. Whether they self-disclose or identify as an ally, you should get a good feel what their experience has been, if they have taken any specialized training or certifications in working with the LGBTQ+ community, and their approach to working with this community. If they have the right life experience it will be evident in their mindset and approach to counseling LGBTQ+ individuals.
Questions to Ask Potential LGBTQ+-Friendly Therapists
Don’t be afraid to ask the hard questions because this will be someone you may be working with over time and you want to gather as much pertinent information as you can.
Here are ten questions that can might elicit useful insights into your potential patient-therapist fit:
- What experience do you have with the LGBTQ+ community?
- Do you have any specific training or certifications that correspond to working with LGBTQ+ clients?
- What is your therapeutic orientation and how does this inform your practice?
- What are your specialities?
- Do you feel confident in working with me?
- What is your availability and do you provide evenings or weekend appointments?
- What is your cancellation policy if I cannot make a session?
- How long do you think therapy will take?
- Do you allow client feedback throughout therapy, and what does that look like?
- How will we know when therapy is finished?
Finding a Great LGBTQIA+ Therapist Is Worth It
Although the process of finding the right therapist can seem daunting, it ultimately will benefit you in the long run. Taking the time to find a therapist that understands what you are going through and can help you with your most pressing mental health concerns will ensure long term success. Think of this as investing in your future, because you deserve it.
We all deserve help, especially during this hard time. As a gay identified therapist who also sees a gay therapist, I can tell you that finding him was the best thing that could have ever happened to me. I have someone who understands my feelings towards my sexuality, understands my struggles as a gay person, and can help me feel whole again.
For Further Reading
Infographics About Finding an LGBTQ+ Therapist
