Photo by bahareh moradian on Unsplash
You've been in a session for ten minutes and you're already explaining yourself. Not the thing you came to talk about. Yourself. Your identity. Your life. The therapist asked about your partner and you watched their face when you said "he." They recovered quickly, but you noticed. You always notice.
Maybe it was the therapist who kept circling back to your sexuality when you'd come to talk about your career. Maybe it was the one who was fine with your identity in principle but stumbled over pronouns in practice. Maybe it was subtler - a hesitation, a slight over-politeness, a sense that they were performing acceptance rather than simply accepting.
You stopped going. Not because you don't need therapy, but because the cost of being misunderstood in the one place that's meant to feel safe felt worse than managing on your own.
Being LGBTQ in a world that was built for straight, cisgender people comes with a tax. Not a single payment but a continuous one, a background process of monitoring, translating, calculating.
Is this person safe? Can I mention my partner without the pronoun becoming a conversation? Will they treat me differently if they know? Am I being paranoid, or was that comment actually what I think it was?
This runs constantly. At work, with family, with new acquaintances, with healthcare providers. It's so habitual most people stop noticing they're doing it. But it takes energy - real, measurable energy - that straight, cisgender people don't have to spend.
The therapy room is meant to be the one place this tax doesn't apply. And yet for many LGBTQ people, it's exactly where they pay it most.
LGBTQ-affirming therapy has become a marketing term. It's on profiles, in directories, on rainbow-badged practice websites. But what does it actually mean in the room?
It doesn't mean the therapist is excited about your identity. It doesn't mean they'll praise your coming-out story or celebrate Pride Month with you. It doesn't mean they're queer themselves, though they might be.
It means you can walk in and start talking about your life without having to lay groundwork. Your identity is not the presenting problem, the subtext, or the elephant in the room. It's just part of who you are, as unremarkable as being left-handed, and the therapist doesn't need you to educate them about it.
It means when you talk about your relationship, they don't pathologise the structure. When you mention dysphoria, they don't treat it as confusion. When you're angry about discrimination, they don't suggest you're being too sensitive. When you mention family rejection, they understand that this isn't a misunderstanding to be resolved but a wound to be felt.
It means you can be a mess about your relationship, your self-esteem, your childhood, your anxiety - all the things anyone might bring to therapy, without your identity being treated as either the cause or the solution.
This is the paradox. Most LGBTQ people don't come to therapy to talk about being LGBTQ. They come because they're depressed, or anxious, or their relationship is falling apart, or they can't stop drinking, or they feel empty despite having everything they thought they wanted.
And sometimes being LGBTQ is deeply relevant to those things. The depression might be entangled with years of concealment. The anxiety might be the residue of growing up in an environment where who you were felt dangerous. The relationship problems might carry the weight of internalised messages about what love looks like.
But there's a difference between a therapist who lets that relevance emerge and one who imposes it. Five sessions in, they keep circling back to "have you thought about how this might relate to your sexuality?" when you've come to talk about your mother. Or the opposite - a therapist so careful not to do that that they ignore identity entirely, even when it's clearly in the room.
What you're looking for is someone who can hold all of it. Who doesn't need you to be any particular kind of LGBTQ person. Who trusts you to know what matters.
There's a layer to all this that's harder to talk about, because it implicates you rather than the world around you.
Internalised homophobia. Internalised transphobia. The messages you absorbed before you had the ability to filter them: from family, from school, from culture, from religion. The part of you that still, somewhere beneath the politics and the pride and the self-acceptance, wonders if there's something wrong with you.
This isn't a failure of self-acceptance. It's what happens when you grow up swimming in a culture that tells you, in a thousand subtle ways, that you're a deviation from the norm. You can reject those messages intellectually and still carry them in your body. Still feel shame you can't account for. Still flinch internally at the thing you've publicly claimed.
This is some of the most important work therapy can do. Not changing what you think about yourself. You've probably already done that. But reaching the older, deeper layer where the shame lives. The layer that formed before you had words, before you had a community, before you had any framework for understanding who you were.
That layer doesn't respond to argument. It responds to relationship, to being fully known by someone who doesn't flinch.
You don't need a therapist who shares your identity, though you might prefer one. You need someone who doesn't make your identity their learning opportunity. Who has done their own work around gender, sexuality, and difference. Who can sit with you in the complexity without simplifying it.
The right therapist won't treat your queerness as a problem. They also won't treat it as inherently interesting. They'll treat it as yours - one part of a whole person who deserves to be seen clearly.
You've spent enough of your life explaining yourself. Therapy is meant to be the one place you don't have to.
