Choosing an LGBTQ Affirming Therapist


Article printed in Mental Health News, a publication provided for the Providence RI GLBT Health Fair by Wilder Therapy and Wellness.To view the publication, click here.

When Meg’s* six-year relationship ended, she was devastated not only about the loss of her connection to her former wife, Jill. She was also grieving the loss of their child, two-year-old Braden*. Jill*, who is the biological mother of Braden, took their child to a state that not only did not recognize the relationship as a marriage; it also did not recognize Meg as Braden’s mother.

To find some support while grieving, Meg decided to find a therapist. She connected with someone whom she thought would be understanding of her many losses. As Meg explained her heartache related to losing contact with Braden, the therapist told Meg that she would recover faster than if “he had been [her] real child” and explained that the grief would not be as bad since Meg “hadn’t given birth to him.” Meg, like many gay, lesbian, bisexual, queer, and transgender individuals, was crushed by the lack of understanding of her experience by the therapist.

“Unfortunately, for many of us in the LGBTQ community, it can be difficult to find a therapist who not only understands our lives, but also can validate our experiences,” said Jami Wilder, Psy.D., Co-Owner of Wilder Therapy and Wellness in Cranston. “It is so vital to our health to find mental health providers who understand the complexity of living as a person in an oppressive culture. By the time most people reach out for help, they are in a lot of distress. The last thing they need is to be oppressed and invalidated by the person who is supposed to be providing care.

“Finding an affirming mental health care provider can be a process that is challenging to navigate. This is particularly true because when most people are looking for therapists, their emotional and mental resources are tied up in just surviving the distress.”

Wilder said that although it can be challenging, there are some helpful factors to consider in evaluating whether a therapist practices in a way that is affirming to LGBTQ people. Key factors to consider include the therapist’s marketing materials and professional affiliations, training and background in LGBTQ issues, and the environment created by the therapist.

 How the Therapist Reaches Out

How a therapist reaches out to the world is a good indication of what is important to them. Marketing materials, like advertisements, websites and presence at LGBTQ events, can give some indication of how that therapist feels about the community. Affirming clinicians will have marketing material and resources for our community.

In evaluating a therapist, consider:

  • If they have resources for LGBTQ people on the practice website.
  • If images used throughout the site are reflective of our community and if language used is inclusive.
  • If the therapist advertises in LGBTQ publications.
  • If the therapist is listed with organizations like the Gay and Lesbian Medical Association (

 Commitment to Training and Knowledge

Many educational programs for therapists lack adequate training for providing care to LGBTQ people. Often, clinicians who are committed to affirming care will seek additional training beyond what is provided in formal education. This is particularly important for transgender concerns, about which little training is provided in typical educational programs.

In evaluating a therapist:

  • Ask about formal and additional training that the therapist has participated in related to LGBTQ concerns.
  • Ask about the therapist’s experience in working with distress similar to yours AND in working with LGBTQ people
  • Ask if the therapist is familiar with the best practice guidelines for the profession. For example, psychologists should be familiar with the American Psychological Association’s Practice Guidelines for LGB Clients. At press time, APA is still developing practice guidelines related to transgender and gender non-conforming clients.
  • For transgender clients, ask if the therapist is familiar with WPATH’s Standards of Care and ask how the clinician understands the therapist’s role in the transition process.

 Welcoming Environment

The environment in which the clinician works can be an indicator of how affirming that person will be to LGBTQ people. Consider the surroundings in waiting rooms and offices, interactions with staff and the therapist, and office forms and other paperwork.

In evaluating a therapist, look and listen for:

  • Language used on forms and paperwork. It should be inclusive and offer many ways for individuals to identify their relationships, family structures, sexual orientation, gender identification, and preferred pronoun use.
  • Inclusion of LGBTQ magazines in waiting rooms and other symbols of inclusion like materials supporting LGBTQ organization.
  • Referral information available for other LGBTQ affirming health providers like medical doctors and chiropractors.
  • Inclusive language used by staff and by the therapist.
  • Willingness of the therapist to acknowledge when there is something unfamiliar and, if a mistake is made, willingness to learn from it to provide you with better care.

“What we know is that people who have the best outcomes in therapy are the ones who were able to find a therapist that they trust and could build a relationship with,” Wilder said.

“The best indicator of affirmative care is how you feel when working with the therapist. If the person you are meeting with makes you feel respected and cared for, you will know that therapist is the right one for you.”

*Not actual names


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